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Managing difficult patients without putting your license at risk

You are going to encounter difficult, demanding patients from time to time in your career as a nurse, so you might as well have a plan for how you are going to handle it. Not having a plan could lead to a rash reaction -- the kind that could put your license at risk due to an ethics complaint.

Here are some tips for managing the most difficult patients with ease:

1. Acknowledge the situation

There's nothing wrong with trying to hit a "reset" button on the whole situation. If you've had a bad encounter with a patient, you can say, "It seems like we've had a bad start to our relationship. Let's talk about it and start over." That may be enough to change the dynamic altogether.

2. Ask the patient why he or she is being so hostile

This is a way of calling a patient out on his or her behavior that's indirect. It allows you to simultaneously say, "This is inappropriate," and "Why are you angry?"

Once you ask the question, however, be prepared to listen to the patient's story and offer some consolation. Realize that most people act out when they are afraid or emotionally distraught.

3. Set some boundaries

You have the right to be free of abuse at work, so it's okay to set some boundaries. For example, you can let the patient know that you won't accept cursing. If he or she continues to curse at you, you will simply walk away until the patient has the opportunity to calm down.

Setting boundaries reminds patients that being ill doesn't excuse them from all of the demands of normal society.

4. Get help -- for the patient and for yourself

If a patient is overwhelming you, there's a good chance that the patient is also overwhelmed. Seek out additional services for that patient -- like a chaplain visit or the hospital social worker.

Also, get help when you have to enter the patient's room. Having a witness standing can be invaluable if your interactions with the patient are the subject of an official inquiry later on.

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