View Full Version : Difficult Patients

02-20-2008, 09:55 PM
I am a healthcare writer who focuses on disseminating patient-centered care best practices. I am currently writing about 'difficult patients'. I would like to hear your thoughts on the following:

1. What are some difficult patients you have encountered. Be specific, what happened, what made it difficult, how did it get resolved, who was involved...
2. What do you do to handle difficult patient situations
3. If you like, comment on this: are there any "difficult" patients? why/not?

I may like to use your story/comments in my writings, so please be specific and if you can, provide contact info.


Mr Ian
02-21-2008, 01:32 AM
A "difficult patient" is one presents a complex clinical scenario.

It is difficult because it challenges the limits of my capabilities; clinically, emotively or physically.

If you are referring to "unhappy or dissatisfied patients" then I have worked with them too.

Mother Jones, RN
02-21-2008, 11:31 AM
This might sound really lame, but I always try to treat patients the way I would want to be treated. I work hard to listen to patients, even if they are be irrational. But, on those occations when people are just being jerks, I put my foot down and set limits on their abusive behavior. I've even pressed charges against patients. Nurses must not tolerate abuse.

Thanks for asking:-)

MJ :pepsi:

02-21-2008, 06:47 PM
From one nurse writer to another----

During my career I found that many times patients and their families were difficult because of something deeper. It is like--every odor has a source--well every difficult patient has a reason. Maybe it is loneliness, or pain, stress, or maybe it is something physical. When we had a difficult patient (in long term care) the first thing I would do, (as DON) was to begin ruling out anything physical or mental that could be fixed.

Before I talked to them I reviewed their chart, diagnosis, meds and current labs.

then with chart in hand I would go in, sit down and act like they were the only patient I had. I never seemed to be in a hurry. Even tho I did not have all the time in the world--they thought I did. Basically I talked with them, never judging, never accusing--or actually more importantly I listened to them. I wrote down their concerns, and told them when I would be back with answers. Then I always followed up by coming back when I said I would whether I had any answers or not.

There are some people that are just difficult people anyway but usually if a patient is being difficult then there is a reason, a source. Our job is to find out what the reason is. I always listened to both sides of the story--I stood behind my nurses and took everything they said very seriously--but I gave the patient the same respect.

Most of the time it is something that can be easily fixed but they have to gain enough trust in you as a nurse to open up and talk.

Did you know that archeologist have found that the reason one of Pharoahs was so mean is because all of his teeth were rotten. He cut off people's heads and did horrible things--I guess because he always had a tooth ache.

So basically finding the root of the problem and trying to fix it is the best thing to do for a difficult patient. Just by visiting them and letting them know that you are concerned and that you want to help them is enough. Sometimes, they just need attention, a pillow fluff now and then or maybe it is something physical, mental or emotional.

I agree with the others--there are times when nurses are physcially and emotionally abused. These are rare occurances and should be handled according to the severity of the issue.