By Luisa van der Linde
General skills that may be of help
Empathy can take you far
Always keep the human aspect of health care in mind. Patience and empathy are important aspects of your calling. A difficult situation can often be defused by just being nice and showing empathy.
An upset patient can become calmer if he or she feels you are really listening. Use phrases such as, “I understand your frustration.”
Remember that the patient is away from their loved ones, probably in pain and uncertain. Show them you care! Treat the patient with respect rather than being on the defensive.
Do not take the behaviour personally
If another health practitioner had been treating the patient, they would probably have had the same difficulties. Try to remember that the criticism is not necessarily aimed at you personally end keep your focus on doing your job as well as you can. Patients hardly ever know your personal circumstances. When a patient uses foul language, it is probably because of their state of mind and not aimed directly at you.
Try to recognise anger in time, before it boils over
In many cases a patient’s anger is misplaced. Other health practitioners have perhaps upset them or they are just afraid and uncertain.
Even if you are trying to ask the patient questions, they are sometimes unwilling to cooperate. Take note of behavioural changes such as clenched fists, a frown or twisting of hands. Perhaps the patient is shy or uncomfortable about discussing certain things with you. Use your training to try to determine why the patient is upset, so that you can discuss it calmly and professionally. It is also useful to know how to change the subject of a discussion if you realise it could possibly end in conflict.
As a health practitioner you have a right to set boundaries when patients make unnecessary or unreasonable requests. Let them know when you will be visiting them and for how long and adhere to the time and duration. If at any time a patient abuses you either physically or verbally, remind them their behaviour is unacceptable and remove yourself from the situation.
Ask, listen and have a conversation
Try to imagine how you would react if you were ill, were feeling really not well, or were uncertain about the treatment you were to receive. You are probably getting to know the patient at a very bad time in their life, when it is easy to be angry.
Patients will more easily share their fears and feelings if you seem genuinely interested in them and listen to what they are saying. Call the patient by name, keep eye contact and speak calmly, even if the patient is shouting.
According to the Oxford manual for life-threatening health care, a study has found that patients are generally interrupted after an average of 23,1 seconds, before they have finished speaking. By asking questions, you will be able to better understand the patient’s fears, beliefs and expectations.
On the website advisory.com Richard Roberts, professor in family health care, says he watches for non-verbal signals for understanding a patient’s agenda better. “Do not judge in a hurry and rather give the patient the benefit of the doubt.”
Do not forget to listen attentively, it could enable you to make a better diagnosis.
Know your patient’s history
Some health conditions may cause behavioural disturbances. Head injuries or cognitive decline may also change people’s personalities. Withdrawal from drugs or alcohol can make patients aggressive, cause hallucinations and make them paranoid.
Study the patient’s mental and emotional history well, then you will be better prepared for aggressive behaviour as a result of their disease.
Be careful of your body language
Your posture, hand gestures and eye contact can facilitate positive communication with the patient. Make sure your body language is always professional.
Dr. Harlan Krumholz, a cardiologist, says keeping eye contact can make patients feel you care and this helps to build a deeper connection in order to help the healing process along.
Continue to speak professionally
Some patients know exactly how to irritate a health practitioner. But do try to adhere to professional language yourself. Avoid comments such as, “If only your would …” or “You should just …” Rather use phrases such as, “Let me see whether I understand you correctly,” which will take you a lot further.
Always put your physical safety first
When it looks as if a confrontation may become dangerous, call for help in time. It is better to have support sooner rather than later. You may absolutely depend on the security staff of the practice or the hospital; they are trained to deal with aggressive people.
An applicable apology can defuse the situation
Patricia Roy, a family doctor, says this on advisory.com: “If the patient is angry, I apologise, even when it is not my fault. If he has had to wait too long? Apologise. He hated the specialist I sent him to? Apologise. Not happy about test results or treatment? Apologise.”
She explains that patients are forgiving when they believe you are really sorry about what happened to them, regardless of how it happened. She emphasises, however, that it is equally important to solve problems as to apologise for them.
As a health practitioner, your personal emotional wellbeing is of the utmost importance. Various health practitioners absolutely believe that they also have to care for themselves at home. Whether with a long, hot bath; a visit with a favourite friend; a run around the block to clean out the cobwebs in your brain; or a funny film; self-care is essential.
See every misunderstanding as a learning experience
It is never pleasant to have to deal with upset, furious or difficult patients, but try to see these as learning experiences. Every time you deal with such a situation, you will know better how to handle something similar next time.
As time passes, you will get to know yourself really well and also know when to rather let a colleague handle a situation. The best plan of action is to put your own feelings aside and focus on giving the patient the best health care possible. And when you actually have to deal with a very difficult patient? Try standing still for a moment, breathe deeply, and then let it be like water off a duck’s back.