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What do you recommend to mentally prepare myself with when it comes to dealing with difficult patients?

I am 18 years old and will be going into the rehabilitation field. I am currently taking a course for this career path and wanted to hear your story of handling patients.

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Rachel’s Answer

As we work in medicine, we need to realize that our patients may not be the best human they can be. They are in pain, worried, anxious, scared and uncertain of their future especially in rehab. You as the care provider need to have a source of replenishment of caring, compassion and empathy. Do you have hobbies or activities that bring you joy or are calming?
Patients are people, how do you handle when a random person is rude or inappropriate to you?
When a patient is being rude or inappropriate, I take a deep breath, let the person finish, and listen to the root cause of the frustration or anger. Clarify with them what you understand to be the root of the problem (pain, difficulty in getting an appointment, someone else was rude to them, scared about their prognosis), and state how you can help them right now (ice pack, heat, setting up the next appointment as soon as possible, apologize for the other person's behavior, help the patient understand their current condition and what are the goals of therapy). "I am so sorry that you are going through this. I am here to help you now. " goes a long way with most people and usually neutralizes them.
You will always have people being inappropriate, but you will have so many more people being thankful and grateful for your help and expertise and that is what gets all of us through the day and keeps us coming back every day.
Welcome to the medical field and good luck in rehabilitation!!!
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Michelle’s Answer

Hello, Melanie !

According to two words, one in your inquiry and one in your hashtag, am I correct in that you would be going into some type of mental health field and a rehabilitation segment of that ? If so, I thought I would contribute because even though I was never a medical professional, I have worked intensely and extensively as a social services Case Manager with mentally ill, homeless and mentally disabled individuals including a wide range of populations such as dementia, traumatic brain injury, substance addictions, etc.

In general, since I do not know exactly what career you are referring to, I can basically say that you should be prepared to have the mindset that every person is different and reacts differently. What bothers one person doesn't even phase the other and everyone takes bad news differently, too. That being said, experience in your field will be the number one teacher of how to handle difficulties with patients.

My advice is to have a positive mind set every time you greet a new patient. Let them express their needs and concerns and affirm what they say and communicate to them. They will be coming there for a service that you provide so they should feel free to express things to you. You should also be prepared to meet patients that also know a lot about health and their own body and how it functions. You may get difficult patients and the way you are trained, you may deem it as refusing care, but you must keep in mind that patients do have the right to refuse care that you say is the right thing to do. You have to get to a place where you are comfortable with patients wanting something different. Just chart/note it and move on.

I wish I did know exactly what type of patients you mean, but another thing that I can tell you, once you start an Internship, Residency or other training forums, you will start to become aware of how to handle mostly every situation. A lot of behavior that comes from "difficult" patients will not be from anything you say or do, rather the patients' mindset, so all you can do is express understanding and try to connect with their concerns. In any event, you can examine, diagnose and discuss the treatment with the patient and if the patient refuses treatment, it will seem like the patient is giving you a difficult time, but all medical professionals handle this differently.

Your tags do indicate that you are pursuing a career as a medical doctor. If this is the case, part of your academic experience will be working with Standardized Patients. Those are actors who portray scripted patient scenarios. You will have these as exams and they are evaluated by one professor as well as a simulation team via video. You will receive all types of scenarios - having to break bad news, addicted patient trying to get more opioid medication from you, if it is for psychology or psychiatry you will see standardized patients (actor portrayals) that have mental health issues. So, you will be trained and have lectures in medical school that will fully prepare you to handle diverse situations.

The patients and situations will also depend on whether you work in a large urban hospital, a small rural rehab center or a suburban hospital. I think that you will be fine, appropriately trained and should be able to know exactly how to handle situations when you are ready for your residency or when you start working as a doctor. Try not to be too concerned about it before it happens. You will get the experience before you know it. But if you want to see some informative videos (hopefully pertinent to your career choice) I have left some videos for you to watch at a link below. I hope they are helpful for the career you are referring to. Best wishes in all you do !

Michelle recommends the following next steps:

ABOUT WORKING WITH DIFFICULT PATIENTS IN THE MENTAL HEALTH FIELD [VIDEOS] https://www.youtube.com/results?search_query=working+with+difficult+psychiatric+patients
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Chinyere’s Answer

Hello Melanie,

In addition to the answers already given by other professionals, dealing with difficult patients can be challenging but also rewarding. Here are some strategies to mentally prepare yourself:

1. Develop Empathy: Understand that patients may be dealing with pain, frustration, or fear. Putting yourself in their shoes can help you respond with compassion rather than frustration.

