DEALING WITH DIFFICULT PATIENT

Introduction as per new or follow up patient

Re-stating : (if suitable)

You seem quite upset. Please tell me exactly what are angry about
It must be very difficult for you, can I just confirm with you that you had a lot of diarrhea and abdominal
pain and you had some problem with wind? Is that right?
Ask for examination (take permission)

Now, I would just like to examine you/ your eyes/your reflexes..? It won’t be sore..
Thank you for allowing me to examine
Does it hurt when I do this? Was that painful? / Did I hurt you?
(Changing topic) All right, based on my examination, I think you have…/ the blood reports indicate that
you have/ your child has…

Do you know anything about this condition? /what do you know about this condition?/ have done
anything for this (infection)/ have you taken any medication for the same? (Check pt’s knowledge)
No?/ or listen to patient
(explanation about the disease/ operation/ complications) Ok, I will explain to you..
Do you understand so far?/ Is that clear?/ any doubts?/ Do you have any questions? (Re-checking)

Reassurance in between…..

Don’t worry / Try not to be worried / There is nothing to get alarmed about/ don’t worry you will be
alringht/ everything will be fine / There is nothing to worry about/ let me reassure you if you follw my
advice the risk of future problems will be greatly reduced
The nurses/ the staff/ the doctors are very experienced and you are /will be in safe hands
In my 7 years of experience, I have not seen any single complication like this so don’t worry. Any major
complication with this procedure..
Sympathy in between…
I understand your concerns/ I know how you must be feeling
I am sorry for the inconvenience

Before starting prevention/ advice to follow at home/ precautions to be taken at home:

1. I see, that must be very difficult situation for you, but the good news is, there are several
options available which will help you. Would you like to hear about that?
2. I can see that you are worried, but try not to be too concerned as this condition can be managed
with medication and rest.
3. Don’t worry, there are various steps we can take to manage / prevent the condition/ infection
4. I am glad you asked and let me explain the treatment options
5. That is a good question Mr.., I will explain
 6. All right Mr.…, don’t worry, if you follow my suggestions, he /you will get much better soon, we
have some very effective strategies to cope with this condition, I would like to explain them to
you one by one, is that okay?
Explain management/ precautions/ preventive measures…..
It is better that you stay in hospital so that if there is a change in your condition, we can give you
immediate care and help you avoid any future complications.

After management, (check understanding / Take feedback)

1. I hope you would be able to manage that..
2. Do you think you can manage that?
3. How do you feel about that?
4. I hope you can understand our situation.
5. I promise that will not happen again
Look at the task is there anything left – come to a conclusion
Is there anything you would like to ask?

Persuade the patient if he doesn’t agree with you

1. What is more important? The risk of permanent damage to your arm or a single game of cricket/
event of dance?
2. If the wound left untreated, the infection will get worse and spread to other parts of the body.
3. If you don’t follow my advice, the infection could get worse and then you need to get
hospitalized, you would not like that, would you?
4. If pt wants discharge: the best advice is to get plenty of rest, if you go back to work soon, then
you may not make full recovery and your condition could get worse, you don’t want that to
happen, do you?

If patient is convinced,
I am glad that you made the decision, / I appreciate that you agreed… (Appreciate patient )

Review: (if in the task)

I hope I have answered all your questions / please make an appointment with reception to see me in a
week/month/after 5 days…/ Is there anything else I can help you with today?
Thanks for coming to see me today, good bye.