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First times - dealing with a difficult patient

Handling an angry patient can be a distressing experience as anger can be a difficult emotion to contend with.

In some circumstances, it is easy to understand patients' anger: they might have been told bad news or have concerns about their clinical care. At other times, you are taken unawares, the anger will be unexpected and you can feel ill equipped to deal with it. In response, you might feel angry with the patient.

The patient's anger may represent an expression of anxieties and concerns that he or she feels unable to cope with. They might be able to identify more readily with medical students than more senior members of the medical team, and medical students can become the emotional receptacle for the patient's feelings as a consequence.

So how do you begin to handle the situation?

Validate the feelings of the patient: they might just need to know that they are being heard, even if you are unable to help them directly.

Define your role and what you can and cannot do. Problems can result if you feel pressurised into giving advice or taking on a role for which you are not qualified. It is important, therefore, that you keep your boundaries and you try to separate yourself from the emotions of the patient.

Recognise that in the majority of cases patient anger is not 'personal'. Do not reflect anger back on the patient. If the experience of dealing with an angry patient has been distressing, then it's important for you to debrief with a colleague or senior member of your team.

Through debriefing, you can address the emotional impact of the experience on you, take the opportunity to learn from it and consider how you might do things differently in the event of a similar situation arising in the future.

You should also make sure that the patient's legitimate concerns are channelled to the appropriate person.

Dealing with angry patients is an important skill to acquire when you are training to be a doctor. With experience, you will come to develop mechanisms that will enable you to respond appropriately and with confidence in this difficult and charged situation.