STNA Training Information » communication

How to Deal with a Difficult Patient

admin — Mon, 08 Feb 2010 03:24:11 +0000

They complain, shout, swear and may even try to hit you – despite your good intentions, difficult patients can be an unfortunate fact of life in healthcare.

It’s often impossible to predict which patients will likely become difficult, abusive or violent. While some patients are prone to violent behavior because of their disease state, the best thing you can do is to watch for certain emotions. Isolation and fear can lead to anger, which can escalate into violence. Many patients also feel let down by their failing bodies, while others experience spiritual betrayal, asking why God let this happen to them.

Regardless of the circumstances, here are some things you can do when faced with a difficult patient.

Notice a patient’s words, voice or attitude to pick up on rising anger levels. Overly compliant behavior is also a warning sign that a patient has lost his identity and sense of competence, which can lead to vulnerability, fear, anger and violence.

Uncover and directly address a patient’s underlying feelings with comments. Saying, “You sound worried. What can we do to help?” will go a long way toward establishing a personal connection and cooperation.
Show respect. Make eye contact, and try to approach patients at eye level. Always address patients as Mr. or Mrs., and speak in a friendly manner.
Rushing can be counterproductive, especially when caring for those with dementia.
Enlist relatives to help break the isolation, create solutions and provide support.
Know your employer’s patient bill of rights, as well as its policies and procedures for dealing with difficult patients.
Do not tolerate disruptive behavior. Clearly explain what is unacceptable to avoid problems later.
Don’t take it personally.

Barriers to Communication

admin — Mon, 23 Nov 2009 04:28:46 +0000

One of the most important, and most challenging, aspects of your career as a nursing assistant will be communication. Unfortunately, communication with your residents can be blocked in several ways.

Resident does not hear you, does not hear correctly, or does not understand. The best thing you can do in this situation is to face the resident directly and speak at a slower pace. Speak clearly and do not mumble.

Resident is difficult to understand. Be patient and take the time to listen to what the resident is saying. Politely ask your resident to repeat or explain. Restate the message in your own words to ensure that you heard correctly.

Message contains words that the receiver does not understand. Do not use medical jargon with residents. Use simple and clear language that can easily be understood.

Do not use slang words and do not curse. Slang can confuse the message and is not always easily understood, plus it is considered unprofessional. Do not curse or use profanity, even if the resident does.

Avoid cliches. These are overused words and phrases that doesn’t actually have meaning. Instead, listen to what is actually being said and respond with a meaningful message.

Giving advice is inappropriate. Giving advice or opinions is outside of your realm of expertise as a nursing assistant, is inappropriate, and can be dangerous.

Asking “why” makes residents feel defensive.

Asking yes/no questions are conversation killers. Rather than asking a resident if they slept well, try asking, “how did you sleep last night?”

Get to know your residents and respect what they want/don’t want to talk about.

Culture can also affect conversation. These are learned behaviors that are influenced by outside sources, such as a person’s background, values, and language.