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How to build rapport with a patient who appears to not be your biggest fan

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We’ve all been there: experienced one particularly gruelling shift with one particularly testing patient. But this time, Emily turned it into a learning experience

The other day, not working in the guise of a student nurse but as a bank healthcare worker, I cared for a patient who was intent on pushing my buttons.

Every healthcare professional has their own individual approach to ‘dealing’ with unruly service users. I myself have seen some very effective, professional techniques used when attempting to get a patient on side, yet unfortunately, I’ve also witnessed some very counterproductive responses.

Following the encounter with my difficult patient yesterday, I feel that I have finally landed on my own personalised tactic to diffusing tense relations. It is a tactic which can be widely used by most student nurses, most healthcare professionals in fact: it is the simple recognition that “I am annoying you”.

It is the simple recognition that “I am annoying you”

I pride myself on being a fairly patient, understanding person. I never snap at patients and on the rare occasion that I do, I apologise profusely for losing my professional ‘cool’.

Even when patients spit frankly rude, sometimes quite hurtful comments at me, I ignore them, smile sweetly and attempt to be extra brilliant. Extra nice, extra helpful, extra polite- hoping the patient will recognise that I am not a threat, I am doing nothing but trying to help. However on occasions this approach proves unsuccessful and a more direct approach is needed.

The patient I was looking after was in pain and discomfort, however, I felt that this didn’t completely allow for the unjust way he was addressing me. This is exactly what I told him quite firmly upon our confrontation.

“He confirmed the idea that has been niggling at the back of my head since I started my nurse training”

It struck a chord, and some time after, we had a discussion about how we had set off on the wrong foot. And then he said it; he confirmed the idea that has been niggling at the back of my head since I started my nurse training. He said that he felt that I was taking control from him.

I could have said “no, of course I wasn’t!” After all, I had consistently gained his consent for every task I had completed, I had rigorously asked his permission for every procedure undertaken.

But I took a step back, tried to look at the situation from his point of view and realised, yes, ‘I am annoying you’.

I heartily agreed with him.

“I had still fussed around his bed space, tidying scraps of rubbish, moving glasses closer to his reach”

Despite trying to involve him in every decision made, I had still fussed around his bed space, tidying scraps of rubbish, moving glasses closer to his reach. And it was annoying.

Yes, his mobility was impaired but he was still capable of doing things for himself. I realised that, although all I ever do is to try to help and care for my patients to the best of my ability, I often do more damage than good by not stepping back and putting my hands firmly behind my back until assistance is asked for.

“I often do more damage than good by not stepping back”

After this revelation, me realising my ultimate flaw and the patient realising that he had been undeservedly unkind to me, we were best friends for the remainder of my shift.

He asked me to say bye before I left so at 8 o’clock on the dot I poked my head around his curtains and we wished each other the very best and to take care.

And then he said perhaps the most appreciative comment a patient has ever uttered to me “sometimes you get stupid ‘uns, and sometimes you get good ‘uns… and you? You’re a good ‘un”.

Emily Bridges is in her 2nd year studying adult nursing at Leeds University

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