In nursing, we don’t always like the patients that we take care of. It sounds harsh, but let’s be honest. The caveat to that statement is that we don’t have to like them. We do, however, have to provide the best possible patient care that we can, while maintaining an appropriate level of professionalism and compassion.

People in general can be difficult to deal with. With sick people who are frightened, this quality can intensify. In addition, medications and conditions such as confusion can also make our patients behave in a way that we don’t understand. Some of our patients are just demanding and never seem to be satisfied with anything that we do for them. Sometimes we may want to curse the person who invented the call light. Instead, we need to focus on mechanisms that we can use to help effectively handle a difficult patient.

From a patient care and satisfaction perspective, we should consider the following:

  • Remember what position the patient is in. He’s sick. He’s uncomfortable. He’s frustrated. He’s frightened. He may feel that he isn’t getting enough attention from caregivers or that people aren’t listening to his concerns. It’s not his choice to be a patient. It is our choice to be a nurse.
  • Don’t just hear what the patient says, listen to him. Let him know that you are listening by maintaining eye contact. It’s been said that approximately 80% of our communication is nonverbal. Don’t stand with arms crossed, don’t look at your watch as if you have someplace else more important to be, etc. Also, watch for the patient’s nonverbal cues. Taking these steps will help to establish a level of trust and enhance the effectiveness of our nurse and patient communication.
  • Be nice. Be caring. Keep your promises. Remember that our role as nurses is not only to provide safe care, but also to provide information, support, and reassurance to our patients. We made a commitment to do these things when we chose nursing. 

From a risk management perspective, some other steps are also important:

  • Adequately document any relevant events. If an adverse event occurs, document it in the appropriate part of the patient record or on an incident report per facility policy. In the event of litigation involving the patient, good objective documentation can increase the chances of a positive outcome for the nurse.
  • Pay attention if a patient threatens to sue you, the facility, the physician, etc. While in many cases these are only threats, you never know for certain. Inform your nursing supervisor and risk manager that the patient has made this statement, so that steps can be taken to resolve any issues that the patient may have, thereby potentially avoiding litigation. If a patient tells you that they have previously sued a healthcare provider, pay even closer attention.
  • Seek the assistance of your supervisor. This is important if you are caring for a patient who makes you feel uncomfortable, either physically or emotionally. There are times when a change in patient assignment is a reasonable step to take.