How Do You Deal With A Difficult Patient?

This article was republished with permission from SCRUBS Magazine.

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.

What do you think? How do you deal with difficult patients? Share your thoughts in the comments section below.

This article was republished with permission from SCRUBS Magazine.
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Christine B
21 days ago

I worked at a state hospital in a unit that served people who had substance use issues and co-occurring mental illness. One of my patients had a roommate who was difficult for both staff and other clients. When I asked my patient how he got along with his roommate, he answered that the roommate “is just who he is”. So simple! It gave me ‘permission’ not to take the troublesome patient’s behavior personally. Nearly 20 years later, I still remember that I am not responsible for how others act.

kathleen caulfield
4 years ago

I think they should have him go to another hospital. Things like that can be arranged. I can guarantee he will come back with a different attitude. You don’t have to be mean in doing this recommendation. Say it is in his best interest to seek out a different set of eyes to care for him. OR when he appears in the ER perhaps there could be no available beds for his admission..

4 years ago

I recently was watching 600-lb life show and there was a patient who was really very abusive to the staff. I really admired the fact that the surgeon who does the weight loss surgeries on the show stood up for the staff. He told him his behavior was unacceptable and when it continued he discharged him. I don’t know if that happens so much in daily life but when I saw it on the show I cheered! The other comment I would add is we all need to check ourselves occasionally and sounds like this person needs to check himself!… Read more »

3 years ago

Sounds like he is afraid. He needs someone to talk to about what he is feeling. As a nurse we should be aware that patients and family may be stressed and we need to have the compassion to try and find out what is going on with the person. It most likely is not the doctor, nurse etc. Take the time to stand by the bed and hear what the patient is saying. I recently had surgery and the nurses were wonderful. I was having difficulty swallowing post C4-C7 fusion. There were three nurses in my room that spoke with… Read more »