Don’t let patients get you down

Don’t get angry, take a break

Every healthcare professional needs to develop a basic set of skills to help them cope with difficult patients so they can get through the encounter and not come out emotionally bruised, says John Banja, PhD, professor of rehabilitation medicine, medical ethicist at Emory University’s Center for Ethics and director of the Section on Ethics in Research at Emory’s Atlanta Clinical and Translational Science Institute.

“The first human response when people feel uncomfortable is to defend themselves, rather than trying to understand what is going on with the patient. With difficult patients, this is probably the wrong thing to do, and it’s probably why relationships between difficult patients and healthcare professionals don’t tend to improve very much,” he says.

Don’t take it personally and resist the temptation to push back when patients lash out at you, adds Tammy Lenski, EdD, chief executive officer of Tammy Lenski, LLC, a conflict resolution and negotiation consulting firm based in Peterborough, NH. Remember that there is a huge difference between yelling at somebody and yelling towards somebody, she says. “Most people coping with an illness or injury are not combative because they don’t like the person with whom they are dealing.” Lenski points out. They’re acting that way because they are on edge, frustrated with a lot of things, and everything is a major struggle.

“When people realize that the combative patient is yelling toward them and not at them, it helps them understand that the person yelling actually is expressing frustration and pain. Then the healthcare professional can have compassion for the patient’s misery,” she says.

Keep in mind that in some cases, the best thing you can do is to keep a difficult encounter from getting worse, Banja says. You may think at the end of the discussion that it went poorly, but remember that you’re likely to have another conversation with the patient and it probably will go better, Banja says.

Once your emotional trip wires have been activated, it’s time to take a break and do something different, Lenski says. “If you stay in a hot conversation, it doesn’t get any cooler. It’s better to take a half-hour break and do something to take your mind off the topic,” she says.

Sit quietly and take deep breaths until your heart stops racing. Seek out a colleague and talk about a movie you saw, an upcoming event — anything but the problems you are having with your patient.

Acknowledge that dealing with challenging patients is a very real problem for everyone in the healthcare profession and that dealing with them can cause burnout, Banja says. Look for opportunities to educate yourself and develop a good skill set to cope with these patients.

Banja recommends that training programs for case managers include information on how to cope with difficult patients. “Nurses need to be better trained to react when they come across difficult patients, which probably happens every day,” he says.

Evaluating a case manager’s ability to cope with difficult situations should be part of the hiring process, he says. “It’s a huge mistake to hire a case manager based only on their intellectual ability. They need to be able to cope with all the difficulties they are going to encounter. Someone who understands clinical medicine very well may not be able to negotiate a difficult relationship,” he adds.