DiversityNursing Blog

Patients become difficult for many different reasons. They sometimes become challenging due to diseases that affect their reasoning, like dementia or Alzheimer’s. Other times, patients can become verbally or physically abusive due to high-stress situations or unmet wants or needs. Regardless of why some patients become difficult, Nurses can help handle and diffuse difficult patient interactions with these 5 helpful tips.

Stay Calm

It may be challenging to stay calm when dealing with a problematic or irrational patient, but controlling your emotions is one of the most important things you can do during a confrontation. Reacting to a patient with anger can only escalate the situation and make it worse.  

When dealing with a difficult patient, remember in most cases, they are only being difficult to get their needs met and not to cause trouble. However, other times, patients may be misdirecting their feelings of fear or uncertainty onto you, and it is our job to help them navigate their feelings and de-escalate the situation. Some Nurses have found practicing meditation and yoga helps to develop healthy coping methods and strategies to navigate stressful patient interactions.  

Control Your Body Language

It is only natural to become defensive during a controversial situation. Your body language can often speak louder than spoken words. When interacting with difficult patients, it is important to evaluate your nonverbal communication and ensure it is portraying the right message. You should also avoid standing with your arms crossed, as it can be interpreted as rude or standoffish. Learn to control your facial expressions, gestures, and posture during difficult interactions to help diffuse the situation.  

Listen

When a patient becomes loud or argumentative, it’s natural to respond with anger and defensiveness. In these times, it is essential to remember that the patient is coming from a place of needing to be heard. Whether their request is reasonable or not, we as Nurses must listen to their concerns or complaints.

If you set aside your own feelings about the situation and listen to what the patient is saying, you may be able to get more insight into the situation and come up with a better solution to the conflict. Many times, you may not need to come up with a solution for the patient. They just need someone to listen to them and feel heard. We have to remember, patients are usually in a vulnerable state when being cared for and can be scared, frustrated, or hurt. Listening is one of the easiest ways we can connect with our patients and help them to heal both physically and mentally.  

Have Empathy

Empathy is one of the most important traits of a Nurse. When dealing with difficult patients, it is important to remember they are going through a tough time, and they may be displacing their anger onto you as their Nurse. Make sure you always try to put yourself in your patient’s shoes to better understand where they’re coming from. Patients are only human. They want to be heard and understood. If we connect with them through empathy, it will help to diffuse many uncomfortable situations.  

Set Boundaries

As Nurses, it is our job to provide for the wants and needs of our patients, but it is important to do so within your set boundaries. Sometimes, patients demand things that are unreasonable. Make sure they understand the limitations of your role. As a Nurse, it is important to find the balance between meeting your patient's needs and also standing your ground and not letting a patient push you around. Some patients may try to take advantage of your kindness so it is important to set boundaries and stick to them.

Unfortunately, every Nurse has had the unfortunate experience of dealing with a difficult patient. Next time you find yourself in a challenging situation with a patient, keep these helpful tips in mind so you can get back to providing your patients with exceptional Nursing care. 

Choosing the right Nursing specialty can be a challenging decision, as there are many areas of Nursing to consider. Here are some steps that can help you choose the right specialty:

Assess your interests

Think about the areas of Nursing that interest you the most. Do you enjoy working with children or adults? Do you like working in a fast-paced environment or a more relaxed one? Do you prefer working in a clinical setting or a community-based one? Weighing your choices based on your interests and personality traits will help you narrow down your options.

Research Nursing Specialties

Once you have identified your interests, research the specialties that align best with them. Look for information about the scope of practice, work environment, patient population, salary, and required education and certification. You can also talk to other Nurses who work in these specialties to get a better understanding of what it's really like to work in these areas. 

Johnson and Johnson offers A Nursing Specialty Quiz to help guide you in learning more about specific specialties that fit what you're looking for.

Consider Your Strengths

Think about your strengths as a Nurse. Do you excel at critical thinking and problem-solving? Are you skilled at patient education and counseling? Do you have strong leadership skills? Are you able to work well under pressure? Looking at the areas you excel in will help you pick a specialty that suits you.

Think About Career Goals

Consider your long-term career goals and how a particular Nursing specialty can help you achieve them. Do you want to advance into a leadership role? Do you want to work in a specific healthcare setting or with a particular patient population? Understanding your career goals can help you better choose a specialty that aligns with them.

“One of the best things about being a Nurse is your career can change and flex as you grow,” says Ashleigh Woods, Clinical Assistant Professor of Nursing at Berry College. “Nursing is versatile. Unlike other professions, as a Nurse, you can specialize in ICU medicine, but then after a few years, you can become a specialist in another area.”

