Dealing with Angry Patients: Strategies for Hospital Workers

Abstract

Hospital personnel are not immune to the anger of patients. As patients become sicker, they become more vulnerable, and some react to their fears and uncertainties with anger. This anger may be projected toward health-care personnel, who in turn may feel frustration or anger in response. In hospital settings, much of the contact between personnel and patients is intermittent, leaving little opportunity to build rapport and explore the multitude of issues so often surrounding a patient's health. In a way, health-care personnel are intruders, interfering with patients' lives when patients would prefer to be left alone. Under these circumstances, symbolizing caring is difficult. More often than most health-care workers would like, they are representatives of bureaucracy, messengers of fear, bearers of needles, or deliverers of unpleasant news. Even while acting in a caring fashion, as might a nurse listening to a patient's lament about the hospital, the health-care worker may have other things on his or her mind, and the patient senses this. In effect, health-care workers setting out to do their job of relieving suffering may act as living symbols of institutional control, becoming more objects of negativity than agents of healing. Methods: To date, no studies in Spanish medical literature analyze methods for handling conflicts in doctor-patient relationships. Experts recommend remaining calm, listening attentively, understanding and expressing empathy, and searching for a solution. They also suggest various coping strategies to prevent confrontations. Repressed anger signs include feeling overwhelmed, depression, irritability, sensitivity, and decreased concentration. Conclusion: Failure to manage angry behavior can jeopardize the patient-physician relationship and effective care. Assertiveness, good listening, and concern for the patient's loss of control can improve communication. Support is necessary for both the clinician and patient. Short-term suggestions include rapid treatment of life-threatening anger and using medications appropriately. Maintain professional boundaries regardless of the patient's behavioral problems. When anger becomes violent, safety is paramount, and backup should be summoned. Training, planning, and resources are essential. Quantitative studies are needed to verify strategies' usefulness. Outpatients with psychiatric diagnoses often have concomitant medical illnesses and are seen in hospital settings. Hospital staff must feel comfortable with at-risk populations. Assisting angry out-patients can prevent serious situations. Hospitals should anticipate victims of community violence at any hour.