Getting to the root of the issue: how to deal with challenging patients

Grab a cuppa, it is time for Physiopedia Tea Time. Every month, the Physiopedia Team comes together in our virtual gathering spaces, cups of tea or our favourite beverages in hand, to connect, unwind, and share our experiences. Physiopedia Tea Time is not just a casual get-together; it is a cherished virtual tradition that allows us to strengthen our bonds as a team, foster effective communication and build a supportive community.

As a remote team, spread across various locations, we value activities that promote effective communication and team building. Even before the COVID-19 pandemic necessitated remote work, Physiopedia was successfully bridging geographical gaps to work cohesively towards our shared goals of providing free access to rehabilitation knowledge. This ability to excel as a far reaching team has been one of our unique successes and has allowed us to continuously support one another while working towards our common mission and vision

During our recent Tea Time, amidst the laughter and updates on each other’s lives, the conversation took a thoughtful turn towards the challenges we encounter when dealing with difficult patients. This open and honest discussion highlighted the importance of collaboration, empathy, and innovative approaches within our profession.

We often forget that people are referred to rehabilitation professionals when they are not at their best. They are navigating physical, mental or social limitations, changes to their daily routines, potentially disrupted sleep, medication and the effects of pain. Dealing with challenging patients can be demanding, but there are strategies you can employ to manage difficult situations effectively.  

Here are a few best-practices that we discussed in our tea-time to ensure we are being competent and mindful clinicians:  

Maintain a calm and composed demeanor: Remember that their behavior may stem from fear, frustration, or pain, and it’s important not to take it personally.

Active listening: Give the patient your undivided attention and actively listen to their concerns. Show empathy and understanding, which can help defuse tension and build rapport. Building trust is important for the patient and the effectiveness of the rehabilitation process. 

Practice effective communication: Use clear and concise language when explaining information or instructions to the patient. Avoid using medical jargon and speak in terms they can understand. Ensure that your body language and tone of voice convey respect and empathy. If language is a barrier, find creative ways to ensure your messages are understood. For example, the use of communication health widgits

Establish boundaries: Set clear boundaries regarding acceptable behavior from the outset. Let the patient know what behavior is expected in the healthcare setting. If the patient becomes agitated or aggressive, calmly remind them of the boundaries and the importance of maintaining a respectful environment.

Involve the patient in decision-making: Whenever possible, involve the patient in their care decisions. Empowering them and giving them a sense of control can help alleviate frustration or feelings of helplessness. A patient-centric care is important for empowerment. 

Identify and address underlying concerns: Try to identify the underlying reasons for the patient’s challenging behaviour. They may be experiencing pain, fear, or a lack of understanding. Address these concerns directly and provide appropriate support or education to alleviate their distress.

Seek support from colleagues: If you’re dealing with a particularly challenging patient, don’t hesitate to seek support from your colleagues or supervisors. Discussing the situation with others can provide valuable insights, advice, and emotional support.

Maintain professionalism and boundaries: It’s important to maintain professional boundaries at all times. Avoid getting drawn into personal arguments or engaging in confrontations. Focus on the patient’s well-being and prioritise their care.

Practice self-care: Dealing with challenging patients can be emotionally draining for the clinician. Take care of your own well-being by practicing self-care techniques such as engaging in hobbies, exercising, seeking support from loved ones, and seeking professional counseling if necessary.

Document incidents: In cases where a patient’s behavior becomes consistently difficult or disruptive, it’s essential to document the incidents accurately. Maintain detailed records of any incidents, including dates, times, and specific behaviors. This information can be useful for future reference or if further actions need to be taken. Your safety is just as important as the safety of your patients. 

When working with challenging patients, trying to get to the root of the problem as to why people are behaving a certain way is key.  Some might be personality-driven, other reasons could be fear, shame, pain, a feeling of judgment, or not being accepted. At the end of the day,  we do not know what is happening in their lives. Showing empathy and taking time to understand a person’s perspective are important, and not only for our patients but also with each other, a value that we encourage through our tea-time discussions. 

For further reading, check out the resources on top tips to deal with challenging situations and tips for asking and responding to difficult questions during a challenging clinical encounter.