How do you deal with difficult patients?

Sun0408, ASN, RN · Oct 9, 2015

Difficult pts are rotated between staff. That has been one of the best things I've noticed. It depends on the person how I respond. I'm pretty straight forward and not very sugary with my pts so that seems to work with me. I'm also honest and upfront with all of them so they know what to expect. Education also helps. If they are NPO, I tell them and why. If they just had surgery, I tell them straight up they will be in pain. The first day or so is the worst and it will get better. I also tell them pain management is my goal also but pink and breathing is the upmost importer thing to me. Hope this helps you some

Natasha, RN, BSN · Oct 9, 2015

You ask a very good question, because it does pose quite a challenge to care for the difficult patient. For me, I always do and say everything with a smile and use a sympathetic tone (whether a difficult pt or not). This way, the pt cannot add to their list of complaints (as difficult pts typically always have this) that I was not kind or friendly. Sometimes, there is just no pleasing people, and all you can do is hope your shift goes quickly. I also forewarn the next nurse so they are not blindsided. But using a warm and friendly voice is sometimes all it takes for that pt to realize you are there for them, willing to listen, ready to care, and doing all you can to help them. Difficult pts can act out due to being scared, feeling alone, and tired of being in pain. My willingness to give them that extra bit of time and attention (which we know is hard when balancing multiple pts!!!) can make a big difference, in my humble opinion :)

vintagemother, BSN, CNA, LVN, RN · Oct 9, 2015

I try not to view my pts as difficult, because once I do this, it affects my interactions. Like one professor told me, "it's not personal, it's professional."

I try to take the view that they're being difficult because of their illnesss. Whether they're being difficult because they're stressed about their medical condition, or they have a psych issue.

I take the view that if they're acting out, it's a reflection of them, not me. I think pt education goes a long way, as does compassion.

Also, I try to keep a professional distance. It can be challenging, but it's best not to personalize interactions.

Larry3373 · Oct 9, 2015

In my experience, patients that are problematic to other nurses are not difficult for me. I always try to treat them respectfully, and as I would want to be treated. When they have prn meds like pain medication, I give it. Some nurses hold medications because they do not feel the patient is truly in pain or they don't want to give too much. My philosophy is that I am not going to cure their addiction to narcotics in this short hospital stay, nor is it my job to try. Many patients, unless they are opioid naive, can handle a lot more pain medications than you would think, and if you are not sure, you can simply check on them more often. I emphasize drug seekers because these are typically the patients who I see with snotty attitudes most often. Many of them self medicate at home, and it may truly be difficult to achieve adequate pain relief, because they have developed such a tolerance for opioids. I would also add to always introduce yourself, set realistic expectations at the beginning (give yourself some wiggle room), and explain what is going on to the patient and family.