When a patient is reaching the boiling point, it is important that you recognize the signs early and attempt to defuse the situation. When you sense that a patient is becoming agitated, here’s how you can help them to regain their cool:
1. Invest some time
Sometimes a patient’s anger is really a cry for help or attention. Although being around a riled-up patient is no fun, avoid the temptation to steer clear. Because perceived neglect could increase your risk of liability in the event that something goes wrong, you should spend even more time than normal going over the plan of care with the patient and discussing prognosis and progress.
2. Dial up the empathy
When patients become belligerent, it can be hard to stay calm. Tapping into your empathy and trying to understand what your patient may be feeling may help you to tailor a response that addresses the root of your patient’s anxiety. Patients can sometimes overreact to minor things (ie, a short wait in a provider’s office) when they are really feeling anxious about something else (ie, receiving the results of a recent test), so you should try to figure out what is really causing the patient’s outburst. In any case, it is important to acknowledge the patient’s feelings and indicate that you understand their concerns.
3. Keep your cool
Resist the urge to become defensive, raise your voice, or speak over the patient. Avoid trying to defend yourself against threats and intimidation, such as “I’m going to sue.” Speaking softly, allowing your patient to finish, and continuing to treat the patient with respect usually takes the wind out of his or her sails pretty quickly.
4. Mind your body language
Even if your words are soothing and calm, your body language can give you away if you are feeling irritated or defensive. Crossing your arms, standing with your hands on your hips, or clenching your fists/jaw can signal to the patient that you are angry, too, even if your words suggest otherwise. Avoid fueling the fire by standing with your arms hanging loosely at your sides.
5. Physically protect yourself
Most patients stop at a verbal barrage, but it is not outside the realm of possibility that an irrational patient could put you in physical danger. Put some distance between yourself and the patient. If possible, position yourself close to the door in case you need to exit the room quickly. If you feel physically threatened, do not hesitate to call for help from other staff members, security, or the police.
6. Legally protect yourself
Whether your patient is a little angry—or a lot angry—you should meticulously document clinical AND administrative complaints, your interaction with the patient, and your attempts to resolve the problem. Avoid trying to justify the situation, “over-sharing,” or defending your actions, as your patient may attempt to use your words against you later. Keep your statements respectful, brief, and clear. If you are especially concerned about potential legal action, it may not hurt to debrief with your attorney and ask him or her to review your documentation to ensure that it is sufficient.
7. Try to end the conversation on a positive note
Most angry patients will eventually lose steam, but a persistent few could carry on for hours if you let them. Try to bring the conversation to a close by asking what the patient needs from you, or how the patient thinks the problem could be solved. You might want to suggest options for what could be done to resolve the patient’s complaint. Don’t forget to summarize the next steps you will take so the patient knows you are serious about addressing his or her concern.
Although anger is high on the list of unpleasant emotions to deal with, it can usually be defused and managed with a bit of finesse, preparation, and experience.