Dealing with difficult people

SteffersRN87, BSN, RN · Oct 8, 2009

If you worked at McDonald's, chances are you would experience the same thing! I just kill them with kindness and think to myself, "you are a flipping idiot/nutjob"!

Batman24 · Oct 8, 2009

It sounds like you handled the situation appropriately and the doc backed up the info you gave to the patient. My guess is he knows the patient is difficult and is letting them get it off their chest, but realizes the patient is annoyed at the policy not you.

If you realize your true feelings show in your face or speech it is always best to take a deep breath and count to ten. Put them on hold for a sec and collect yourself before responding. I have also found that making them see that you understand why they are upset often helps as well. Patients often just want to be heard. "I'm sorry you weren't pleased with Doc Xs referral. We ask that you speak to your insurance company for another referral is this is the only specialist the doc suggests in this area. We all want you to be happy and I'm sure you insurance company can suggest a few they use in this area to ensure that happens." You were polite and factual. If they don't like it not much you can do beyond that.

tatara · Oct 8, 2009

Talk less. Let her vent her frustrations and anger. Look at her in the eyes and don't show any reaction. Now, as she paused to gasp for air, speak audibly about the policy that has to be followed. Be calm yet firm and consistent. Be cool, that's grace under pressure. Don't retaliate. Don't stoop down to her level. She will get tired and eventually leave.

flightnurse2b, LPN · Oct 8, 2009

Hi there, I'm really hoping to get some advice from you wiser, more-experienced people out there. I have recently been accepted into a nursing program and I will be (god-willing) starting in January. Lately however, it has come to my attention that my people skills kind of suck. To give you a bit of background..... I currently work as an MA in an internal medicine office. 95% of our patients are wonderfull. They are considerate, caring and understanding. We have our group of "regulars" who love the staff to death (all 2 of us lol) and bring us snacks and lunch and thank us on a regular basis. Then we have a few "other" patients who are demanding and want things done "their way".
Lately I've butted heads with a couple of these people and they have become very upset. Afterwards I've been really upset with the way I've handled these situations. For instance one patient recently called stating she was unhappy with the ENT she was referred to and she wanted the name/number of another doc in a local big city. As protocol in our office, if a Pt is unhappy with someone they have been referred to, I have been instructed to advise them to call their insurance for a further referral. This is what I advised this Pt to do. She was not happy with this explanation and stated that "we have to" know another doctor in this city she wanted to go to. I attempted to politely explain to her that I really didn't know another doc in the location she wanted to and I doubted the doc did either. The Pt became irrate and told me this was unacceptable and I better go talk to the doc immediately because she did not believe this. I did go speak with the doc who said the exact same thing I had already told the Pt, that she needed to call her insurance.
At this point the Pt began screaming at me and telling me she did not believe this and she wanted to speak to the doc. As a rule of thumb the doc does not get on the phone and discuss these kinds of issues with Pts...but of course there are the few that he "bends" the rules for. He did get on the phone with this Pt and told her the same thing over the phone. Now she is completely ticked and feels that I was rude and she is coming in tomorrow to meet with the doc. I know that I did what is the general office policy when handling this situation but looking back at it now I see how possibly could have been more accomodating to this person. I feel like at times when people start getting upset I become defensive and get upset myself. This leads to an all-around bad situation.
What do you do when dealing with people like this? For the record this particular person is often rude to the staff but of course is completely plesant when dealing with the doc so of course he is going to believe her when she says I was rude. I am beginning to wonder if I am cut out for nursing because I know I will probably end up encountering people like this on a regular basis!! What should I do to better handle these type of situations??!!!

your people skills don't suck, jadedgreeneyes. of course she wasn't rude to the doctor! they never are :)

people in general, when they don't feel good, can get nasty... and the first person they get nasty with is usually the first person they get a hold of.... you. if this person who doesn't feel good is a generally nasty person, it amplifies the nastiness. people get sick, they get scared, they get rude.

