Your most difficult patient and how you turned it around

[SarasotaRN2b]

This is a question for those experienced nurses. We would all like to be empathetic to our patients. Many are scared, besides being sick and they and/or their families may want us more running out of the room than to help, which is not an option.

Give us a time when you were able to take that most difficult patient:angryfire and tell us how you were able to turn that around:) .

Thanks in advance.

[SarasotaRN2b]

This is a question for those experienced nurses. We would all like to be empathetic to our patients. Many are scared, besides being sick and they and/or their families may want us more running out of the room than to help, which is not an option.

Give us a time when you were able to take that most difficult patient:angryfire and tell us how you were able to turn that around:) .

Thanks in advance.

[UM Review RN, ASN, RN]

Most patients who appear angry are really frightened.

When I have a difficult patient, I have to work a little harder to earn their trust.

I usually take extra time to explain why something needs to be done and what they can expect.

Always validate their feelings. "Yes, Mrs. Smith I can see that you'd be upset that your doctor didn't come in til this afternoon and then cancelled your discharge. But suppose you'd gone home anyway, and then needed to come back? You'd surely be in worse shape than if you'd simply stayed."

If someone's really angry, it can help to defuse the situation by sitting down. Look like you're prepared to listen.

You might start by listening and simply agreeing with them. "I see how you'd be feeling frustrated and angry in this situation. How can we help to make it better?"

Don't make the mistake of saying, "I understand." That turns people off. Instead, just nod and try to put yourself in their shoes for a moment.

If all else fails, they've vented a little bit, and you've established that you're concerned enough to pay attention to them. If their diet allows, offer them a little ice cream or some chicken broth.

Remember, some patients feel so utterly helpless that their bodies have betrayed them, their only defense is to try to manipulate the staff. Your job is to turn that angry energy into energy the patient can use to get well.

That's enough for most, but in the case of the ones who aren't ever satisfied, you can at least say you did your utmost to improve the situation.

If patient is still upset and no improvement, call the Charge and the Admin on Duty, in that order, to try to reason with the patient.

But at that point, I get a copy of the AMA (Leaving Against Medical Advice) form and put it on the chart.

After all, this is a hospital, not a jail. They come here to get better, not to fight with the staff. If they don't want to cooperate, they can always go somewhere else.

[UM Review RN, ASN, RN]

Most patients who appear angry are really frightened.

When I have a difficult patient, I have to work a little harder to earn their trust.

I usually take extra time to explain why something needs to be done and what they can expect.

Always validate their feelings. "Yes, Mrs. Smith I can see that you'd be upset that your doctor didn't come in til this afternoon and then cancelled your discharge. But suppose you'd gone home anyway, and then needed to come back? You'd surely be in worse shape than if you'd simply stayed."

If someone's really angry, it can help to defuse the situation by sitting down. Look like you're prepared to listen.

You might start by listening and simply agreeing with them. "I see how you'd be feeling frustrated and angry in this situation. How can we help to make it better?"

Don't make the mistake of saying, "I understand." That turns people off. Instead, just nod and try to put yourself in their shoes for a moment.

If all else fails, they've vented a little bit, and you've established that you're concerned enough to pay attention to them. If their diet allows, offer them a little ice cream or some chicken broth.

Remember, some patients feel so utterly helpless that their bodies have betrayed them, their only defense is to try to manipulate the staff. Your job is to turn that angry energy into energy the patient can use to get well.

That's enough for most, but in the case of the ones who aren't ever satisfied, you can at least say you did your utmost to improve the situation.

If patient is still upset and no improvement, call the Charge and the Admin on Duty, in that order, to try to reason with the patient.

But at that point, I get a copy of the AMA (Leaving Against Medical Advice) form and put it on the chart.

After all, this is a hospital, not a jail. They come here to get better, not to fight with the staff. If they don't want to cooperate, they can always go somewhere else.

[SarasotaRN2b]

Angie O'Plasty, thank you so much. This was exactly what I was looking for. I try to think how I would feel if I were a patient and how I would want to be treated, but nothing beats how much help more experienced nurses can offer.

[SarasotaRN2b]

Angie O'Plasty, thank you so much. This was exactly what I was looking for. I try to think how I would feel if I were a patient and how I would want to be treated, but nothing beats how much help more experienced nurses can offer.

[talaxandra]

Yep, I never say I understand - I don't. When I'm trying to explain things and cool irate patients down I [i[do[/i] often say that I know it's easy for me to optimistic, when I can go home in the morning. Almost always they say in return that no, what I'm saying makes sense.

Unless their judgement is compromised, I'm very comfortable with patients leaving if they don't want to stay - just sign the paperwork! Sometimes I see nurses (and doctors) wrapping themselves into knots to convince a patient to stay. It just seems like such a waste of energy. By all means explain why staying in is advisable, absolutely give them a chance to vent, validate their frustration, etc, but at the end of the day it's their decision. Especially for patients with chronic problems, who've been there before.

[talaxandra]

Yep, I never say I understand - I don't. When I'm trying to explain things and cool irate patients down I [i[do[/i] often say that I know it's easy for me to optimistic, when I can go home in the morning. Almost always they say in return that no, what I'm saying makes sense.

Unless their judgement is compromised, I'm very comfortable with patients leaving if they don't want to stay - just sign the paperwork! Sometimes I see nurses (and doctors) wrapping themselves into knots to convince a patient to stay. It just seems like such a waste of energy. By all means explain why staying in is advisable, absolutely give them a chance to vent, validate their frustration, etc, but at the end of the day it's their decision. Especially for patients with chronic problems, who've been there before.

[ERNurse752, RN]

Succs, Versed, and restraints. (j/k, long night!)

[ERNurse752, RN]

Succs, Versed, and restraints. (j/k, long night!)

[merricat]

Succs, Versed, and restraints. (j/k, long night!)

i love it. um, i read a book years ago called customer service for dummies. there were really good suggestions for dealing with difficult people in it. seriously! also, with call lights? i find answering them and being really sweet and sunny and solicitous helps and will eventually work-- i know that sounds optimistic but it has always worked for me. i mean for the people who are always on the light-- it helps them relax and stop it, somtimes it may take a shift of it before the person mellows out. hugs-- i gigve lots of hugs and it helps people relax, i think. sounds too simple?

[merricat]

Succs, Versed, and restraints. (j/k, long night!)

i love it. um, i read a book years ago called customer service for dummies. there were really good suggestions for dealing with difficult people in it. seriously! also, with call lights? i find answering them and being really sweet and sunny and solicitous helps and will eventually work-- i know that sounds optimistic but it has always worked for me. i mean for the people who are always on the light-- it helps them relax and stop it, somtimes it may take a shift of it before the person mellows out. hugs-- i gigve lots of hugs and it helps people relax, i think. sounds too simple?