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How do I deal with a difficult patient?

Image: Irene Lamprakou | Flickr | Getty Images

We all have them from time to time, that one difficult patient that no matter what you do for them, it is never right.  They ask for one thing, you bring it to them and then they complain because they really wanted to something else.  You come to their room every morning with a smile on your face ready to have a good day, and then they start screaming about something and send you over the edge.

Here is my problem of the moment.  I have a patient that has been in and out of the hospital for years after a botched surgery.  Every time he is discharged, he is back in the ED and admitted within 72 hours.  That leads to another admission that lasts several months.  When he starts to smell a discharge coming, he finds another problem to complain about that will get him a few extra days.  Well, the nurses and the medical staff are now talking discharge and he is up to his old tricks.

A couple of days ago, I was called to his room because he wanted to talk to me about something.  When I came in, he pulled out his “log book” with information about every nurse, CNA, physician or whomever has taken care of him and what they did, wrong or right.  And, this patient and his family request to be on my floor every time they are admitted, and pitch a fit if they are placed on another floor until they get transferred to me.

I told them, that what they are doing builds distrust with the staff.  If they feel like every single thing they do is going to be documented, they will not trust the patient or family and may even avoid his room entirely.  I then went on to say that if they felt the need to document this information they it shows me they don’t trust us and that maybe the best course of action is to transfer him to another unit where he can trust the staff.

The best way to handle that difficult patient is to confront their behaviors directly.  If they are complaining about your performance, ask them to be direct and tell you exactly what you did wrong and how they feel you could have been better.  Maybe they are right and you are not aware of how you are, but maybe they don’t understand your job and responsibilities and with a little education they can learn something.

Being in the hospital is a stressful time for most people and they may from time to time lash out at us.  But, usually, if somebody is confronted about their behavior they will change.  Especially if they know that you are all working on the same team whose focus is their well-being.

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Rob Cameron

Rob Cameron is currently a staff nurse in a level II trauma center. He has primarily been an ED nurse for most of his career, but he has also been a nurse manager for Surgical Trauma and Telemetry unit. He has worked in Med/Surg, Critical Care, Hospice, Rehab, an extremely busy cardiology clinic and pretty much anywhere he's been needed. Prior to his career in nursing, Rob worked in healthcare finance and management. Rob feels this experience has given him a perspective on nursing that many never see. He loves nursing because of all the options he has within the field. He is currently a grad student working on an MSN in nursing leadership, and teaches clinicals at a local university. Away from work, Rob spends all of his time with his wife and daughter. He enjoys cycling and Crossfit. He is a die hard NASCAR fan. Sundays you can find Rob watching the race with his daughter.
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