Difficult Patients Flashcards

1
Q

What effects do difficult patients and family members have on clinicians?

A
  1. frustration
  2. decreased work satisfaction
  3. make it difficult to provide pt-centered care
  4. poor communication
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2
Q

T/F: Difficult patients are always difficult due to situational circumstances.

A

F: difficulty can be a chronic attribute of a patient.

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3
Q

What are two examples of how pt’s are seen as difficult, when they are really not being difficult at all.

A
  1. counter-transference

2. provider intolerance to some behaviors (smoking, weight gain, lifestyle choices)

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4
Q

What are ways clinicians can decrease counter-transference, biases, and stereotypes?

A
  1. increasing self-awareness
  2. monitoring their reactions
  3. increasing self-knowledge of beliefs, biases, and stereotypes
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5
Q

What situational circumstances can result in difficult patient interactions?

A
  1. long wait times
  2. crowded waiting room with sick ppl
  3. time taken out of pt day to come to hospital
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6
Q

What patient attributes/events can result in them coming off as being difficult to work with?

A

Emotions: fear, insecurity, anxiety, stress; difficult personality; receiving bad news

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7
Q

How should you approach difficult patients?

A

Empathetically.

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8
Q

What is the general strategy for approaching difficult patients?

A
  1. try to think outside the box as to why they are upset or having problems
  2. respond to pt emotions
  3. ask what the problem is, why it is a problem
  4. avoid getting defensive
  5. try to establish common goal for the visit
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9
Q

Dr. Drummond created the “Universal Upset Person Protocol” (UUPP); what are the phrases he suggests be used to approach up set patients? Hint: 6

A
  1. recognize emotion (“you look upset”)
  2. Tell me about it
  3. I’m sorry that happened to you/that you feel that way
  4. What would you like me to do next to help you?
  5. Here’s what I suggest we do next….
  6. Thank you for telling me how you are really feeling.
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10
Q

What is anger?

A

A secondary emotion; based on fear, stress, threat, etc.

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11
Q

T/F: people may have reduced cognitions when they are angry.

A

T.

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12
Q

How can you use education to help connect with an angry patient?

A

inform them that it is okay to be angry and important to express their feelings

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13
Q

How can you enlist your angry patient?

A

Ask them how to improve the situation and apologize if appropriate.

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14
Q

T/F: it is important to solve an angry person’s problems.

A

F

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15
Q

T/F it is appropriate to defend yourself and others to an angry patient.

A

F

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16
Q

What are possible cognitions of silent patients?

A

That they have something to say and are to shy or unsure of how to express themselves.

17
Q

How can you use education to connect with silent patients?

A

educate them on the collaborative care model and inform them that you need their input

18
Q

What is the common emotion underneath demanding patients demeanor?

A

Fear; fear that their condition is serious or worse than you think it is

19
Q

What are the cognitions of a demanding patient?

A

I know what I need.

20
Q

You seem pretty convinced that you need a beta-blocker. Can you tell me why? Is a good example of engaging with a ____ patient.

A

demanding

21
Q

How should you educate your demanding patients?

A

Explain the chosen Tx AFTER validating their feelings

22
Q

How do you validate/empathize with an angry or demanding patient?

A

Explain that what they are feeling is a normal response to fear or stress.

23
Q

How do you engage a “yes but patient”

A

acknowledge you are frustrated and try to elicit what the patient thinks the problem is from their perspective

24
Q

“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.

A

Yes-But

25
Q

What is the best way to enlist a “yes-but” patient?

A

Specific contracts about behavior; one they help to develop.