Award-winning Bariatric Physician Dr. Jan McBarron, A Guide to Patient Pushback
The lives of doctors and nurses are not without their challenges. Even the most rigorous of educations are not an end-all, be-all preparation for what’s to come, and textbook knowledge is only going to help you so much with one of the most common issues in medicine: Difficult Patients.
There are always going to be patients that are troublesome, giving pushback and requiring far more patience and problem solving than most. It can be a daunting challenge to provide compassionate medical care to a seemingly argumentative, unappreciative and even combative patient. Dr. Jan McBarron has graciously provided a guide to help caregivers cope with the stress of patient pushback.
Use the Right Language
When dealing with patients who are not cooperative with their treatment, the first step is to look inwards and assess the language that you are using. Language is what you are communicating, and it’s not just about what you say, either. Body language can speak volumes and it’s the first thing you should self-evaluate. Avoid any negative gestures such as clenched fists, crossed arms or poor eye contact, anything that can give the appearance of annoyance, frustration or anger is not acceptable. People respond to how you make them feel rather than simply to what you say.
Second, Jan McBarron notes it’s a good idea to be proactive in a conversation and gently acknowledge any tensions that are happening verbally. When you do this, you’re keeping yourself and the patient on the same page so that you can be better suited to finding a solution.
Next, it may seem obvious, but always avoid arguments, always. Troublesome patients will often use logic that is entirely suited to and biased towards them, and attempting to get them to see their error will only escalate the situation.
Finally, when it’s your turn to talk, use open-ended language. Allow the patient to fill in the gaps with their own impressions and understanding and do your best to guide them along to see the bigger picture of why their way may not help them get well sooner. Open-ended questions and statements are also non-aggressive, and ideally defuse the situation.
Be the Bigger Person
It’s a hard pill to swallow, but with high probability you will never convince a patient they are wrong. Instead, Jan McBarron states you should step up as the bigger person, because patients can’t always see the bigger picture, and part of their pushback and aggressiveness stems from things like fear and anxiety. In addition, remember they are sick and how you feel when you are sick. Often, we revert to childish behavior and want our own way.
Empathy is the key here in order to try and build a connection, as well as calm a patient down. Acknowledge their problem and do everything you can to be genuine when you try to see things from their perspective.
Everyone has a story, and a lot of patients have a desire to be heard. When you take the time to let their story come out, oftentimes you can start to piece together the ‘why’ of the situation and you can have a better idea of what they need to hear from you.
Finally, sometimes in order to be the bigger person you need to take a moment away from the patient to cool down and collect yourself. This can make the difference between your returning to help them with an improved state of mind and letting the stress get to you. Once you allow your own negative thoughts or emotions take over, this can seriously jeopardize your ability to provide the best care. Furthermore, you will probably regret it later.
Jan McBarron’s Final Thoughts
What it boils down to is that patients who give pushback are acting in the moment, seeing only the short-term implications. They cannot be expected to have the same knowledge or objectivity as the professional taking care of the them. Furthermore, even if they do, remember they are sick and reverting to childish, unreasonable or inappropriate behavior. Instead, it’s all about approaching them with the right language and attitude, as well as acknowledging that you can and will do your best for them, even if they seem ungrateful.