Difficult Patients Flashcards
What effects do difficult patients and family members have on clinicians?
- frustration
- decreased work satisfaction
- make it difficult to provide pt-centered care
- poor communication
T/F: Difficult patients are always difficult due to situational circumstances.
F: difficulty can be a chronic attribute of a patient.
What are two examples of how pt’s are seen as difficult, when they are really not being difficult at all.
- counter-transference
2. provider intolerance to some behaviors (smoking, weight gain, lifestyle choices)
What are ways clinicians can decrease counter-transference, biases, and stereotypes?
- increasing self-awareness
- monitoring their reactions
- increasing self-knowledge of beliefs, biases, and stereotypes
What situational circumstances can result in difficult patient interactions?
- long wait times
- crowded waiting room with sick ppl
- time taken out of pt day to come to hospital
What patient attributes/events can result in them coming off as being difficult to work with?
Emotions: fear, insecurity, anxiety, stress; difficult personality; receiving bad news
How should you approach difficult patients?
Empathetically.
What is the general strategy for approaching difficult patients?
- try to think outside the box as to why they are upset or having problems
- respond to pt emotions
- ask what the problem is, why it is a problem
- avoid getting defensive
- try to establish common goal for the visit
Dr. Drummond created the “Universal Upset Person Protocol” (UUPP); what are the phrases he suggests be used to approach up set patients? Hint: 6
- recognize emotion (“you look upset”)
- Tell me about it
- I’m sorry that happened to you/that you feel that way
- What would you like me to do next to help you?
- Here’s what I suggest we do next….
- Thank you for telling me how you are really feeling.
What is anger?
A secondary emotion; based on fear, stress, threat, etc.
T/F: people may have reduced cognitions when they are angry.
T.
How can you use education to help connect with an angry patient?
inform them that it is okay to be angry and important to express their feelings
How can you enlist your angry patient?
Ask them how to improve the situation and apologize if appropriate.
T/F: it is important to solve an angry person’s problems.
F
T/F it is appropriate to defend yourself and others to an angry patient.
F
What are possible cognitions of silent patients?
That they have something to say and are to shy or unsure of how to express themselves.
How can you use education to connect with silent patients?
educate them on the collaborative care model and inform them that you need their input
What is the common emotion underneath demanding patients demeanor?
Fear; fear that their condition is serious or worse than you think it is
What are the cognitions of a demanding patient?
I know what I need.
You seem pretty convinced that you need a beta-blocker. Can you tell me why? Is a good example of engaging with a ____ patient.
demanding
How should you educate your demanding patients?
Explain the chosen Tx AFTER validating their feelings
How do you validate/empathize with an angry or demanding patient?
Explain that what they are feeling is a normal response to fear or stress.
How do you engage a “yes but patient”
acknowledge you are frustrated and try to elicit what the patient thinks the problem is from their perspective
“I am frustrated with how things are going. Let’s start again and see if what I see as a problem is really a problem for you.” is an example of engaging a _____ patient.
Yes-But
What is the best way to enlist a “yes-but” patient?
Specific contracts about behavior; one they help to develop.