2. Set Boundaries: Establish clear boundaries to protect your own mental health. It's important to be empathetic without becoming emotionally overwhelmed.

3. Practice Active Listening: Really listen to your patients' concerns and validate their feelings. Sometimes, just feeling heard can deescalate a tense situation.

4. Stay Calm: Maintain a calm demeanor, even if the patient is upset. Your calmness can help to soothe them.

5. Seek Support: Don't hesitate to seek advice or support from colleagues or mentors when dealing with particularly challenging situations.

6. Self-Care: Regularly engage in activities that help you relax and recharge. This will help you maintain a positive and patient attitude.

7. Continuous Learning: Attend workshops or read up on the latest techniques in patient management and conflict resolution.

8. Reflect on Experiences: After a difficult interaction, reflect on what happened and what you could do differently next time. This helps in continuous improvement.

My Personal Experience:

As a guidance counselor, I've had the opportunity to work with a variety of students, each with their unique challenges and aspirations. One memorable experience involved a student who was struggling academically and socially. Let's call him John.

The Situation:
John was a high school sophomore who had been facing difficulties both at home and in school. His grades were slipping, and he was becoming increasingly withdrawn. Teachers were concerned about his lack of participation in class and his declining performance on assignments.

Initial Approach:
During our first meeting, I focused on building rapport. I asked open-ended questions and actively listened to his responses. It became clear that John was dealing with a lot of stress at home, including his parents' recent divorce. He felt overwhelmed and unsupported.

Developing a Plan:
Together, we developed a personalized plan to address his academic and emotional needs:
1. Academic Support: We arranged for tutoring sessions in the subjects he was struggling with the most. I also worked with his teachers to create a more supportive classroom environment.
2. Emotional Support: I referred John to a school psychologist for more intensive counseling. Additionally, we set up regular check-ins to discuss his progress and any new challenges he was facing.
3. Social Integration: To help him feel more connected, I encouraged John to join a school club that aligned with his interests. He chose the art club, which allowed him to express himself creatively and make new friends.

Progress and Outcome:
Over the next few months, John began to show significant improvement. His grades started to rise, and he became more engaged in class. The support from the tutoring sessions and the positive reinforcement from his teachers played a crucial role in this turnaround. Emotionally, he felt more stable and started opening up more during our sessions.

John's involvement in the art club also helped him build a supportive social network, providing him with a sense of belonging. By the end of the school year, he had not only improved academically, but also developed better coping mechanisms for dealing with stress.

Best wishes!
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Hwal’s Answer

Melanie,

I see great advice posted already on the topic. Let me add the following tips from my experience. I think you're off to a good start by anticipating difficult patient encounters, because whether you pursue medicine or psychology, you will not have the same experience with every patient and some encounters will require more effort or different approaches from you than others. Whenever you experience a difficult encounter though, I hope you remind yourself why you chose the career you chose and what you want your own and your patient's experience to be like, at all times. For example, if you want an experience that is safe and respectful for both yourself and your patient, it would be helpful to learn to recognise when an encounter is not safe or respectful.

At the same time, I hope you don't feel like you need to know exactly what to do in every difficult situation involving a patient. Instead, it might be more helpful to make sure you have people/colleagues/supervisor who can support you befor, during, and after difficult patient encounters so that you will learn from each experience and be better each time. This has been my personal experience and I'm still learning and improving, and I'm glad I am.

Let me know if you have any specific questions I can help with.

Hwal
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Kim’s Answer

Melanie,

To the two excellent answers you already received, I will add this, from my experience in law enforcement. People interact with you for the role that you are in, they are not interacting with you on a personal level. Many times people were rude to me because of the uniform I wore - nothing more. So remember not to take it personally!

Hopefully along the way you will learn to "compartmentalize" your thoughts and feelings - tuck them away and bring them out later to think about or discuss, but for right now, you have to move on to the next patient, no time to react to the rudeness of the patient.

I always make an effort to "connect" with people. Often through some sort of humor. Sometimes it backfires, but, still I try. Nowadays we have to assume everything we say or do is being recorded, or so it seems, and we are taught to maintain our "professional" image. I think when people step out of the role-playing and become a human, it works better. IMHO.

Also, Rachel mentioned apologizing. If you are going to apologize, make it a genuine apology. Do not say, "I'm sorry you feel like he treated you with disrespect." Say, "I'm sorry he was disrespectful towards you." An apology that isn't an apology infuriates me (and probably others as well)! Something you don't want to do.

Really and truly, after two years of working (probably less) you will have this all figured out. Experience is indeed the best teacher. And remember to always treat everyone the way you would want your grandmother to be treated!

Best,
Kim
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