I'm moonlighting in an urgent care and once in a while come across a difficult patient or family member of the patient. For example, one husband kept coming out of the room demanding when his wife was going to be seen (for her cold), when I went in the room, he practically was standing at the entrance making it difficult for me to come in the room. Then was extremely rude to me, saying how he runs his own business and would not run the urgent care the way it is. Etc etc. I try to treat others the way I want to be treated, so I apologized for the wait, but he still kept going off. He eventually really got to me. Maybe my skin is too thin, but it really messed with my head. and I'm wondering what things I can or cannot do in situations where patients are being very rude? Can I refuse care? Would I be at risk for being sued if I did this (assuming the patient is stable)? Can I just flat out start arguing back and not take their crap?
Dealing with a difficult patient.
- Thread starter pockey
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You will run into rude people with unrealistic expectations in any clinical field, or any vocation, for that matter. Residencies and employers now are providing training on how to deal with difficult patients/customers-I suggest you take advantage of those when possible. What you ask is beyond the scope of this forum, but some specific answers to your questions:
1. Unless you are being physically abused, I don't think you can just turn on your heels and walk out. You can certainly suggest that the patient would be happier getting their care elsewhere and if in a continuity of care situation, can send a letter dismissing them from your practice.
2. Fighting back verbally will accomplish nothing positive except maybe make you feel good for a short time, but it can come back to bite you. Sometimes you just have to suck it up and take it and acknowledge the patient's feelings (I didn't say agree with) and try to defuse the situation.
This is a very difficult area but very relevant. Hope you can get some training.
1. Unless you are being physically abused, I don't think you can just turn on your heels and walk out. You can certainly suggest that the patient would be happier getting their care elsewhere and if in a continuity of care situation, can send a letter dismissing them from your practice.
2. Fighting back verbally will accomplish nothing positive except maybe make you feel good for a short time, but it can come back to bite you. Sometimes you just have to suck it up and take it and acknowledge the patient's feelings (I didn't say agree with) and try to defuse the situation.
This is a very difficult area but very relevant. Hope you can get some training.
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pockey said:
I would have told that husband to stop being rude or to take his wife and go elsewhere. I would not be afraid of getting sued. I have decided I won't take lip from rude patients. If they get roudy, I'd just call the cops.
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A few things: refusing care depends on what the situation is that you are in. If you are in an ED, no, you can't refuse. Check with administration.
Second, in urgent care, there are always rude rude people. They have a mcdonalds attitude. And even after apologizing and explaining that UC is not first come first serve, etc, they will still be pissy. Remember you are in control and you can have the patient wait in the waiting room.
third, spouses that refuse to leave a room are often a flag for abuse. get the husband out of the way by tellign him to leave.
If a patient is over 18, the husband cant 'do anything ' he watns with his wife.
Second, in urgent care, there are always rude rude people. They have a mcdonalds attitude. And even after apologizing and explaining that UC is not first come first serve, etc, they will still be pissy. Remember you are in control and you can have the patient wait in the waiting room.
third, spouses that refuse to leave a room are often a flag for abuse. get the husband out of the way by tellign him to leave.
If a patient is over 18, the husband cant 'do anything ' he watns with his wife.
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On a few occasions, I've told patients something that has been pointed out by an acquaintance of mine who is an EP: when you think about it, you don't really want to be priority number one in the ED or the Urgent Care, now do you?
As a tech in an ED, I roll around and get vitals on patients as they wait, so I get the "how long?" question a lot. I can be non-committal and get out of the room without really answering, but if the patient or a family member is beginning to take on an attitude, I'll try to help the team out by nipping that in the bud. I'll mention that every time you hear the overhead page, it means somebody someplace had to take a ride in the ambulance, and that diverts staff. Just in general, I'll say there are other people here, and many of them are in worse shape or need more intensive attention -- the implication being, be grateful you're not one of them. Then I always close by thanking the person for being patient with us, and I let them know we're not happy to make them wait either.
The obnoxious family member can sometimes be calmed by taking them aside, even just to a corner of the room, and steering them back toward the reason they're here. "You know, your [wife/husband/daughter/mom] is particularly senstive right now to emotional stresses, and it would really help us out if you could make sure she doesn't get too anxious. We're making sure to do all the things we need to make [him/her] feel better, but you're an important part of taking care of her, too." The implication being, please chill the hell out. Give people a role to play, and the feeling that they're contributing might be enough to give them what they need.
