I think staff splitting only occurs when we nurses let it. If you know a patient is difficult and manipulative, ( and it's pretty obvious early on in their game) letting them feel they've won, often puts out their fire.
Arguing,confronting, correcting them, presenting your side of the story, what ever way you look at it, is telling them the delusion is not real, even nicely. You run the risk of shattering their delusion and then you become the object of their rathe. If the patient wants to believe someone is going to be fired immediately- let them. If my 29 yr old wanted to believe he is a doctor- let him. I am not going to argue and create a bigger mess, one in which I would get into trouble. There were no appointments, and the more I told him that the madder he was going to get because he wasn't getting his way. He wanted the Red Sea parted for him. He didn't want to wait his turn- something kids learn in kindergarten. He wanted to be able to come in, and have every other patient who did make an appointment sit and wait their turn, while he was made King for a Day. If a patient wants to BELIEVE another staff member was rude, ignorant and stupid, I'm not going to waste my precious limited time arguing, "That staff member has been here for years, she most certainly knows her job, you, lady patient, are wrong." That the patient would remember- an argument with a nurse. Her complaint was said to me and died with me. I like to think of it as - redirecting them- by the time her appointment was over- she forgot all about her complaining. She got the one-to-one attention she wanted. All is good, no worries and it is, what it is. On with the shift, Next!!