Ten things to understand about dealing with difficult patients during med school

December 8, 2014

Article by Global Pre-Meds
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Students learning from their mentor at Rajavej Hospital in Chiang Mai During medical school, one of the most important aspects of your training is clinical rotations. During rotations, you will have the opportunity to provide direct patient care including assessments, examinations and prescribing treatment. In addition, treating patients allows you the chance to learn how to deal with a variety of patient situations.

In many instances, patients will be polite and comply with recommendations. But in some cases, patients will be less than cooperative. Patients can be a challenge to deal with for a variety of reasons.



What constitutes a difficult patient?

In an ideal world, all patients you meet would thank you, be polite and smile. But that is not always the situation. Patients can be difficult in different ways. For example, you may encounter patients who are angry over their situation or the care they are receiving. Patients who are angry may yell, curse and sometimes even become violent.

Patients who are demanding and never satisfied with the care they receive can also be hard to deal with. Other types of difficult patients include those who are defensive, combative and non-compliant.

There are several reasons why patients can lose their cool. For instance, some patients may have a psychiatric condition, which leads to issues with behavior. Other patients may feel their concerns are not being heard, and they become upset over their care.

Although the cause may be different, at some point in your medical school training, dealing with difficult patients will be part of your job. Learning ways to handle the challenge is important for med students. 


Factors to consider when dealing with difficult patients

 It’s not personal

There may be times when patients are rude or even hostile. If a patient is insulting or combative, it can be hard to not take it personally. But it is essential to remember, patients don’t know you personally. Even if a patient is using bad language and being difficult, it is most likely due to their circumstance.

Certain conditions may cause mood disturbances

In some cases, patients may become aggressive or belligerent due to their medical condition. For example, a patient going through withdrawals from drugs or alcohol may have hallucinations or become paranoid, which can lead to combative behavior. Dementia, head injuries and some psychiatric disabilities can also cause a patient to be difficult to deal with. Knowing a patient’s history before seeing them will give you a heads up on the situation and allow you to be better prepared.   

Compassion can go a long way

As a medical student, you may be focused on learning the science behind medicine and how to perform various types of medical procedures. But try to remember the human aspect of medicine. Being compassionate and caring is an important part of being a doctor and it is a lesson you should learn in med school. Sometimes, you can defuse a difficult situation by showing a patient a little kindness and compassion. 

Patients deserve a little slack

Imagine not feeling well and having to undergo various medical procedures, some of which are uncomfortable. When you come across difficult patients during your career try to remember, you may be dealing with patients during the worst time of their life. It is easy to lose your temper or be irritable and take it out on someone else when you are feeling ill. Cutting patients a little slack when they are not behaving their best may be a good way to handle the situation.

Being judgmental never helps

Sometimes you will have patients who are uncooperative or hostile. They may also be in a situation due to their own choices. For instance, you may take care of patients who are addicted to drugs or noncompliant with their treatment. Put your personal feelings aside and continue to provide the best care you can. If a patient feels you are judgmental, it will only make things worse.

Recognize signs of anger before the situation gets out of control

When you start your clinical rotations, you will eventually have to deal with anger from a patient. It is important to understand, anger is often misplaced. A patient may be upset with other things, but directs their frustration at staff including med students. It may be possible to defuse the situation by remaining calm and talking with the patient. Watch for signs of anger, such as clenched fists, wringing of the hands and a furrowed brow.

Keep your personal safety in mind

Occasionally, patients can become physically aggressive. If you get a sense things are going to get physical, call in reinforcements. Dealing with a combative patient on your own is not a good idea. Hospitals have security for a reason. Security staff are trained to deal with aggressive patients. Not only will enlisting help reduce your chances of getting hurt, it can also prevent the patient from hurting themselves.

Difficult patients can teach you a few things

Sometimes the most challenging situations teach you the most. Although it is not pleasant to deal with a patient who is unhappy, rude or angry, try to look at it as a learning experience. Each encounter will prepare you to handle things in the future.

Use statements that convey understanding

When patients are frustrated and upset, it can ease the situation if they feel they are being heard. Ask what the problem is and listen to their concerns. Using a statement, such as “your frustration is understandable,” can be helpful. Remember a calm, reassuring tone can sometimes defuse the problem.

Don’t get drawn into conflict

It can be easy to lose your cool when a patient is yelling at you, especially if you feel it is unfair. But engaging in conflict with a patient is a bad idea for a lot of reasons. As a med student, you are supposed to be learning how to handle tense situations. Getting into a shouting match with a patient is unprofessional.