Dealing with an uncooperative patient

rabbitgirrl · Feb 10, 2009

I suspect that the biggest reason for uncooperative behavior in a lucid patient is anger resentment at the loss of control that poor health entails. Maybe the next cause is that many patients associate healthcare personelle with the illness itself. The last may be proximity: they are mad and you are handy. Rarely, it is because of lack of understanding.

My practice has been first assess for education needs, then to empathize (to dispel emotional obstacles) and then request cooperation. If they don't comply after one or maybe two requests, I simply allow them to do as they please. I have too little time and too many patients who actually want healthcare and are willing to be compliant.

Equinox_93 · Feb 10, 2009

It really all depends on WHY they are being uncooperative. Usually if you can explain WHY they need to do (insert whatever you are trying to get them to cooperate with here) I'd think most would go ahead and cooperate. Many adults balk at being told what to do with no explaination. As a patient, I've balked at doing things that I've considered unnecessary and annoying (to me) but if given a reasonable explaination- I go ahead and go along with it. However, in some cases, people just don't like doing something because it's just a routine procedure/policy (like people who refuse weight checks or whatnot...) Not a whole lot else to say without more info as to what the problem is... If you could describe it by changing the specifics, maybe people could give better ideas?

mcknis · Feb 10, 2009

If uncooperative...the word Taser brings a certain image to my mind All jokes aside though, I have personally experienced this as a pt, but it usually has to do with loss of control/sense. Try talking with them and empathize with them regardin the issue(s).

Valerie Salva, BSN, RN · Feb 10, 2009

It depends on why the pt is being uncooperative- some people are just jerks and will be jerks no matter how sick or how well they are.

In these cases, chart everything, ask the pt yes or no questions, be brief and business-like, spend as little time with the pt as possible.

jjensen · Feb 10, 2009

I so agree with everyone. Nobody really likes to be sick and in the hospital and they lose a sense of control, so they take it out on us and try to find any ray of control that they can... I just explain why they should be doing what I ask them to and then leave it up to them... I have learned that if I give options and let them chose, it helps...

RNperdiem, RN · Feb 10, 2009

A nurse needs a certain amount of command.

A polite "Mr. Jones, here are your meds" will give you more cooperation than a hesitant "Are you ready for your meds, Mr. Jones?" Unless Mr. Jones is especially difficult, the first approach works.

I used to work with confused elderly people a lot, and giving meds(and some people take lots of meds) requires cooperation.

Lotte242 · Feb 10, 2009

Thank you all for the great responses. I definitely think that knowing effective communication skills is very important to gain cooperation from patients. Being assertive is probably one of the most important skills to have when dealing with other people in any situation even outside of nursing. How do you all feel about actively involving your patients in their care? Giving them choices, etc. Also, does having an uncooperative patient increase the stress level you feel while at the work place?

classicdame, MSN, EdD · Feb 13, 2009

sometimes the simplest thing helps - ask "what do you suggest?" This should tell you how far off the patient is from the reality of the situation.