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Coping with different kinds of patients

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Dealing with challenging patients can be stressful and upsetting. But there are ways that you can make life easier for everyone

The angry patient

Some people find it hard to admit when they’re feeling frightened or vulnerable. Some find it easier to express fear as anger, by shouting or calling people names. Expressing anger may help to make a patient who is feeling vulnerable to feel more in control of their situation.

Think about:

  • How is the patient really feeling?
  • What does their body language say to you? Does it give the same message as their words?
  • How would you feel if you were in their situation?

How to act:

  • Apologise for your patient feeling upset, even if you think you’ve done nothing wrong. Making a genuine attempt to acknowledge hurt by saying something like ‘I’m sorry you feel like that,’ can go a long way
  • Remain polite and try not to lose your own temper
  • Don’t ignore the anger but try to be clear about its source. Ask questions. You could say something like ‘It sounds like you’re pretty upset, do you want to tell me more about what’s happened?’ Listening to your patient will help them to feel more in control of their own care
  • Don’t take it personally, they’re not angry with you, they’re angry with their situation
  • If possible, take action and let the patient know that you’re going to do so, and let them know the outcome too
  • If it’s too much, ask for help. Speak to your mentor and check with them what they think is the best thing to do
  • It might help to come to a compromise, think about meeting each other half way, “I’ll do this bit my way and this bit your way” or take turns, “I’ll do it my way this time, and your way next time”

The demanding patient

You will encounter patients who will demand a lot of your time; asking questions, asking for specific items and generally insisting on taking a lot of your attention.

Think about:

  • Does your patient seem frightened? Are they really asking for reassurance?
  • What is your patient’s state of mind like at the moment?
  • What is your patient’s day-to-day life usually like?

How to act:

  • The Nursing and Midwifery Council code of conduct say that you should always seek to offer information to your patients in a clear way so that they can understand and make choices and decisions about their care. Some patients may need you to spend more time with them explaining about their care than others, this may help to lessen the amount of reassurance and attention that they need from you later on
  • Remember that all patients have the right to decline treatment. If this happens ask your supervisor for help
  • If you believe your patient is feeling scared and isolated, is there any way that you could make their surrounding feel more familiar and comfortable? Could you suggest to their relatives that they bring in familiar objects from home like photographs or ornaments?

The patronising patient

It’s not uncommon for nurses to sometimes feel patronised by their patients.

Think about:

  • Does he/she mean to cause offence?
  • Is it worth engaging with?

How to act:

  • Remember, you’re the one that’s the professional in this relationship so try not to lose your cool.
  • Sometimes it’s better not to engage and brush off words that you may find patronising when at work. You can always go home and scream into your pillow to let off steam.
  • If someone questions your treatment be clear about your role as a student nurse and that you’re not yet qualified, acknowledge that it is their right to see a registered nurse if they so wish
  • 4 Comments

Readers' comments (4)

  • Adam Roxby

    Empathy and understanding are important skills for a student and it's rarely the subject of lectures and textbooks.

    I would be interested to hear other peoples experiences or suggestions though.

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  • Very helpful information.

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  • Some patient's can swear or be aggressive but it is always important to introduce yourself to the patient. It may take time for the patient to feel comfortable. I always explain what I plan to do and try to promote the patient's independence when I can.

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  • I feel the demanding patients, it is really difficult to not lose your cool. You will get a little angry and lose almost the kind compassionate side of your nursing. You will obviously remain proferssional and be polite, but we are humans too, we will feel our emotions. Being in placement, I rarely see compassionate nurses that take they time sitting down with patients, holding their hands and providing that one-to one therapeutic relationship. University teaches you about providing compassionate care, but when your at placement, it is more like de-compassionate but professional type of care. Nurses are very busy dealing with demanding patient's relatives especially now the opening visiting hours policy that has been introduced in most Birmingham hospitals. What can we do?

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