Given the bad or frustrating news patients may receive in the hospital, patients can be violent, draining, and overwhelming. If nurses don’t set emotional boundaries and deal with patients in proactive ways, they’ll find it difficult to maintain their stamina. Here are some of the most difficult types of patients to handle and tips for staying in control.
The hospital can be a stressful environment for patients who are getting bad news. Add this news to already troublesome violent backgrounds, and you could have a recipe for disaster. Patients often have high expectations of a doctor’s power to cure their problems. Aggression can often cover up for poor communication skills. The most important part of dealing with an aggressive patient is looking for warning signs. Beware of agitation towards the receptionist, clenched fists or abrupt movements. Always review records for prior convictions as well. Be prepared to deal with these aggressive patients. Stay calm. If you react in anger, you’ll spur more angry actions in your patient. Empathy can quickly reduce the patient’s stressful attitude. Maintain your physical distance and do not turn your back to the patient. Make sure to document your conversations in case they’re needed in a case down the road.
Patients who have been dealing with ongoing illness or terminal illness can easily develop depressive thoughts and feelings. “They are sick and may be depressed because of their illness,” says Dr. Godfrey C. Burns, nephrology section chief at Saint Vincent Catholic Medical Center. “Many are frightened, have poor coping skills.”
Depressed patients need sensitivity and perception. Nurses need to evaluate the mental state of the patient and how severe his or her depression is. The first step is to find out if the patient is suicidal. Ask several questions to determine whether this is the case. Recommend that your patient refrain from alcohol and offer several possible solutions to poor mood. When patients feel they have options, they are more hopeful.
Hypochondriacs believe that they have a serious illness even when medical professionals deem otherwise. The term is widely misunderstood. Concerned patients do not qualify as hypochondriacs. Hypochondriacs resist doctors’ reassurance and almost seem to have a desire to be sick. With the advent of the Internet, hypochondriacs have gotten even more emboldened. “You have to understand your own personal limitations,” says Dr. Cain. “The Key is understanding what you can and can’t control. You can’t cure patients’ hypochondria, but you can help them manage their lives.” Mark Bauer, MD, suggests keeping contact with patients to show that they are getting support. If the workload of keeping in touch is too much for one nurse, enlist your team of nurses and others on your medical team. In the worst cases, suggest your patient seek therapeutic help from a psychologist or psychiatrist.
Not only do nurses have to provide physical care for patients, but they have to maintain emotional distance when a patient is behaving inappropriately. As nurses deal with difficult patients, they must keep in mind that they need to help their patients while protecting themselves as well.