Three Steps for Handling Difficult Patients

When my little sister was training to be an RN, she came up one day and said, "I need to practice my injections on you."

"What?" I said. "You mean like with a needle?"

"Of course with a needle. I've been working on an orange for days, and I need skin now."

To prove her point, she pulled out a huge, perforated orange and a sticky needle.

"Get away from me!"

"Don’t tell me you're scared?" she said. "Just stand still."

I bolted for my room and locked the door.

"Wow, real nice. I'm going to remember this!" She yelled. "When I'm your nurse, you’ll be sorry."

My sister became a great RN. She just laughs off the injections and says the challenge isn't the medicine, but finding the right words to calm agitated patients and their families.

Healthcare Hostility

Healthcare personnel are constantly bombarded with a wide range of complaints. Here are just a few examples—and I'm guilty of hurtling a couple of these myself:

  • My appointment was an hour ago, why am I still waiting?
  • I'm giving you this information again? Don't you have computers? 
  • I want a different doctor.
  • I've been researching this online. I want the test I read about.
  • You're going to do what?!

Words and Signals

The answers to these complaints may vary, but the signals that accompany the answers shouldn't. The correct signals can mean the difference between a happy and a furious patient.

In the video The Right Words at the Right Time... Customer Service Recovery for Healthcare they demonstrate three simple signals that health care professionals should consider when handling upset patients.

  1. I care. Start off with an apology. "I'm sorry you're having problems with XX." go a long ways and demonstrate you care about the patient's issue. And, of course, make sure that your tone matches the words. "I'm sorry" while rolling your eyes sends the opposite message.
  2. I understand. First, be quiet and listen to their needs, then follow up with "I understand you want to XX." Patients need to know they have been not only been heard, but understood.
  3. You can trust me to take are of this. There may not be an immediate solution to the patient's problem, but the patient needs to know you're willing to take action on their behalf. For example, the statement "Would you be willing to let me XX for you?" not only gives the patient some choice, but also lets them know you're on their side.

These three steps seem simple, but if you're in the health care profession you know it takes practice to choose the right words. Patients can be irrational and can freak out. But we're just looking for answers.

Recently I asked my sister, "What do you do with patients that don't want shots?"

She just smiles. "People love to get shots from me. Stand still."


Diane Mettler has been a manager for nearly 20 years. She's also a freelance writer and editor—with hundreds of her articles published in a variety of magazines—and teaches writing at the University of Washington.