Tips for Dealing with Difficult Patients

Working in the health sector is not easy at the best of times. However, COVID19's additional pressures mean that healthcare workers are increasingly facing difficult interactions. In order to sustainably manage this new normal, we need three things. Firstly to understand and support our own wellbeing. To increase our ability to empathise with the patient and skillfully help to reduce their emotional reactivity. Secondly, to know what is unacceptable, what our options are and feel confident to act. And finally, to feel supported by our colleagues when these situations arise.

For patients, COVID19 means that the added health concerns are on top of an already heightened emotional state. Patients are more likely to feel overwhelmed, inpatient, less tolerant, less understanding. Systems have changed, so even those who are used to the health system have to learn how to navigate it again.

Below are some great tips that can be utilised as a healthcare professional to deal with difficult patients.

1. Understand the impact of the pandemic on our emotions

Everyone's "normal" has changed. Routine, work, socialising, holidays and how we relax have all been disrupted. Whatever your emotional state before COVID19, however, the pandemic has impacted you, we are all a few steps closer to feeling overwhelmed. This is true for you, your colleagues and your patients. One of the key indicators of our ability to manage difficult situations is our expectation and understanding of what we can control and what we can't. Unfortunately, we do have to expect that more patients will become overwhelmed, and we will have to have the skills and capacity to manage.

Action: Prioritise our own wellbeing and aim for sustainable resilience, not just doubling down and risking burn-out.  

2. Prioritise our own wellbeing

In order to skillfully cope with the increased demands of work and patients, we will need to prioritise our own wellbeing. Find a routine that prioritises the five steps to wellbeing (Connect, Be Active, Keep Learning, Give and Take Notice).  

Action: Identify what you are already doing for your wellbeing and make sure you prioritise these. See if there are any you need to add - make them accessible and achievable.  

3. Try and Connect

Whatever emotion a patient is displaying, try and understand the need behind this emotion. Often people are fearful, insecure, overwhelmed or uncertain. Try to connect not with what they are saying, but how the unmet need behind their emotion. People need to be seen and heard and to know that they are not just another number.

Action: Practice with your friends and family. Recognise emotion as the expression of an unmet need. This will help you not to take any language or behaviour personally.

4. Calming tools - know what works for you

All patients deserve the best care we can provide, but we can only do this when we are calm ourselves. Staying calm will help you ease tension and keep the situation from escalating. Make sure you have good strategies that work for you. Your EAP Provider can support you to develop these strategies for quick tools to de-escalate your own emotions. Staying calm will help you to remain observant. In this way, you may be able to diffuse a tense situation before it starts.

Action: Call your EAP provider today and make sure you are well trained to calm your own emotions. Whether it's breathing, visualisation, mindfulness, counting, find a couple of strategies that work for you and practice them daily to develop mastery.

5. Don't accept abuse

Difficult patients require skilful management. However, it's not part of the job to accept abusive behaviour. No matter the circumstances, never hesitate to call for help or walk away if you feel a patient is placing you in physical danger or being abusive. Warn them that their behaviour is unacceptable and alert a senior colleague if they do not listen.

Action: Make sure you know what to do and who to call if a patient becomes abusive. Then be brave and follow the process. Everyone in the team must show zero tolerance for abuse. Lead the way so that those more vulnerable than you feel confident to take action and keep themselves safe if they are ever faced with a similar situation.

6. Work as a team

Some days we can cope with difficult situations better than others. Work with your team so that you all feel safe to step out of a situation if you need to with no questions asked. Having a supportive team is important for everyone's well being and everybody's psychological and physical safety. He waka eke noa - we are all in this together.

Action: Talk to your team or team leader about having an agreement where people can step out of a conflict situation if they need to. Know the team's strength - develop skills across the team, don't rely on one person to manage the difficulties, but equally, don't blame people if they find this hard. Support each other, use your strengths but share the load.