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Managing the

Challenging and Demanding Patient. 

Notes From Group Session. Cascade teaching day 15.6.00

 Identified 2 broad groups of patients: 

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The Somatising patient. 

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The more up front demanding, difficult or aggressive patient. 

Noted that different Doctors find different patients demanding and difficult. Helpful as we can learn skills from each other.

Points Identified as problems. 

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Loss of Structure 

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Fear of loss of control 

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Annoyance and irritation. 

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Feeling disempowered 

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Challenging our competence

 Skills and suggestions we could use.

 Learning to accept our negative emotions, understand them but not react to them.

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Stand back and stay calm, whatever is going on inside us.  

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Look for the reason for the reaction. Empathise. Try to explore patients I.C.E.

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Step back from our reactions and possibly hurt and pain, into what we already know with consultation skills. 

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Watch out for our own negative non-verbal signs, and try to use positive non-verbal signs. 

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Structure is important and OK structure can and does give us safety. 

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Be honest BUT kindly, in our honesty. 

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Learn to become a mirror and not a sponge, reflective not absorbing. 

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Accept that some things may be non-negotiable, and some consultations may be unrecoverable, in the sense of a peaceful outcome.

 Finally a useful guide, 

Knowledge 

Expel Prejudice 

Express Concern.  

Position Appropriately 

 

Confront with Care.  

Avoid Touch 

L else (Canít now remember the significance of this one!! )  

Manage.

 

i.e. Keep calm 

Tony Bond 26.6.00

 

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