By 
As nurses, we often find ourselves working with difficult patients. These uniquely hard-to-work-with patients come in many varieties. Some of them suffer from dementia or severe mental illness, making them combative and noncompliant in ways that they can’t really help or control. Others are simply rude. And then, there are the needy and demanding patients, the ones that treat us as “the help” who should be available at their beck and call.
This article is about the “needy and demanding” kind of difficult patients. You know the type. They hit the call light constantly, to the point that we curse the day those stupid call light systems were invented.
Using the call light too often is like crying wolf. It’s incredibly frustrating, and it can lead to a phenomenon known as “alarm fatigue.” When you hear an alarm go off too often, you get desensitized to it. Plus, it’s hard to take it seriously when the patient called you in twenty minutes ago because their tongue kept touching their teeth. But you can’t just ignore it, in case something really is seriously wrong.
When you start getting alarm fatigue, your brain starts to filter out the sound of the call button.
Call Light Overuse Spoils It for Everyone
Patient overuse of call light systems has led many nurses to essentially tune them out. It’s hard to tell if someone’s bothering you for something mundane, like fluffing their pillows, or if there’s a serious medical problem. For that reason, as many as 13% of patients report that the calls weren’t attended to right away. It’s no wonder that this is the case — let’s face it, few of our call button summonings are actually a real emergency.
Dealing with Difficult & Demanding Patients
From rude comments to hitting the call light constantly, difficult patients can be exhausting. These tips can help you deal more effectively with even the most challenging patients.
- Don’t try too hard to change their behavior. Some people are difficult to work with and be around. There’s not much you can do to change their attitudes and behavior. Some people are in love with their own misery, and there’s little that can be done.
- Don’t take things too personally. Chances are, you didn’t do anything wrong. Some people lash out at everyone, or treat all the nurses like their personal maid, or simply can’t be satisfied no matter what you do for them. It’s important not to take this personally.
- Set boundaries. You don’t have to be a pushover. It’s okay to set some polite boundaries with a difficult patient. You can make it clear that you won’t be spoken to in a rude or condescending way, without stepping out of bounds and getting yourself into trouble.
- Remember what position the patient is in. They’re sick or injured. In some cases, they may be suffering from emotional or cognitive problems of psychiatric or organic origin, which affect their behavior and demeanor. No matter how unpleasant they are, they are deserving of compassion and of adequate medical care. Treat them as you’d want to be treated, even if you don’t get anything in return.
- Remember that some medical or psychiatric conditions cause irritability, aggression, and other mood disturbances. If someone is suffering from psychosis, or are detoxing from alcohol or other substances, they may be hallucinating and acting irrationally. This can lead to combative behavior, or even to hitting the call button constantly. Your elderly Alzheimer’s patient may not remember that she rang you just fifteen minutes ago.
- Document everything. Occasionally, difficult and demanding patients can be quick to become litigious. Document everything thoroughly to protect yourself against any accusations from them.
- Remain calm. No matter what happens, don’t lose your cool. It’s important to act professionally in these situations.
- Avoid engaging in arguments. Difficult patients, the kind that hit the call light constantly, are apt to try to pull you into arguments. Avoid arguing with them when possible.
- Keep your personal safety in mind. Occasionally, difficult patients can become combative. If someone is being physically aggressive, it’s okay to call for backup.
Difficult and Demanding Patients are a Fact of Life for Nurses
Most of our patients are wonderful, but there are always patients that are rude, demanding, or even aggressive. It’s something that we all deal with regularly, but there are tactics and strategies for managing that patient that keeps hitting the call light constantly.
