We all agree that nursing can be a very tough industry. You spend years studying for your CNA certification, and then you must write an exam and spend time conducting clinical research. After, you are on a hospital floor working with a mentor, trying to learn the ins and outs of the industry. Personally, I know that many people don’t last through the entire process, because they don’t have the patience for it. I’ve also heard, that many nurses must deal with so many different personalities both professionally, and with the patients whom you are taking care of. The good news is that with practice, you get better at handling different situations. There are also several resources available to you both during the clinical trial and online, from those who have been in the profession before you.

I know the health care industry is a growing and tough industry, with things not slowing down anytime soon. Therefore, it’s important you have the right resources available to you when you need them. I decided to do some research, gathering tips to help you when interacting with a difficult patient. Let’s explore some of the best tips available to you, and your feedback will be appreciated in the comment box below.

Before we continue, here’s our

Basic Nursing Skills CNA Practice Test

Identifying the Difficult Patients

While doing some research on this, I’ve heard that with experience, you’ll learn which patients are more prone to disruptive behaviors. For example, some who are isolated from their communities or family members tend to be aggressive, because they are mad at the world for being left alone. You also have some with psychiatric disorders, who have a hard time controlling emotions because they have a different view of the world. These patients are fighting irrational thoughts, which can be very tough on them both emotionally and physically.

Some of the nurses I’ve spoken to have stated that many patients are clearly bothered by their failing bodies, their illness, or simply by being in a hospital. It’s the decreasing sense of control which has led to aggressive, depressive or difficult behavior.

During the clinical examination or placement, you’ll learn how keeping an eye on your environment is very important. This will be stated several times, because it’s through this practice that you’ll learn how to spot certain behaviors. Once you know what types of conditions are sensitive, you’ll be able to create a proactive plan of how to deal with these particular patients, before they lose their cool.

Identify A Game Plan

Once you’re able to identify the types of conditions that are prone to causing aggression or difficulty, you can start to formulate a plan. For example, it has been noted, that in patients who are suffering from dementia, mental confusion is mainly the cause of their difficult behavior. Here’s something from Dan Kuhn, MSW, director of education for Mather LifeWays Institute, on aging:

“Because people with dementia misperceive their environment and the intentions of their caregiver, they often react in negative ways,”

At the same time, you must keep in mind that these situations are new to the patient, and they don’t know what to expect in the future. They have never experienced cancer, depression or growing dementia, so are very fearful and not at all ready to hear any negative news. They don’t know how to cope with their growing condition, and especially having to communicate with someone about it. Therefore, having patience is very important, and is something which is taught in nursing school and during the clinical period.

With experience and practice, comes quick thinking and reflexes, when you are faced with difficult situations. Therefore, it’s important to have a plan in place that you can quickly utilize when dealing with your patients. The best advice experienced nurses will give those entering the industry, is to have a short form action plan ready which you can apply immediately. On this plan, you should have quick pointers that will help you quickly handle a situation when it presents itself. Keep this list in your pocket for the next few months, until you gain further experience in handling specific situations.

Here are some of the best action steps going forward –

Always Observe – you should keep a close eye on your patient’s condition i.e. words, voice and attitude. Keeping a close eye on them over a period of a few days will help you assess and control a situation before it happens. If you need help implementing this habit in the beginning, it’s a good idea to ask someone who is more experienced, for guidance.

Show Respect – sometimes aggressive behavior is triggered through disrespect from nurse to patient. This can cause tension overtime leading to further difficulty. I encourage you to always keep in mind that you are dealing with a human being, especially one going through hardship.

Importance of Connection – Just like with any relationship, having a one-on-one connection can help lower the chances of aggression. A respectful connection full of authentic passion and care will help you calm a patient during difficult times.

Patience Helps – aggressive behavior can be caused by pushing too quickly or forcing a patient to do something before they are ready.  Slowing down the process can help resolve the situation. Not to mention, some conditions cause the patient to understand your requests slower than normal so it’s important that you take your time with them

Ask for Help – if you’ve read my previous post, then you know how asking questions and networking is important. If you are having a hard time with a patient, it’s important that you ask for help from someone who is a little more experienced. At the same time, you should observe what the more experienced nurse is doing, so that you can apply this method the next time around.

Stay Informed – always know your employer’s patient bill of rights, as well as its policies and procedures for dealing with difficult patients.

Now that you know how to better prepare yourself, it is as important to know, what to avoid when handling patients.

What to Avoid –

Never Bully – as a caregiver, it’s easy to get carried away because of your status. You spent years in school and are fully certified which can get to your head. However, remember your place and why you are in the profession.  Never threaten your patients.

Assuming Can Hurt – it’s easy to get carried away, and jump to conclusions about the problems that you will face. But, you must keep in mind what the patient is going through and remember that their aggression can be attributed to irritation, vulnerability, cognitive impairment, inability to express themselves, or loss of identity. Keep this in mind when you approach any situation, so that you take the correct steps going forward.

Be Proactive – if you are clear about what is considered disruptive behavior, then you can be proactive going forward. Some of the problems arise by not clearly establishing the boundaries between you and the patient. If you are clear about what’s expected, then you can avoid future problems. You will also know how to handle problems better in the future.

Never Avoid – think about why you entered this profession, and that you are here to help people. When there’s an issue, be the first to help gain control. Sometimes irritation and aggression can be caused because the patient can’t find the help they need when they need it.

Taking It Personally – just like in every profession, you can’t please everyone so don’t take things to heart. You are dealing with patients that suffer from mental impairment, and this can cause them to act a certain way, completely different from their true behavior. Take everything with a grain of salt, and remember your purpose as a caregiver.

Final Thoughts

Just remember to keep in mind that if a patient is behaving differently from their norm, or if they are being difficult and causing complications in your interactions, there may be a reason for their behavior.  Remember not to react, and to stop and think of a solution before the issue becomes even bigger or more complicated.  Your role as a CNA is important, and that includes keeping your patients comfortable, even when it can sometimes be exasperating.  Face the issues head-on, do your best to repair the situation, keep calm and level headed, and above all, remain professional.

We would love to hear what all of you think about some of the solutions mentioned above. Please leave your comments in the box below, and we will try to answer all of them. We work closely with many CNAs (certified nursing assistants) to get you the support and answers that you need.

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