Introduction
Being a patient is never easy. You don’t know what is happening, even when you do, it seems like it’s never enough, every time you look around, you see people either rushing round, people who are also in pain, people who also need help and this adds to the confusion and anxiety that you feel. This is true for one patient, multiply that by just ten more, and without a sense of even simply hierarchy, then every part of the hospital will fall into chaos. This scenario is just for an average day, try multiplying that to even more patients on a day with an emergency.
This may already be confusing, but the same cannot be said for the one taking care of said patients for it is even worse. Imagine for a moment that you are taking care of these confused, frustrated and sometimes even irrational patients. Imagine taking care of one who has tendencies to turn violent, then multiply that by a small number such as even five and you can now imagine the amount of pressure that a medical care personnel feels.
This unfortunately cannot be avoided. This is the reality of any given situation in any hospital at any given time. Of course, this does not mean that the hospital is always in turmoil, but it does mean that there is a lot going on that doctors, nurses and other medical personnel have to live with to provide the best amount of care possible to any given patient. What must first be understood with challenging patient situations, is the fact that problems such as these have many facades.
One part of the problem, as stated, comes from the patient, another part comes from the care giver, and another part of this comes from the situation itself. Regardless of the situation, the problem still exists and thus must be resolved. Resolving said problem in turn can take numerous steps, or sometimes even one if the root of the problem can be found. This paper aims to look into the different kinds of challenging patient situations, their causes, their possible solutions and how they can possibly be avoided in the future, if that in itself can be achieved.
The Beginning of Challenges
No problem ever begins with a bang; everything always begins with something small, even challenging situations. More often than not, problems with patients begin with a misunderstanding. Some misunderstandings arise from being human in general; meaning preferences.
The Medical Professional
Take for instance, the inability to acknowledge some personal feeling of the care giver. While the same can be said about the patients, we will first look into the medical professional as, regardless of what the patient is going through, the most basic place to begin with is the self, additionally, the medical professional is expected to know more about the patient when it comes the latter’s condition.
As stated, it is normal to have preferences, especially personal ones. A professional may have reservations when it comes to, say, treating a patient who is a soldier, due to some experience in the past with a different soldier. This feeling of fear, disgust, anger, hate, or whatever it may be, is natural to feel as the medical professional is also a person, but it is also expected that a medical professional act as a professional when it comes to treating their patients, despite personal conflicts or problems that the professional faces in their life, something that the patient is not expected to do .
Again, as the doctor, nurse, care giver, technician, etc. is the learn-ed in the given situation, it is expected that they act as such. However, it has been proven on numerous occasions that no amount of training can prepare someone for every challenging situation that arises when it comes to patients as they are humans as well, thus are as complicated as or even more so than the medical professional.
The Patient & the Situation
In the introduction of this paper it is stated that being a patient is hard, anyone who’s ever been a patient can attest to that, I can even be harder for a medical professional to be a patient than a person not working in the field of medicine because they know just how good or bad the situation is and no matter how many times, it’s been said to them to let others do the work, they will keep trying to put in their own assessment of their situation .
Usually however, a “challenging” patient is one that is simply, a patient. Normally, a patient is not considered as “challenging” because of their medical condition however, but because of their disposition . There are some patients that just need to be understood, some who are truly confused and are extremely vulnerable emotionally. While understandable, there are those who turn demanding and abusive because of their fragile state and then there are those who are abusive because of their nature and upbringing. While both have their own set challenges that need to be addressed, it is the latter that is always harder to solve or overcome while it is the former than is simply acting out because of his or her situation .
Kinds of Difficult Patients
- Controlling
A patient classified as “controlling” is the kind than will keep forcing for results in the least amount of time, sometimes impossibly so. The greatest challenge that comes with this kind of person is that they sometimes even blame their caretakers for the problem that they are having. Additionally, this type of patient tends to work on the model of knowing everything about their condition and will try to keep their medications within only what they know or understand .
- Perfectionist
These types of patients in turn are those that, for the lack of a better description, expect a happy ending regardless of their situation. Normally these type of patients will decline a certain treatment because it is not “100%” effective or because there is a risk to the procedures. Additionally, these type of challenging patients can also be “whiners”. They tend to keep complaining about a certain course taken in their medication either because of discomfort or because the said course is not one with a guarantee.
- Attention Seekers
Possibly the hardest kind of patient to treat, attention seekers are just that: attention seekers. These are usually those that are the said emotionally fragile patients. A term coined for them is “grenade” as these are the patients with the tendencies to go off at any minute. While most of these tantrums are not dangerous in nature (as stated, it is only because of the situation that they are in), there are those than must be restrained for their own good. Not all attention seekers are like this however, there are some that believe that they know everything about their condition.
