Working with Uncooperative Patients

Working with Uncooperative Patients On those rare occasions, you know within the first few minutes of meeting a new patient, this is not going to be good. The bad thing is that initial impression is probably right, you are in for a long day, and since you are the professional you are, you simply smile and keep going as usual.

The following is a retelling from Susan, a retired nurse.

My Patient I once had a patient named Barbara. She was an older lady, and to see her at first glance you want to smile and assume she must be a nice woman.

However, as you get closer, you will change your mind, trust me. When I first met Barbara, she said to me, “come over here, dear, I want to tell you something.”

As I got very close to her, she spat in my face. Trying to do her intake, I got answers like, “Well, what you think?”, and next of kin as Mickey Mouse, and so on. As the days passed, and Barbara's knee began to heal, I started to look forward to seeing what she would come up with each day. On rare occasions Barbara would be very nice, asking how I was, etc., and then she would follow it up by calling me a variety of not-nice names, some I'd never even heard of and won’t recount here.

Related: A Day in the Life of a Nurse As the days passed, I got accustomed to Barbara and what she might deliver that day: a plate of food thrown, or just some very colorful language. Then one day I went to work, and Barbara's room was empty. She had passed during her sleep. During the evening hours, her breathing labored, and she made it clear to her doctor, that she had a DNR in place. The night nurse came to me prior to leaving for the day and said Barbara had left a message for me. It read, “I'm getting weaker every day, soon I will be gone and I know you are going to miss me. We’ve been through a lot you and I, and I really like the fact I never made you lose your temper back at me. Oh well, I love you girly, now get back to work!”

We never really know what our patients were like prior to their injury or illness. Pain, fear, and facing the end of life can alter a person's demeanor tremendously. It's a good thing to keep in mind when a patient is uncooperative. It may be a reaction to their fear, pain, or a number of factors, such as concern for family members.

Tips for Getting Cooperation  Being understanding- let the patient know that you understand they may have pain, or are worried, not knowing what happens next.  Relate- this is the biggest thing you can do with a patient, simply letting them know that you can relate to the concerns for family members, and for their own health. Most people appreciate knowing that someone relates to their feelings.  Be patient- if you need to cut the time with the patient short, do so, they may just need time alone. Always maintain composure, the person in the bed is not trying to upset you, they are reacting to their own discomfort.  Ask for assistance from a coworker when needed, sometimes two people can just accomplish more with a patient than one.  Determine a common interest or topic; this may lighten the mood and the patient's attitude. Ask what they do in their spare time, if they have pets, etc. anything that demonstrates that common bond.

Related: Working with a Demanding Patient Safety When working with an uncooperative patient, it's important to keep your own safety in mind. If you are dealing with an 85 year old female patient, your physical safety is probably not in jeopardy. However, if your patient is a 30 year old, you could get hurt in the event they become physical. Always wait for assistance when you have concerns for your safety or the safety of the patient.

Hospitals are geared toward patient satisfaction, and making sure patients are more comfortable than ever before. Many facilities have adopted a patient centered plan that makes the whole medical experience easier and more productive for the patient. Today medical centers compete for business, which is something that did not happen 20 years ago, it's a relatively new concept. It is a team effort to ensure patient satisfaction, which may include working with an unhappy patient, and not getting frustrated, or at least not letting it show.

Many people view nurses as saints, and there may be some truth to that, but some patients can push the kindest heart to its breaking point. On a positive note, 9 out of 10 patients are cooperative and follow medical advice and instructions. Your professionalism and understanding will go a long way in gaining cooperation from even the unhappy patient.

Related: Skilled Nursing Assistant and Future Nurse in Maine, Sierra M. Savage, CNA, is to Be Published in the Worldwide Leaders in Healthcare Please follow us on Facebook, Linkedin, Pinterest and Twitter