This one is for all my professional friends, including cardiologists, vascular surgeons, interventional radiologists as well as their premier staffs of nurses and technologist. Dealing with the clinical issue is only a part of what you do.
I’ve heard horror stories and witnessed difficult or challenging patients back when I “carried the bag” as a device rep. These encounters can range from the hostile verbal assaults from angry or dissatisfied individuals to the long, exhausting encounters with emotionally needy patients. While some of us are more gifted at interpersonal communication than others, we can all benefit from the following tips.
Tip #1 Model Calmness
Remember that frustration provokes anger, while calmness breeds conciliation. In her book, Success Under Stress; Powerful Tools for Staying Calm, Confident and Productive When the Pressure’s On, Sharon Melnick, Ph.D., advises that if you can learn to be calm when dealing with someone who makes you seethe with anger or frustration, you will, in turn, learn the magic ability to calm the other person. She describes a cycle of frustration that must be broken to reach a successful outcome. So take some very deep breaths, count to ten, find your Zen, whatever it takes for you to remain calm. Not only does this act preserve your dignity but it also models behavior that the patient will pick up on and mimic.
Tip #2 Identify the Base Issue
Cut through the static and immediately get to the root of their problem. Some patients become difficult to deal with if they are feeling emotionally needy. The root cause of this neediness can stem from the fear that they are not being heard or understood. Whether the issue is with billing, personnel, or general dissatisfaction, much anger and frustration can be diffused by the act of identifying the complaint, validating the cause for their concern and assuring them that it is being taken seriously.
Tip #3 Use Humor Carefully
For some, humor is the go-to reaction when faced with a stressful situation. There are times when this strategy works wonders because it is often unexpected. However, in the case of a difficult patient, misplaced humor can be the fuel to a smoldering fire. In the article, Defusing Difficult Situations: The Unexpected Response, Dr. Michael H. Smith describes the use of humor in these scenarios as a high risk/ high gain proposition. When used effectively, an unexpected response can disarm the aggressor and shift the power dynamic. Perhaps this should be used only when you know the patient’s character to be typically pleasant.
Tip #4 Don’t be Afraid to Apologize
Another trait some develop in the healthcare industry is to approach situations from a risk management standpoint, which often puts them in a defensive posture. We are often coached not to admit when a mistake is made. However, there is a benefit to offering a brief apology, if only to acknowledge the patient’s feelings. Even if the effect was unintentional, the apology should not be framed to avoid responsibility. For example, don’t say “I’m sorry your feelings were hurt by this situation,” instead take ownership and say, “I’m sorry that I hurt your feelings.”
Tip #5 Don’t Take it Personally
Many external factors can lead a patient to behave in a difficult manner, likely you have nothing to do with any of them. By eliminating personal feelings from the conversation, you can approach the situation with genuine empathy that will translate positively in your communication.
Tip #6 Set Boundaries
In all healthy relationships, there exist boundaries. The patient-staff relationship is no exception. If a patient’s behavior becomes abusive, communication should halt. By accepting the behavior, you enable the patient to continue an unhealthy response. This also applies to patients who have become overly needy. Your time is a resource that must be used efficiently and productively. To avoid being pulled into a lengthy debate or exhausting conversation, you must establish these boundaries early. Be polite but firm when explaining your time constraints. If more time is needed, offer to schedule time for a more thorough discussion — and follow through.
Tip #7 Follow up any “Encounter” With Written Communication
As medical professionals, we are accustomed to documenting our interactions. In dealing with a difficult patient, it becomes important not only from a risk management standpoint but also to reinforce the outcome. When emotions are high, it is not uncommon for patients to forget or misremember important points. If resolutions were reached during a conversation that occurred in person or over the phone, make certain to follow up with written communication.