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.