Tips: How to Defuse the Angry Patient (or at the Very Least, Make Things Worse)

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Handling the angry patient (or family member) is a very delicate situation, so we should all be grateful that we were never educated on this during medical or nursing school.  At times, dealing with the angry patient can feel like walking on eggshells.

angry patientWhen that happens, I call environmental services and ask them to clean up all the eggshells before someone slips and gets hurt (that’s just a lawsuit waiting to happen!).  If the floor is egg free and the patient is still angry, follow this guide to either (1) come to a resolution or (2) make things exponentially worse.


Call in sick.

There is nothing wrong with avoidance or running away, as you long as you’re okay forever being known as a spineless human.  Call in sick, say that you tripped, falling forward, leading you to accidentally suck on the filthy doorknob of a public bathroom and are subsequently symptomatic.  Better to have someone else deal with your mess, right?  “What if I’m already in the hospital?” you ask.  Simple: call out sick.  Just say you tripped, fell forward, accidentally sucking on the MRSA-infested doorknob of the office bathroom instead.

Have someone lower than you on the medical totem pole go fix it.

If your rank has you “above” another (say a student, intern), then this is the perfect time for them to practice what we call “real-world medicine.”  Tell the said person that if he or she defuses the situation without your assistance, you may consider not failing them.  If he or she does fail, tell them it’s an eternity of bowel disimpactions (no mask or gloves either).

Man up and wait until tomorrow, hopefully it’s better then.

In the event you can’t escape the hospital or clinic for greener pastures, then simply play the medical version of hide and seek from the angry patient until the next morning.  Avoid the floor that contains the angry patient and if possible bury anything through which you might be reached: phone, pager, computer, house.  Sure, there’s only a 0.000001% chance that he or she will not be angry in the morning, but isn’t that a chance worth taking?  If the angry patient finds you before the morning?  Scream “Tag!  You’re it” and run away.

Say you are sorry… that someone else screwed up.

There is no better time to shun responsibility and play the blame game than at the bedside.  Why own up to your mistakes when you can easily find someone else innocent to blame?  There is no other moral or ethical alternative, and if there is, it’s best to ignore it.  It’s time to act like a grown up and say with the utmost conviction and sincerity, “He did it!!!”

Take a deep breath and bring a puppy to bedside.

Before you enter into the room, make sure you gather yourself: close your eyes, take a deep breath, and become one with the situation.  Once you wake up, direct Sparky right into the lap of your angry patient.  This is a critical juncture so be sure to take the time required to find the cutest and furriest puppy possible.  “Who can stay angry at this cute little face???!!!”  Helpful hint: If you do not have access to a puppy, then (1) ask if the angry patient has pictures of a cute pet, thereby distracting them or (2) change out of your clothes and don a shirt with the picture of a baby golden retriever or pug.  Your love of puppies will win the patient over in no time.

Call Psychiatry and pray that it’s psychosis or something.

So you accidentally left the patient NPO for the past 72 hours.  It’s an honest mistake!  Or is it?  The patient is angry at you because you haven’t fed him.  But maybe it could be psychosis?  Does he have decision-making capacity?  Is he withdrawing from something?  Most likely it’s food, but you can’t be too sure.  Psychiatry is more than happy to help, although probably not.

Be the bigger person and discharge the patient.

The customer may always be right, but who says that the patient is?  Why pay attention to the patient’s legitimate concerns when you can play the ultimate card, the ace of hearts, the discharge?  They may howl and cuss, but it’s a great way for the angry patient to meet everyone, like the charge nurse, nursing supervisors, administration, risk management, and security.

When all else fails, call Palliative Care.

We all do it, it’s the ultimate failsafe.  Palliative Care makes it all better.  You may try to dance around the consult and win them over with key phrases like “code status” and “goals of care,” but they’ll figure it out, based on the patient hollering belligerently in the background of your phone call.  But that’s what’s amazing about Palliative Care.  They’re fazed by nothing, and when all’s said and done one of two things will happen: (1) the patient will be cooperative or (2) the patient will be DNR.  I’m not sure how they make this magic happen, but I swear they do it every time.

Or you can just accept responsibility, apologize, learn from it, and try to become a better person and provider because of it.

Ha-ha!!!!  Just kidding!  What a HILARIOUS thought though!!!  Am I right??!!  I mean, who on earth would ever do that??!!

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