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Handling the Angry Patient
No matter what field you work in, these tips will help you keep
your cool when patients take their frustrations out on you.
Even patients who are normally calm may quickly reach the
boiling point when illness threatenstheir health, mobility, and
independence. Pain and fear can lead to increased stress, anxiety,
andfrustration, which can result in anger and even loss of control.
But do you know how to spot your
patient's anger early and defuse it
!or guidance, read on. "hese tips will help you get control of
the situation and hopefully reducethe likelihood of legal action
down the road.
Look for the signs
"here are signs that indicate a patient's emotional state is
deteriorating. #ook for changes in bodylanguage, including a
tightened $aw, tense posture, clenched fists, fidgeting, and any
othersignificant change from earlier behavior. % talkative person,
for example, may suddenly becomequiet.
&bserve the patient for additional signs that his temper is
rising. s his voice raised s hedemanding excessive attention
f you detect any of these warning signs, you'll need to act fast
to help the patient vent his
feelings in a productive manner. (tart by spending extra time
with the patient. %lthough youmight be tempted to spend less time
with him, doing so only increases your risk of liability.gnoring
his complaints or, say, rushing him may prove detrimental to his
care. %nd if somethinggoes wrong, dissatisfied patients are more
likely to sue.
f, for instance, you work in a healthcare facility, take time to
ensure that he is thoroughlyfamiliar with his plan of care and the
rationale behind it. )eview the care he's received so far, the
progress he's made, and how long his recovery should take.
Show empathy
(ome patients won't be soothed by your extra attention and may
become belligerent, demandingto know such things as, *+hy can't you
start my therapy now * *+hy isn't my treatmentworking * or *+hy
aren't my medications ready yet * our calm approach in answering
suchobviously loaded questions can prevent anger from turning into
a behavioral crisis.
)ather than becoming defensive, you'd be wise to respond calmly
to the patient and treat himwith respect.
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f a patient is uncooperative, try to identify the underlying
reason. % patient who balks, forexample, when a P" suggests
replacing one exercise for low back pain with another may
actually
be anxious about an upcoming procedure or the results of tests.
%fter you hear him out, reassurehim that you take his concerns
seriously. Empathi-e with him, saying something like, *understand
how upsetting this must be for you.*
Be sure, however, to calmly explain the consequences of his
refusal. n this example, the P"would need to elaborate on the
reason for the new exercise and explain that the
patient'sunwillingness to cooperate will delay his recovery.
f, on the other hand, the problem is an administrative one such
as having to wait too long to seea healthcare provider speak to the
appropriate person about scheduling a time that's less likely
toinvolve a wait.
Keep your cool
f a patient is angry enough to verbally abuse you, remain calm
and professional. /eep somedistance between you and the patient and
do not respond until the verbal barrage is over. +hen itis, speak
softly and call the patient by name. !or instance, an E0"
confronted by a patientscreaming that he doesn't want to be touched
should listen quietly until the patient is done. 1ecan then try to
soothe the patient, saying something like, * know you're scared,
0r. (mith, but
$ust want to take your blood pressure and make sure you're
okay.* "hat approach may calm the patient enough to allow for a
more thorough examination.
(hould a patient become irrational, he's likely to try to
intimidate you. 1e may say things like,* 'm calling my lawyer* or *
'm going to sue.*
"rying to $ustify the situation or defend your actions will only
make things worse. 2se activelistening instead3 Paraphrase back to
the patient what he's already told you, while at the sametime
identifying the real feelings behind the words fear or
helplessness, for instance. /eep yourstatements short and simple.
4ontinue to treat the person with respect and show accepting
bodylanguage by letting your arms hang loosely at your sides rather
than standing with your hands onyour hips or with your arms
crossed.
f the patient *blows up,* he has lost control and is so
irrational he will no longer hear what yousay. %s in dealing with a
child's temper tantrum, your reaction may determine exactly how
longthe fireworks last.
/eep your cool and don't be manipulated by the patient's anger.
5ever get angry yourself or tryto set limits by saying, *4alm down*
or *(top yelling.* %s the fireworks explode, maintain eyecontact
with the patient and $ust listen. "ry to understand the event that
triggered the angryoutburst.
+hen the person has quieted down, acknowledge his feelings,
matching your words to his levelof anger. Express regret about the
situation, and let the person know you understand. "ry to findsome
point of agreement, perhaps acknowledging that his complaint is a
valid one.
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%sk for the patient's solution to the problem. 2se phrases like,
*4an you tell me what you need *or *6o you have some suggestions on
ways to solve this problem * End the conversation bytrying to reach
an acceptable arrangement. &ffer options by saying, *1ere's how
we could handlethis.*
f the patient threatens you physically or you fear for your
safety, don't hesitate to contactsecurity or the police. !or more
immediate assistance, consider establishing a code phrase
thatindicates when a staffer needs help.
)egardless of the extent of the patient's anger, documenting
complaints as well as attempts toresolve them and the results of
each intervention can ward off frivolous claims or help in
yourdefense if a lawsuit proceeds to trial. f applicable to your
line of work, note administrativecomplaints in an incident report.
6ocument clinical complaints in the patient's chart.
6ealing with difficult patients will always be a challenge. But
your finesse in defusing andmanaging anger will keep the focus on
getting the patient healthy and protect you from
unwarranted legal action.