Gain Experience

Once you have narrowed down your options, try to gain experience in different areas through clinical rotations or job shadowing. Some Nursing schools offer part-time work for interested students which would allow you to make money and gain experience. Hands on experience can help you get a better sense of what it's like to work in these areas and make an informed decision about which specialty is right for you.

Ultimately, choosing the right specialty is a personal decision that depends on your interests, strengths, career goals, and experience. Take the time to explore your options and gather information before making a decision, and don't be afraid to seek guidance from experienced Nurses and healthcare professionals.

1. Set your phone or digital watch to military time. In healthcare, the 24-hour clock is generally used in documentation of care as it prevents any ambiguity as to when events occurred in a patient's medical history.

2. Get to know your team. Don't hesitate breaking the ice, introduce yourself, others are probably wondering who this new person is! Once you get to know everyone, try keeping a close group of people you can rely on and talk to when need be. Every one needs a helping hand or shoulder to lean on time and again. 

3. Don't be afraid to ask questions, no matter how small. It's better to not know and ask, than act like you know and risk a patient's safety. Listen, watch and learn from seasoned Nurses. Learning is a never ending part of the job. 

4. Seek a mentor. This one-on-one experience provides a safe space for new Nurses to ask questions and learn the social and professional inner workings of their profession.

5. Self care is important. If you aren't caring for yourself, you won't be able to care for others.  Be mindful of how you feel and recognize when you need to give yourself some extra love and attention. Even small 15 minute breaks during shifts can make a world of difference. 

6. Never stop learning. Invest in continuing education, keep certifications up to date and seek knowledge in places outside the hospital setting. 

7. Buy good shoes! Nurses are on their feet constantly so invest in a pair that are comfortable and durable. Also try wearing compression socks.

8. You may not be able to do everything yourself, but together we can do anything. Offer help when you can and accept help when you need it. 

9. Carry many pens with you!

10. Remember why you started. It will help you get through tough times or when you're feeling down or burnt-out. Nursing is stressful, but also rewarding. 

You might be a recent graduate and are worried about what to do when you get a difficult patient or maybe you are an experienced Nurse and are looking for new tips or ideas to try. We created a list of ways Nurses avoid or diffuse challenging situations with patients.

1. Don’t take it personally

It’s easy to think a difficult patient is upset with you personally, but that’s almost never the case, according to Julianne Haydel, veteran nurse turned nurse consultant at Haydel Consulting Services.

Remember that the patient is dealing with unfortunate circumstances and likely isn’t in the best mood. Continue to do your job and don’t let their negativity get in your head. “Just knowing that the nastiness is not about you is a good start,” says Haydel.

2. Stay Calm

When dealing with trying patients, the best approach is to remain calm. Remember that the patient is not attacking you personally, but rather acting out on feelings of anxiety, a perceived lack of attention or resistance to what has happened to them. Remaining calm will allow you to keep control and address the patient in a way that will defuse the situation.

3. Show that you care

Sometimes difficult patients make a fuss about minor requests because they feel like no one is listening to them. Set aside your frustration with the patient and do what you can to meet their needs, as long as it doesn’t take away from other patients’ level of care.

Nurse Angelis recalls swallowing his pride and getting a second cup of coffee for a particularly irritable patient: “I stayed gracious and her whole demeanor changed. She just wanted to know that someone cared and she wasn’t going to be ignored.”

4. Set Boundaries

When it comes to difficult patients who make seemingly endless or unreasonable demands, a useful approach is to set limits. Let them know you will check on them again in 15 minutes or a half hour, and then follow through. In some situations, you’ll need to set boundaries to keep yourself safe. Doing so can help avoid escalating anger.

5. Realign Your Body Language  

Charlene Berube, chair of the undergraduate nursing program at Simmons School of Nursing and Health Sciences in Boston says, “When I start to get frustrated because I’m not making progress with a patient, I take little breaths." Berube also says, “We both need to refocus at that time. If the patient is becoming demanding, and I’m getting frazzled, those energies need to be refocused. And when you do that, your body language realigns.”

Patients come to nurses with mental health issues, mood disorders, depressions, anxiety and a host of other complications. They have lives or lifestyles that you may not understand or even agree with.  But none of that matters.  Each patient deserves the best nursing care you can give them. Remember that you need to find the calm in yourself, be objective and be honest with them. Showing empathy and giving them your undivided attention and time could make a big difference in their attitude and soften those hard edges.

If you have other tips or advice please comment below we would love to hear what you have to say!