unfortunately part of nursing is learning to deal with people like this and not let it eat you up. know that you did your job to the best of your abilities and that you could have done nothing else to appease her, and move on from there--there are other patients who will need you! i am not one to put up with a patient/family/doc being very rude to me but there are ways i've learned to say things where i am not out and out putting my foot down per say, but letting them know that i am not at work to be abused. i remember my interview for nursing school where i was asked to describe my most difficult encounter with a person i sincerely disliked.... they then asked me, "would you be able to care for this person and be able to set aside your personal feelings if they needed you? would you be able to clean them if they soiled themselves? or medicate them if they were in pain?" and the answer has to be yes. silence truly goes a long way.

i will tell you right now that what you have experienced with this patient who was upset may be mild from what you experience as a nurse in a hospital setting, should you choose to work in such an area. you will be dealing with not only patients, but their families and doctors... and not over referrals, but possibly life and death situations. since health care is such a big business, customer service and the "customer is always right" mentality are unfortunately the priority of alot of administrators leaving the nurse to bear the brunt of complaints.

in any matter, i hope i have not scared you away from nursing--we complain on here because this is our safe place, where we know other nurses will understand our frustrations... but there are moments where you can't imagine doing anything else, because being a nurse is such a wonderful and one of a kind profession--i've seen

first breaths and last breaths, i've seen miracles, i've assisted in life saving procedures, i've been there to pick up the peices for someone who has no one else, ive been there to soothe broken hearts and to celebrate good news.... the rewarding aspect of it, for me, truly outweighs biting my tounge for those patients who want to try and bring you down.

best of luck in nursing school.

you'll be just fine. :yeah:

eriksoln, BSN, RN · Oct 8, 2009

Feet talk. When someone is acting like this, I don't stand on the firing line. Tell them you will attend to it as soon as time allows and leave. I'm not saying ignore them or just give them a cold shoulder, but don't stand in front of a pt. whose only agenda is to escalate a situation and wait for it to happen.

Ratios are getting harder and harder, less and less support staff, supplies harder and harder to find. My time is valuable, and I don't spend it humoring verbal jabs and unralistic/attention seeking requests.

meluhn · Oct 8, 2009

I just kill them with kindness and think to myself, "you are a flipping idiot/nutjob"!

Exactly, just relax and nice them to death. This is much easier to do over the phone than it is in person. Just dont allow yourself to become emotionally involved.:argue:

It does a couple of things. First, it difuses the person's anger/frustration/whatever and it puts you in control. For a split second you can almost believe that they are not total morons and feel empathy for them.

jadedgreeneyes · Oct 8, 2009

Thanks so much guys!! I think I just need to talk less and listen more. I try to hard to reason with these difficult people and I think that just makes them angrier. Probably because they know I'm right LOL!!! It doesn't help that the doc has these "special" people that he bends the rules for! How am I supposed to know which ones don't have to pay their copays and which ones he will talk to on the phone when he has a waiting room full of Pts!!??? :no:

PostOpPrincess, BSN, RN · Oct 8, 2009

1. Don't escalate a situation.

2. If they are getting angry, just say, validate them, and just repeat the same mantra (nicely of course) of what you can do.

3. Some one already said to kill them with kindness. This always works.

4. If you don't have anything nice to say or if you are trying to "one up" them by trying to change THEM, DON'T...just smile...and keep your mouth SHUT.

tewdles, RN · Oct 8, 2009

Don't beat yourself up over this...sounds like you followed procedure and were professional in your comments to her. As human beings we learn as we age...if you are interested in building superior "people skills" then you will, over time. the important thing to remember about demanding patients and families in healthcare is that it is often about one of two things...their sense of "loss of control" in a changing situation, or their micromangement issues in general. Either way, it is largely out of your control. I find that my biggest tool is to listen. Let them blow off steam, try to "hear" what the underlying issue is, ALWAYS respond in a kind and polite fashion, and validate their feelings/concerns. None of those things insures that they will get exactly what they want, exactly when they want it; but it usually helps them to understand that YOU are not the enemy. On the other side of the coin...you are not a punching bag for abusive people...so if patient/family comments become personal, end the conversation as quickly and politely as you can, document the crap out of it, and make sure that your supervisor knows about it...you want your butt covered when/if that patient tries to get you in trouble over their issues. Trust me, there are mean and abusive people in all walks of life...when you deal with the public in healthcare you get to meet a good many of them!