How to Prevent and Resolve Difficult Patient Encounters

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If you work on the front lines of patient care, at some point, you will have a patient situation that is challenging, to say the least. One study published in the Journal of General Internal Medicine found that about 15 percent of patient encounters were classified as difficult by the doctor involved. Nurses and allied health professionals may have even higher percentages of difficult situations. How you handle these difficult situations makes a big difference to both your patients and yourself.

Factors That Contribute to Challenging Patient Encounters

Healthcare providers, from doctors to nurses to therapists, have challenging patient interactions that occur every day. Those situations can develop for a variety of reasons that may be caused by the patient, healthcare provider, or both.

For example, patients can be angry, uncooperative, or have unrealistic expectations. Healthcare providers may also contribute to an interaction becoming unpleasant. Long wait times, understaffing, and poor communications, all make the experience worse for the patient, which in turn may lead to hostility.

In some cases, it’s the situation or the patient’s condition that makes the situation challenging. For example, pain, lack of control, and receiving a poor prognosis may lead to all types of emotions, which may make a patient encounter challenging.

A challenging situation may also include family members. It may involve family becoming impatient or frustrated with their loved one’s care.

Strategies for Effectively Dealing with Difficult Situations

The best way to deal with a potentially tricky situation is to try to prevent it, but that may not always be possible. When you cannot avoid a challenging encounter, there are ways to defuses the situation and prevent it from escalating. Communicating in a respectful and nonjudgmental way is essential, even if you are stressed.

Although every situation is different, there are some general strategies for dealing with challenging patient interactions, including the following:

Choose the right words

From time to time, we can all come across as abrupt or harsh. It might be the words we choose or how we say them. To defuse a potentially difficult situation with a patient, choose your words carefully.

If a patient feels attacked or like they are not being heard, it immediately may make them defensive or unwilling to listen. Avoid language that sounds judgmental or accusatory. Choose words that are not offensive. Be compassionate and empathetic. That does not mean you skirt around an issue or topic. You can be straightforward while still being sensitive. Also, break down information into small bits that are understandable and don’t overwhelm the patient.

Defuse the situation

One of the most challenging situations to deal with is an angry or aggressive patient. The situation can get out of control quickly, which can escalate into a patient hurting staff or himself. Recognizing warning signs that a patient is becoming increasingly angry helps you act fast to defuse the problem.

Watch for changes in your patient’s body language, including:

• Tightened jaw
• Clenched fists
• Tense posture
• Raised voice

If signs such as those above point to a deteriorating emotional state in a patient, there are things you can do to try to deescalate the situation. For example, maintain personal space. Research indicates that when personal space decreases, tension increases.

Also, remain calm and professional. Spend time with the patient and listen for the real message. Restate the patient’s problem and try to respond to the complaint. If you cannot help immediately, don’t promise something you won’t deliver. Instead, state what you will be able to do.

Be aware of your nonverbal communication

Nonverbal communication also sends a message to our patients. For example, if you avoid eye contact and stare at a computer screen while talking to your patients, it may come across as though you are uninterested. While that may not be the case, it is still the impression you may give. In fact, your nonverbal communication is often as important as the words you say.

Be aware of your gestures, eye contact, and body posture when trying to deal with a challenging patient situation. Keep the tone of your voice calm.

Get back-up

In certain situation, it’s best to get assistance. The type of help you need may depend on individual circumstances. For example, you may need security if a patient has a history of becoming violent. In other cases, staff may provide additional support to a patient or her family. For instance, the hospital Chaplin or social worker may be helpful when delivering bad news.

Having difficult patient encounters is often part of the job when you work in healthcare. Whether it’s helping a grieving family member or defusing an angry patient, your finesse in dealing with these challenging encounters makes a difference in the lives of the people you care for.