by Luisa van der Linde
The main purpose of health practitioners in a clinical environment is to treat and care for their patients to the best of their ability.
Sometimes, however, differences in expectations, perceptions and communication styles may lead to challenging interactions between a health practitioner and the patient.
Many patients are polite and follow their practitioner’s recommendations exactly, but unfortunately not all patients do so.
There are many reasons why patients sometimes become difficult to deal with. Some are unhappy about where and when they receive bad or life-changing news. Others experience the health practitioner’s non-verbal communication negatively; interpret messages ambiguously; or have “researched” their condition online and insist on a certain type of treatment. Or the patient struggles with the dearth of answers or solutions; does not trust medical practitioners; or disregards instructions towards getting better.
Health practitioners must also choose their words with care; must communicate bad news under difficult circumstances; or are not able to spend as much time on a patient as they would have liked to, due to time constraints.
Deal with difficult patients like this
The patient criticizes the treating health practitioner
Do not react defensively if you or a colleague is criticized. Try to listen to the patient’s complaint and then follow up if necessary. Instead of saying, “Dr Smit will never give bad advice,” rather say, “I will discuss your worries with Dr Smit.” If the criticism is not aimed at you, mention that you will discuss the matter with your colleague.
The patient will not stop crying about a routine operation
Always reassure the patient; be open and honest; and never offer false reassurance. Do not dismiss your patient’s fears, rather say, “We do everything we can to help you,” or, “I see you are worried, let’s talk about it.”
In case of a serious illness, never minimise the after-effects of any operation or treatment. Remember that it is better for patients to be prepared and take part in the treatment decisions than to be unaware of the consequences of the disease.
The patient tries to pick a fight
Esther Smit, programme director at the Thuto Bophelo Nursing Academy, says, “It reminds me of the film Madagascar, where the penguins just smile and wave… You just have to control your temper and try to achieve the best outcome. As a health practitioner you will have to use critical thinking to keep matters under your control. Easier said than done. Listening skills once again come into play. Listen, but keep your own mouth shut. It is not easy, but it is doable.”
Danielle Brown writes in gapmedics.com that it is easy to lose your temper when a patient shouts at you, especially if you feel it is undeserved.
“But to become embroiled in mutual conflict with a patient is a bad idea for many reasons. You should have learned how to handle these situations as a student already. Shouting at a patient is unprofessional.”
The website www.advancedcare.com agrees. Unhappy patients may try to involve you in a conflict situation. “You have a right to voice your opinion, but do so with respect. Instead of explaining why their medication is late or they are not receiving the attention they need, just apologise and assure the patient you will see to it that the matter is sorted out.”
The patient complains about family members
Do not judge. Instead of saying, “You did the right thing when you told your husband off,” rather say, “It sounds as if you are having a difficult day.”
Esther says, “You listen with a soft heart but keep your opinion to yourself. Reassure your patient that you are there to listen and then watch the situation. Observation is a health practitioner’s greatest aid. If you work in a team, you can afterwards discuss the matter with the multidisciplinary team to see whether attention should be given to emotional support for the patient.”
The patient refuses to take the medication
This often happens, especially in the children’s ward of hospitals. This is where your skills around patience and powers of persuasion are tested on another level. You as the health practitioner must make a plan.
If you demand an explanation from the patient, he or she will go on the defensive. Instead of asking, “Why are you not taking your medication?” rather ask, “Tell me about your problems with your medication?”
If all else fails, you will have to notify the patient that not taking the medication may have a negative impact on his or her health or recovery.