Healing with HEARTS

Dealing with Difficult Patients and their Caregivers

Dealing with patients and their caregivers is the reason most of us got into healthcare in the first place, but they are also potentially the most challenging aspects of any given work day. A number of factors can contribute to a patient or accompanying loved one becoming difficult.

• Personal factors, such as cultural or language barriers can create frustration, discomfort and defensiveness.
• Environmental factors at home or in the healthcare office, such as wait time or tardiness, access to food and beverages and disruption to routine, plays a part in the patient’s mood, discomfort level or demeanor.
• The disease or condition that brings the patient to your care may have an impact on him or her and the family members, as it can alter mood, discomfort and behavior.
• Medical and administrative professionals can contribute to the patient’s and caregivers’ attitudes through scheduling difficulties, transport and parking issues, check-in procedures and waiting room experiences.

Regardless of why a patient or loved one becomes upset, you need to address the situation. What is the best way to defuse the situation? A simple five-step approach moderates most scenarios and leads to a positive outcome.  Just remember the acronym HEARTS.

Hear: Hear the person out. Make sure you’re listening – really listening. Give the speaker your full attention. You can make notes during brief pauses, and you can and should ask clarifying questions to fully understand the problem. Don’t plan out responses, though, as when you’re doing so you’re not really hearing them speak. Focus on what they’re saying and not saying, and on their body language.  Make sure when you speak, you use their preferred form of address (that should be in your notes and records – if it’s not, or you don’t have access to them – you can ask them how they’d like to be addressed).

Empathize: Having empathy means that you can relate to a person’s circumstance because you’ve “been there.” You won’t always be able to relate to a specific scenario, but relate to the feeling of being frustrated, scared or uncertain.  Find ways to relate to the person’s feelings and do your best to convey that shared emotion. People like to know that they are heard and understood.

Acknowledge: Acknowledging a person’s frustration or concern does not mean that you agree with his or her position. It’s important that you acknowledge that the person standing in front of you is upset about the issue that has brought him or her to you, and that he or she clearly believes he or she has a reason to be upset, but you do not have to admit guilt or responsibility or fault if it’s not warranted.

Respond: Respond to the patient or family member(s) in a way that provides options and choices.  Avoid negative phrasing, such as “I can’t do that,” and rephrase with positive responses, such as “what I can do is.”

Thank: No matter how painful it may seem at the time, every complaint is an opportunity for improvement. Sincerely thank the patient or family member for bringing the issue to your attention.

Survey: After the issue is resolved, document the problem and include your LBs and NTs – what you Liked Best (LB) about the resolution and what you’ll do differently Next Time (NT) to either avoid the problem entirely or improve the resolution.