How do you deal with angry/upset with patients?

Jory, MSN, APRN, CNM · Nov 27, 2018

I have had a lot of de-escalation training and the biggest piece of advice I can give you...when they need to vent? Don't interrupt them. Let them talk, let them air it out. The first thing that you need to say when they are done is, "I very much apologize that you feel _____ about ________. Let's talk some more about your concern so I can do everything in my power to come to a resolution."

Interrupting them, starting any sentence with "I can't, our policy, I'm not, I won't"...those are what I call fuel words...they fuel any tense situation.

If you have a patient that is complaining about another nurse, just apologize "the situation happened like that" and say, "I am here now, what can I do to make you more comfortable during my shift". I never tell a patient they are right or wrong about another nurse b/c you are only hearing one side of it and it increases liability for the facility.

Now, you are going to have the grumpy patient sometimes that you are never, ever going to make happy. They want to complain just to complain. I stay silent when they talk because they are looking for a rise and a reaction. Stick to questions that have to do with the plan of care.

That's all you can do.

Sour Lemon · Nov 27, 2018

Hey guys! I was wondering what the best way to deal with angry/upset patients?
Or patients that just don't like you?

That depends 100% on what they're upset about and how they're expressing it.

AceOfHearts<3 · Nov 28, 2018

Sometimes the patient just wants and needs to be heard.

In morning hand off one day I was pretty much told good luck and that I was going to have a rough day with a particular patient. The patient was upset about something that should have been handled days before I had them and they had every right to be upset. I listened to them and told them I completely understood where they were coming from. I apologized that the issue hadn't been addressed properly and told them I would do what I could. I wasn't on my home unit, so later in the morning I introduced myself to the manager, told them the situation, and also said I thought she should personally speak with the patient.

The next time I rounded on the patient I couldn't believe the change. My grumpy patient was much happier, so respectful, and thanked me for having the manger stop by. The issue hadn't even been resolved at that point- just being truly listened to made all the difference. I'm also happy to say that the issue was resolved by the afternoon because the manager got the proper people working on it.

Sometimes things don't work out so nicely and that's ok too. The important thing to remember is to stay calm and unemotional. It's also perfectly alright to tell a patient "I'm here to help you and I don't deserve to be treated/spoken to like this".

offlabel · Nov 28, 2018

3 words. Validate...validate...validate. All they want is to be heard. They don't really care about the issue because at some level they realize they know nothing about the issue. Just say:

"You are so angry. I would be too. I don't blame you for wanting more for your loved one. This is terrible. I promise you that I will investigate how this happened and will get back to you with what I find out."

That's it. Tell the truth when you get back to them and that's the last you'll hear of it.

Works for messed up dinner trays to missed meds and worse...

JKL33 · Nov 28, 2018

Yes it totally depends on the expressed reason behind their displeasure.

If there is anything that remotely requires "service recovery," try to make it right the best you can.

If it is a misunderstanding, listen, listen more, educate as appropriate.

If it is something of a seemingly unreasonable nature, listen, listen some more, then try to arrive at a compromise.

If it is totally inappropriate and/or personal in nature, inform them calmly that it sounds like they have some concerns that should involve others, and so you are going to inform [our supervisor, my manager, etc].

Try to start with giving them the benefit of the doubt unless it's unsafe to do so.

KelRN215, BSN, RN · Nov 28, 2018

That depends 100% on what they're upset about and how they're expressing it.

Yes, this. Earlier this year I had a mother literally scream at me for 15 minutes because I woke her up for a scheduled visit (at 12pm and she has a disabled 8 year old) and was the 4th person to wake her up that day. She couldn't be de-escalated so I left and notified the child's social worker (the child was in state custody at the time but back living with her mother).

Hoosier_RN, MSN · Nov 29, 2018

acknowledge the concern. If you don't know what to do, let the complaintant know that you will involve someone who can help (manager, charge nurse, Dr, etc) and make sure that you do so. When you do pass it on, let them know who you passed it to, and if there was any indication of the expected time of contact (My manager, Sue, RN says that she will check in on you after lunch and discuss it with you then). NEVER make a promise toa resolution that cannot be kept. If you can resolve, do so in an appropriate amount of time. Let them know what your solution is and make sure that it is acceptable to them. It's also ok to acknowledge that we cannot please everyone, all of the time

WonderF · Nov 29, 2018

I have tried this time and time again and it works like a winner!

WonderF · Nov 29, 2018

I have tried what Jory said time and time again and it works like a winner!

Davey Do · Nov 29, 2018

Hey guys! I was wondering what the best way to deal with angry/upset patients?
Or patients that just don't like you?

On geriatric psych, I once contacted the NP and began the conversation with, "I"m having problems with two different patients..."

Before I could start relaying a medical report, the NP said, "Just unlock the door and they'll eventually leave".

anewsns · Nov 29, 2018

What everyone else said: and also, if there is a big ongoing issue, patient visitor relations is a good resource.