Difficult Patients

Every nurse will eventually get a difficult patient on their list of responsibilities. These patients can be mentally, physically, and emotionally combative in many different environments. Consequently, care of these patients should be conducted in a manner for personal and self-protection of the nurse.  Some of the key guidelines are as follows:

1.  Never allow yourself to be cornered in a room with the patient positioned between you and the door.

2.  Don’t escalate the tension with verbal bantering. Basically, don’t argue with the patient or resident.

3.  Ask permission before performing any normal tasks in a patient’s room whenever possible.

4.  Discuss your concerns with other nursing staff.  Consult the floor supervisor if necessary, especially when safety is an issue.

5.  Get help from other support staff when offering care. Get a witness if you are anticipating abuse of any kind.

6.  Remove yourself from the situation if you are concerned about your personal safety at all times.

7.  If attacked, defend yourself with the force necessary for self-protection and attempt to separate from the patient.

8.  Be aware of the patient’s medical and mental history prior to entering the patient’s room.

9.  Don’t put yourself in a position to be hurt.

10. Get the necessary help for all transfers, bathing and dressing activities from other staff members for difficult patients.

11. Respect the resident and patient’s personal property.

12. Get assistance quickly, via the call bell or vocal projection, if a situation becomes violent or abuse.

 13. Immediately seek medical treatment if injured.

14. Fill out an incident report for proper documentation of the occurrence.

15. Protect other patients from abusive behavior.