Amazing as it may sound not everyone is thrilled to see me when I knock on the door with my sunshine and promises of supernatural healing powers!! Some people are grumpy, angry, weepy, unresponsive, talk too much, talk too little. Some people have an agenda to get me in the middle of their family squabbles and of course pass judgement in their favor. Some people expect me to stay for dinner, walk the dog, do the laundry and clean the bathroom. Yep, I have been asked to do it all and seen so much dysfunction in the family group I almost think my family is normal (steady on, I said "almost).
I was once asked in an interview for a job how I dealt with difficult people and after I thought about it for a moment, I answered something like this.
I do not consider that I have difficult patients. I have patients that have baggage like most of us, maybe their baggage is more focused because of an acute illness or the exacerbation of a chronic one. People exhibit stress in so many different ways. The way a person manifests stressed maybe directed at me, the nurse, because I am supposed to be there to fix the problem and don't I have a resource list the size of a telephone book! I have learned to take a deep breath before answering and realize the negativity in the room is not about me and I should not take it personally. This person has a problem that needs solving, and we can brainstorm together. When I turn it around and show concern for a patients anxiety they usually calm down and we can discuss/identify the real problem at hand, be that financial, emotional, a pain response, a lack of acceptance of the health issue. But sometimes a person does not calm down, then its time for a time out and I try and leave to protect everyone.
When I am in a patients house, carrying out care I tend to be chatty, some may say overly chatty! I like to ask a lot of questions, why? because fact finding is a safety tool to find out more of a persons health status. But I also ask lots of questions because I think peoples stories are just so interesting. In the medicare population I serve I have met a survivor from Auschwitz, a lady (now 90) who immigrated on her own from Italy when she was 16, WW2 veterans and more recently veterans from Iraq and Afghanistan wars. These boys are just a little older than my oldest son so the maternal feelings kick in very strongly. One young man I a seeing right now, several times a week for wound care needs can be pleasant and sociable and then the next day can be as dark as a black hole, PTSD is a terrible thing.
Unfortunately, not everyone wants chatty Kathy in their ear when I am doing wound care or checking a BP, I have learned to be quiet when I need to. Quietness can be an important therapeutic tool when dealing with "difficult patients". It gives a person control of what to say and when. Its hard as heck for me to shut up sometimes but it is valuable to hear what comes back.
Now, if I could just learn to do that at home!!!!!
