Nursing Nightmare! How to Deal With Unruly Patients


If you’ve been a nurse long enough you’ve had to deal with unruly patients.

Patients who are difficult, demanding, easily angered, impatient, manipulative, noncompliant, unreasonable ____ (fill in the blank).

As an NP, I’ve had my fair share of unruly patients lash out at me in moments of frustration and disappointment.

This can be tough when you feel criticized when all you’re trying to do is help your patient.

I know how this feels firsthand.

Once, I had a such a negative encounter with a patient that I told the scheduler not to book them with me again. EVER.

Maybe this wasn’t the best way to respond and usually, I’m able to turn the most unruly patients around.

But not this time.

I felt disrespected….and hurt.

I’m human, after all.

But, I broke a cardinal rule in the patient-nurse relationship.

I took it personally.

So, what do you do in these situations, instead?

Our formal training hardly prepares us to deal with unruly patients.

After my “nightmare” patient encounter, I started searching for advice/tools that would help me deal more effectively with unruly patients. While there are many approaches and each situation is different, perhaps what I learned will help you the next time you have a difficult patient encounter.

First & foremost, try not to take it personally when patients criticize or lash out in anger.

Usually, it’s not about you.

Often, there is more going on beneath the surface; a long wait to see you, stress at home, frustration, fear, & sadness about their diagnosis, not feeling heard by health care providers in the past, etc.

Instead, incorporate empathy by imagining how the patient might be feeling, suggests Edward Leigh, Founder & Director at Center for Healthcare Communication.

Next, state your perception of the patient’s feeling, Leigh suggests. “Reflect back with a feeling word or phrase. Once you have found the word you think fits best, incorporate it to a sentence. Here are some sentence beginnings to get you thinking:”

“Sounds like you are…”
“I imagine that must be…”
“I can understand that must make you feel…”

Finally, take time and listen. Effective communication is the key to dealing with unruly patients. Maybe you’re the first person who’s taken the time to listen. It is not uncommon for me to hear this from patients who’ve seen other providers.

Do this and you’ll lower your risk of malpractice.

Patients don’t like feeling rushed or ignored by physicians and nurses who are “too busy” to sit down, listen attentively, and respond to their questions and may set themselves up for problems, such as a lawsuit, down the road, says Leigh. Breakdown in communication between NPs, nurses and patients “fuel distrust and pent-up anger” and patients who are unhappy with their health care provider are more likely to sue.

For more information on effective patient communication, read Great Communication Skills = Lower Risk of Malpractice and Get the Message! 8 Ways to Dramatically Enhance Your Listening Skills

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