We have all been there. We have experienced handling difficult patients. No matter what you do, you cannot satisfy, you cannot reach and you cannot connect with them. These patients monopolize the majority of your time, and it seems as if you are fighting a losing battle. These patients can often be rude, aggressive and demanding, and working with them can be frustrating and exhausting. So, how do you handle them? Consider the following communication strategies in nursing:

  1. Remember, safety first. Regardless of the situation, if the patient begins to get aggressive, threatening or combative, call for help. In the medical arena, emotions are intense and they can cloud judgment. It is essential to remember not to put yourself in a volatile domain, whereby there is the risk for injury. If you do not feel safe working with the patient, notify your nurse manager and document according to facility standards.
  2. Address basic necessities. When the patient is angry or upset, consider the cause. Their pain might not be well-controlled; they might be tired, hungry, frustrated or thirsty. If these basic needs are addressed and met, the subsequent irritability and/or anger is likely to subside.
  3. Acknowledge the patient. Many times if you simply sit down with the patient during an encounter and give him or her adequate time to vent their feelings, the patient will then feel valued and appreciated. Similarly, your advice and teachings, as the clinician, are more likely to be absorbed. Likewise, if their basic necessities are addressed, as noted above, he or she is more likely to feel acknowledged and valued.
  4. Observe the setting. In handling difficult patients, it is crucial to stay mindful of their situation. Notice his or her words or pitch of voice. Stay mindful of some non-verbal cues and threats. If there is any uncertainty about the situation, request assistance. But, being mindful of the extenuating factors can extinguish a potentially dangerous situation.
  5. Remain respectful and professional. When working with patients, make eye contact and address them as, Mr. or Mrs. The tone and the pitch of voice is also important to consider. Similarly, be mindful of non-verbal cues that might be expunged and remain professional when conversing with other professionals outside of the patient's room. Remember, body language in nursing is important.
  6. Be informed. As a means of being prepared, be familiar with your institution's policies and procedures for dealing with difficult patients, and know your patient's bill of rights.
  7. Set boundaries. At the time of admission to the hospital, it is noteworthy to clearly explain what behaviors are acceptable and what are not acceptable. It is equally helpful to set professional boundaries. This establishment of professionalism sets the stage for the continued clinician to patient relationship.
  8. Do not take it personally. Remember that your patients are struggling with a set of complex circumstances therefore they might exhibit abrasive behavior.

Communication in nursing is relevant in dealing with a difficult patient. It might be challenging but it can be combated. Hopefully, with the eight strategies outline above, we, as dedicated clinicians, will be able to handle each patient with empathy, fairness and timeliness in a compassionate fashion.