It is these types of patients that will keep forcing a medical professional or team to try a new, radical or untested procedure solely for the sake of trying to prove that they are no longer in a delicate situation (of course, there are some who are an exception to this definition) .
- Approval Seekers
Almost the same with attention seekers, approval seekers differ from attention seekers in few small manners that it is hard to distinguish the two, thus making it harder to treat them. While attention seekers try to understand their situation with an almost zealous attitude, the approval seeker has little to no opinion on the matter when it comes to their medication. They will either keep saying “yes”, “maybe”, or “I don’t care” to their care givers in almost any situation. Additionally, approval seekers may not always be the patient, but a patient’s very protective family or friend.
As always, there are exceptions to rules and classification, but most will find that most patients can be classified in the four given fields.
The Possible Solutions
Normally, solutions for these challenges and challenging patients are personal in nature, which would depend on how the medical professional himself/herself normally handles any situation in life. Like anything else however, there is nothing truly new under the sun; thus there are certain situations and certain actions that can be taken and applied by all regardless of the cultural, social or even political background of the parties involved, namely the patient, the medical professional and/or the patient’s family.
Additionally, the reason why solutions are needed because without them, the medical professional or even the entire medical team will have to either suffer in silence, succumb to every whim of the patient, change their practices or even try to escape the patient, none of which are solid solutions should the same problem arise in the future .
- Saying “No”
While not literal in nature, it can be taken as such if the patient has become far too abusive to his/her care takers or if their actions have come to the point that it should no longer be tolerated. To understand this, one must first understand that the medical giver I also a person that has the rights to be respected, understood and treated as fairly as they have treated their patients.
Of course, a patient has the right to be part of the decision making process as it is their life, but a medical professional should not take this to the point that they will follow every whim of the patient, especially if the said patient starts demanding for actions that will be life threating . Being rejected outright will normally lead to more problems than solve them however, thus the medical professional should consider declining the patient in a manner that still does not cause the patient more distress.
An example of this would be to try and talk the patient down, explaining to them the necessity of the declination of request (repeatedly if need be), laying down to the patient alternative options and ensuring that the rest of the health team assigned to the patient is aware of the decision to ensure that there are no follow up incidents due to miscommunication .
- Equal, Appropriate Patient Care for All
Despite possible problems that a patient will give his/her medical care givers, the medical team in turn must always remember that the patient must be treated equally and most importantly, appropriately. There is a reason why appropriate is highlighted in this part, because there is a difference between ideal and appropriate. Ideal care should be given to all patients, challenging or otherwise, but it is with challenging patients that appropriate care must be given as the ideal care may not be ideal, given their situation .
- Be in the Know
While rather cliché, this is still a very important part of the solution process. A patient may not always be attention seeking or controlling, as the course of medication continues, he/she may (and usually will) change with the situation that they are in (this is especially true for those that can be classified as a “perfectionist”) .
As the challenge of the patient changes, the medical team must be able to adapt with the challenges as well. This may not always succeed, but as stated in the second solution, the ideal care of the patient may not be appropriate for his/her situation.
Summary 7 Conclusion
There are numerous challenges that a doctor, nurse, physician, therapist or even just a social worker working in the field of medicine will encounter. From possibly new diseases, new formula and solutions that still need to be tested in their accuracy and effectiveness when it comes to curing an old sickness or possibly even creating a new disease by accident. While some of these challenges may be farfetched, improbable or downright crazy, there are other challenges that are present right now.
One such problem is a challenging patient situation. More common, than expected, these situations are also taken for granted and never fully studied upon as its solutions are as ever changing as the challenges themselves. Thus it must be taken into account that there are certain aspects of these challenges that are ever present in most, if not all of the situations that a medical professional will face with his/her patient.
Most of these challenging patients can be classified into four major groups and each group has its own way of being dealt with, but there are certain solutions that can be used for everyone. An example of this individual solution is that, when faced with a “perfectionist”, especially with one who whines a lot, is that you should never agree or disagree with them but find a solution to their problems yourself. This cannot be applied to an approval seeker however as they will simply agree, think over the solution or not care if you show them your solution.
However, being patient with a challenging patient is something that can be applied to all of them. Thus it can be concluded that a challenging patient is simply one that needs a different form of the same type of care that is given to every and all patient within a hospital, clinic or any other medical center.
Works Cited
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Medical Protection Organization. The Challenging Patient. May 2009. article. 13 September 2013.
Secemsky, Brian, M.D. Health Care 101: Dealing With Your Difficult Patient. 25 July 2012. Article. 13 September 2013.
Webb, Anita R., PhD. Difficut Encounters. Fort Worth, Texas, n.d. Power Point Presentation.
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