As a tech in an ED, I roll around and get vitals on patients as they wait, so I get the "how long?" question a lot. I can be non-committal and get out of the room without really answering, but if the patient or a family member is beginning to take on an attitude, I'll try to help the team out by nipping that in the bud. I'll mention that every time you hear the overhead page, it means somebody someplace had to take a ride in the ambulance, and that diverts staff. Just in general, I'll say there are other people here, and many of them are in worse shape or need more intensive attention -- the implication being, be grateful you're not one of them. Then I always close by thanking the person for being patient with us, and I let them know we're not happy to make them wait either.
The obnoxious family member can sometimes be calmed by taking them aside, even just to a corner of the room, and steering them back toward the reason they're here. "You know, your [wife/husband/daughter/mom] is particularly senstive right now to emotional stresses, and it would really help us out if you could make sure she doesn't get too anxious. We're making sure to do all the things we need to make [him/her] feel better, but you're an important part of taking care of her, too." The implication being, please chill the hell out. Give people a role to play, and the feeling that they're contributing might be enough to give them what they need.
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When patients get upset like that, I try to briefly explain why they were seen at that time, indicate that other patients are at a higher acuity right now and if they feel they have been mistreated, they can call the hospital patient advocacy number, which I provide. They're used to dealing with the demanding patients like this, and while I am all about trying to calm family down briefly, there are other patients who need care, too - and spending 20 minutes going over why someone with a minor problem will be seen after many others with more pending issues are seen first is quite honestly mismanagement of time and pushes everyone else back 20 minutes before I can see them, too.
As for letting the person get to you - when patients or family get worked up over seemingly small issues, I think to myself what it would be like to live in their head for a day with all the anger/stress - and be happy that my life doesn't involve such hostility. Feel bad for them, and let it go. They are the ones who have to continue with their social skills, not you.
As for letting the person get to you - when patients or family get worked up over seemingly small issues, I think to myself what it would be like to live in their head for a day with all the anger/stress - and be happy that my life doesn't involve such hostility. Feel bad for them, and let it go. They are the ones who have to continue with their social skills, not you.
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Our jobs are difficult enough without having to deal with a rude/annoying spouse. There is no reason why you have to put up with that kind of behavior----it's completly inappropriate. Regarding your situation, if the patient is in no acute distress, you can inform the man that you'll return after he decides to act more civil. After initially apologizing for the delay, I would request him to leave or you could have security do that for you. Dealing with people of his ilk IS a part of medicine, no question about it. However, you absolutely DO NOT have to suffer from it...particularly if it affects patient care.
Some folks simply cannot be reasoned with, no matter how polite and kind you are. They often need to be put in/reminded of their place. Fortunately these types are in the minority. I've found most patients and their families very appreciative.
Some folks simply cannot be reasoned with, no matter how polite and kind you are. They often need to be put in/reminded of their place. Fortunately these types are in the minority. I've found most patients and their families very appreciative.
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I've dealt with rude/racist/sexist/etc. patients and family members and all I can say is - smile to their face, then b_tch about them later to your colleagues behind closed doors. If it's a patient upset about a wait, I tell them I was caught up in an "emergency" or a "trauma". I've sometimes used white lies - give them a bit of detail about the "emergency" (without violating HIPAA of course.)- "terrible car accident", "a vomiting loud crying baby" etc...
If it's a family member, I usually apologize for the wait, then ask them what they want me to do. Usually, they just want you to take care of their loved ones. Just say that you're planning on doing just that and that the more time you spend talking to them, the more delay they are causing to them getting care. that usually shuts them up.
humor can be successful for some patients. If not, the patient advocate number is always an option - although they are not always available. My last resort is to give them the option of signing out AMA if they are that unhappy with the care. Many of the rudest patients are just scared - they think they are having a heart attack, etc. etc. Reassurance is all that is needed. Making them feel immature by remaining calm and professional can work as well.
If it's a family member, I usually apologize for the wait, then ask them what they want me to do. Usually, they just want you to take care of their loved ones. Just say that you're planning on doing just that and that the more time you spend talking to them, the more delay they are causing to them getting care. that usually shuts them up.
humor can be successful for some patients. If not, the patient advocate number is always an option - although they are not always available. My last resort is to give them the option of signing out AMA if they are that unhappy with the care. Many of the rudest patients are just scared - they think they are having a heart attack, etc. etc. Reassurance is all that is needed. Making them feel immature by remaining calm and professional can work as well.
