"Difficult" Patients - page 2

by Vespertinas 9,867 Views | 32 Comments

I love getting report when the RN tells me about how unmanageable a particular patient is because then I make sure that they're not going to ruin my day and it feels like an accomplishment when I've won those patients over. VERY... Read More


  1. 5
    Sometimes, a change in nurse is all it takes. I find most of the time when I was expected to receive a "difficult" patient, they turned out to be fine. Could be either the nurse or the pt that was having a bad day... Nonetheless, I agree with above posters that going in with a friendly attitude makes all the difference and works most of the time.
    Nurse_, WeepingAngel, canoehead, and 2 others like this.
  2. 2
    CodeTeamB: Do you have a "sane" nurse manager?! Cause, if we try the "scary nurse pants" thing on our floor and a patient or family member expresses the least little thing about it, we're reprimanded...leaving me to wonder, just how much abuse is a nurse expected to take---from pts, family members and my nurse manager?! I'm about at my ultimate limit sadly.
    kylee_adns and StNeotser like this.
  3. 4
    I've always tried to invest time in the 'difficult' patient at the beginning of the shift, before I see anyone else. A lot of times, that 10-15 minutes of talking and goal-setting establishes the tone for the entire day, assures the patient that his/her needs will be met, and usually halts the leaning-on-the-call-light process.
    NRSKarenRN, Vespertinas, canoehead, and 1 other like this.
  4. 2
    I agree that it may be just a change of nurse that's needed. I think about people in my own experience that rub me the wrong way for no apparent reason, and it's possible that is what happened with the nurse giving me report.

    Killing them with kindness is a good strategy, but I find that most adults can see through that, so I do it in a way that makes it less obvious. More than anything I keep them updated, because most patients just want their doctor to come round on them.
    Vespertinas and bebbercorn like this.
  5. 1
    I agree, I always give a little more TLC to those that have given the prior shift a hard time, most anything to get me through my shift w/out incident and to make them happy. But there are those that are just miserable people and are determined to make it miserable for everybody else. Then you just do the very best you can to try to appease them.
    bebbercorn likes this.
  6. 1
    Some people are just difficult no matter what. However, I do try to find out "why" this is and see if I can't find a way to work with them. You can't get along with everyone every time, but often you just need to figure out what approach works best and stick to that.
    VivaLasViejas likes this.
  7. 0
    OP you are doing what we should ALL be doing as nurses. I do the same things you mention and don't have an issue. Sometimes, I had the opposite happen, where patient was being difficult for me and no one else ( even though my nursing care hasn't changed). Sometimes patients react to others differently. Sometimes there is transference of emotions from the patient to the nurse because the nurse reminds the patients of someone in their past.
  8. 5
    Quote from ABitterPill
    CodeTeamB: Do you have a "sane" nurse manager?! Cause, if we try the "scary nurse pants" thing on our floor and a patient or family member expresses the least little thing about it, we're reprimanded...leaving me to wonder, just how much abuse is a nurse expected to take---from pts, family members and my nurse manager?! I'm about at my ultimate limit sadly.
    Yup, my manager rocks... But I also think that the public health care system (I'm Canadian) leads to less entitlement from patients, at least based on the stories I read here. We don't go in for the "customer is always right" foolishness. Patients have come to the ER for our service and are expected to behave in a civil manner. To my knowledge a patient has never complained about me telling them to shape up.

    Also I am young and still quite naive in the ER world, while my scary nurse pants may be effective, they are nowhere close to as intimidating as some of the nurses I work with, and I haven't noticed them getting into trouble either.

    I feel for nurses who don't get this support. If I was expected to take abuse I'm pretty sure I would no longer love my job
  9. 1
    I'm also in Canada and have had my share of difficult patients. Over the last five years, my unit has had only one complaint come in, and nobody remembered the patient. The charting was pulled and the unfortunate nurse who had had them documented every complaint the patient made. They were in an outpatient unit and managed to complain 18 times in three hours. Everything from the temperature of the waiting area, how slow the doctor was, the chair wasn't comfortable. We also had four letters of appreciation for the same shift and two of those mentioned the unreasonable behaviour of the complainer and how patient the staff were with her and her family!

    My favourit manager called a doctor and had a really difficult patient sent home. He had verball abused one nurse so loudly the unit heard it all from his room. Homecare is rumoured to have visited twice and then told him to go to his GPs office for his daily dressing!
    Vespertinas likes this.
  10. 6
    In LTC the "kill them with kindness" mentality can sometimes be majorly counter productive. Making special accommodations is the last thing you want to do for residents with behavioral issues. These people live here, firmness and boundaries are the only way to deal with difficult patients in LTC. Regular staff works hard to establish a routine with mutual expectations. For a new/float nurse to come in and cater to demands shatters this hard won set of boundaries.

    When you tell Mrs Jones that no one will help her go to bed until the CNAs finish with the supper trays, or Mr Smith that he has to stop to get his pills before going to activities, you aren't being "mean", you're establishing rules that are absolutely necessary for any nursing home to survive.

    This is why some NH residents act like it's Christmas morning when a new/float nurse comes on duty. It's like when we were kids and we saw there was a sub teacher. We knew we could get up to all sorts of shenanigans the regular teacher would never stand for.
    kylee_adns, catlvr, metal_m0nk, and 3 others like this.


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