Career advice

Unexpected lessons from ‘difficult’ patients

'Difficult' patients can be hard to like, which can in turn affect the care they receive. But make the effort to step into their world and you can transform the relationship
Difficult patient

'Difficult' patients can be hard to like, which in turn can affect the care they receive. But make the effort to step into their world and you can transform the relationship

One of our dogs, Ben, is a timid little thing, on a lead he can bark and growl and to the untrained eye he must appear aggressive at times. I wont lie, being Bens mum isnt always easy, but our breakthrough came when we started to view things from Bens perspective; his behaviour is rooted in fear and this is not his fault.

Over time we have learned how to keep Ben safe and happy. However, an unexpected bonus is that we have also discovered a great deal about ourselves. Our notion of a good dog brought us nothing but stress.

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'Difficult' patients can be hard to like, which in turn can affect the care they receive. But make the effort to step into their world and you can transform the relationship 


People often display exaggerated behaviour in an alien hospital environment. Picture: iStock

One of our dogs, Ben, is a timid little thing, on a lead he can bark and growl and to the untrained eye he must appear aggressive at times. I won’t lie, being Ben’s ‘mum’ isn’t always easy, but our breakthrough came when we started to view things from Ben’s perspective; his behaviour is rooted in fear and this is not his fault.

Over time we have learned how to keep Ben safe and happy. However, an unexpected bonus is that we have also discovered a great deal about ourselves. Our notion of a ‘good’ dog brought us nothing but stress. Accepting, and working with what the reality brings greater joy and freedom for us all.  

Recently, when pondering over our journey with Ben, I started to think about difficult relationships with people who do not always react the way we want or expect.

Emotional response

It is unrealistic to think that you will feel at ease with everyone you know in your personal life or develop a strong bond with all your patients; if you are honest you can probably recall some patients who you have actively disliked. These feelings are normal and don’t in themselves make you a ‘bad’ nurse.

As a professional you have a duty to care for everyone equally, yet research such as Felicity Stockwell’s Unpopular Patient study has shown that nurses’ negative feelings towards certain patients can affect the level of care provided, even if this is on a subtle and unintentional level.

Take a minute to reflect on your response to patients who you have disliked and compare this to how you react when caring for a ‘favourite’ patient. What differences come up? Can you, for example, recall situations where you took longer to answer a buzzer or pretended to be busy to avoid caring for someone? When this happens you are letting your emotions dictate your behaviour and the care you provide. This can be difficult to admit to, but nurturing self-awareness is essential if you want to grow as a nurse.

Turn it around

Patients’ actions can also be influenced by their emotional responses. If someone acts in a way you find challenging, it can be easy to label them as ‘difficult’, but it is always worth trying to understand what is behind the behaviour. People often display new or exaggerated behaviours in an alien hospital environment.

If you step into your patients’ world in a truly empathic way, it could make a big difference to your relationship with them.

Mandy Day-Calder is a freelance writer and health/life coach

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