Regardless of their specialty, nurses encounter a spectrum of patient emotions every day. While their reassuring presence and medical capabilities are welcomed by most, there are times when nurses are called upon to be both healer and mediator. One of the most valuable skills that a nurse can develop is the ability to effectively interact with an angry patient. The following seven tips outlined below, when repeatedly and consistently implemented, can help a nurse defuse potential conflicts with patients.
1. Don’t Take It Personally
Many within the mental health profession consider anger to be a secondary emotion, meaning it is used to protect oneself from other feelings of vulnerability (i.e. humiliation, rejection, sadness, fear, etc.). While it may seem like a patient is lashing out at you personally, the reality is that they are most likely having an emotional response to a situation that does not even involve you. You just happened to be in the wrong place at the wrong time. Therefore, the golden rule when dealing with an angry patient is to not take anything they say or do personally. By reminding yourself that the patient’s emotions are misplaced, you can circumvent feelings of being attacked and needing to respond aggressively.
2. Watch for Signs
Benjamin Franklin said, “an ounce of prevention is worth a pound of cure.” This is especially true when it comes to dealing with an angry patient. Most people, whether they realize it or not, give off subtle hints that they are stressed or upset (clenched fists, tensed jaw, fidgeting, terse tones, etc.). By watching for these subtle signs, you can help your patients appropriately give voice to their concerns and frustrations. For instance, if you notice that your patient is getting easily agitated, you can try implementing Sakichi Toyoda’s theory of the 5 Whys. This highly effective iterative interrogative technique will help your patient identify the root cause of their angst. Once you patient has identified why they are truly upset, you will be able to offer an appropriate response that deescalates the interaction.
3. Keep Calm
In the midst of a verbal barrage, it is tempting to try and use reason and logic to calm down an angry patient. However, in the heat of the moment, attempts to explain or bring clarity to a situation will most likely be perceived as an attack, escalating the encounter. While keeping calm under fire can be extremely difficult, it is not impossible. Keep your face as expressionless as possible. In your head, slowly count backwards from ten. Remind yourself to take deep breaths. Try to relax the muscles that are feeling tense. Utilizing these various techniques will disengage your body’s natural fight or flight response, making it easier to respond rationally and professionally.
When dealing with an angry patient, it is easy to become defensive or feel personally attacked. However, responding with anger or dismissiveness will only heighten tensions in an already volatile situation. One of the best tactics for disarming an angry patient is to show empathy. Unlike sympathy, which is an understanding of someone else’s suffering, empathy involves experiencing someone else’s emotions. Take the time to hear out your patient’s upsets and concerns. Acknowledge their experience and how it is affecting them. Ask your patient if they would like your help. First and foremost, patients want to know that they are heard and understood.
For a great explanation on the difference between empathy and sympathy, watch Dr. Brené Brown’s The Power of Empathy:
5. Watch Your Language
Communicating with an angry patient requires a great deal of care and tact. One surefire way to escalate a situation is to use aggressive or accusatory language, even unknowingly. For instance, when talking with an upset patient, try to avoid using the words “you” and “you’re.” While uttered with the best of intentions, these parts of speech can make people feel like they are being attacked or told what to do (i.e. you must have misunderstood). Instead, use “I” and “we” to show that you are actively listening and are willing to work together (i.e. I don’t think I explained that well). These simple modifications can substantially alter a conversation’s trajectory.
6. Be Honest
In your attempts to calm down an angry patient, always be honest and forthright about what can realistically be done to resolve the situation. While fibs and white lies may placate an upset patient, they are only a temporary solution. When the truth is discovered, the patient will only be more enraged and could potentially complain to your supervisors or your facility’s management team, threatening your credibility and employment status. If you find yourself in a situation where you don’t know how to best proceed, ask the patient to allow you to go and speak with your manager. Your supervisor has a vested interest in bringing a successful resolution to the conflict.
7. Set Boundaries
When dealing with an angry patient, you may find that they refuse to reciprocate your calm and empathetic approach. In these situations, it is extremely beneficial to set and abide by a boundary. For instance, if you are interacting with a patient that is yelling at you or using foul language, let the patient know that you will terminate the conversation if they continue speaking to you in that manner. If they insist on behaving inappropriately, excuse yourself and alert your manager to what is going on. If you feel unsafe attempting to converse with the patient again, ask your supervisor to join you. Setting and abiding by these types of boundaries will ensure that you always maintain your professionalism.
Your ability to act with a high degree of professionalism will help ensure a successful resolution and that is something you and your employer can be proud of.
While each scenario with an angry patient is unique, these seven tactics, whether implemented individually or simultaneously, are a highly effective way to achieve clarity and calmness. Your patient may not be immediately grateful for your calm and level-headed approach. However, your ability to act with a high degree of professionalism will help ensure a successful resolution and that is something you and your employer can be proud of.