Tips for Nurses to Deal With Difficult Patients
Most of the time nurses deal with gentle and grateful patients. Nevertheless, it will not be a surprise to encounters a difficult patient. The experience of handling complicated patients makes nurses more competent in care giving as they learn how to deal with every kind of person.

You cannot claim to be a professional nurse unless you accept and know how to deal with grumpy, ill-tempered or over demanding patients. It is an inventible happening once in awhile. These tips are essential in helping you to cope with the shock and annoying nature of difficult patients.

It is essential that you learn to identify the warning signs that a patient is becoming upset or angry. Some of the signs are clenching of the fist, tightened jaw, lip biting and other abrupt behavioral changes. Some patients are more likely to become aggressive due to their stressful situations. For instance, you should know that patients suffering from terminal illnesses like cancer, ESRD or Alzheimer’s diseases are possible candidates for adverse emotional reactions. Patients suffering from drug abuse or those in shock from a recent nasty experience like a brutal attack are also likely to be aggressive.

When dealing with patients with one of the above conditions, you should be extra careful in observing their mood and behavior to set boundaries. You should also understand the patients are not deliberately difficult, but it is because of the illness. When you identify the reasons why a patient does not cooperate as you wish, it allows you to plan a personalized approach that allows you to care for their special needs.

When you deal with a difficult patient, the right approach is to stay calm. It is worth to consider that if the person does not attack you personally, the annoying action is out feelings of anxiety, resistance to changes in health or life or assumed lack of attention. Staying calm helps in defusing the tension and staying in control as a patient will go quiet after realizing that you are not reacting to the tantrum.

Upset patients could try to get you into an argument. You have a right to give an opinion regarding the behavior, but it is essential that you make your point respectfully. If they have a genuine reason to complain, you can apologize and sure the patient that you will take care of their need. If the patient is angry, avoid explaining why it was impossible to give the kind of attention that a patient expects or the reason for medication lateness. He may assume you are justifying a wrong and start an argument thus the matter will not end.

Try to start a discussion as it will help to draw out the feelings. Most of the problematic patients only want to get attention. Call the patient by name and maintain eye contact when speaking. Speak softly even when the patient yells and avoid negative language. Use polite expressions such as “please let me explain.” It also helps if you ask a patient for ideas or suggestions on how to handle the problem. It helps in making the person know that you understand his or her feelings.

The above tips will help in dealing with an unreasonable patient but if the patient does not calm down or continues making unjustified demands, ask to leave and promise to return later. Stay away from 25-30 and allow the patient to cool down. When you leave the patient alone helps to prevent escalating anger.



A blood transfusion is a transfer of blood or its products to a person bloodstream. It is a usually a maneuver to replace the blood cells and products after a loss through severe bleeding or surgery.

Blood transfusions save a life, and it is the reason why volunteer donor blood banks exist to ensure fast accessibility when there is a need. Proper screening of blood helps to reduce chances of adverse events to the lowest.

The likelihood of contracting infections from a blood transfusion is low but can occur. The safest transfusion is that which uses your blood (Autologous) the transfusion uses your blood thus there is no risk of contraction illness from another person. It is an option that requires planning, especially before an optional surgery.

In most instances, a patient cannot donate their blood because of the acute nature of illness which requires more blood. The person needing treatment is mostly in dire need of blood hence cannot donate. Although it is within a patient’s right to refuse transfusion, it could cause life-threatening consequences.

A parent has a legal right to decide on behalf of a child but must understand that in life-threatening situations, he must act in the best interest of the young one regardless of the belief in autologous transfusion. In non-urgent medical procedures, it will be safe for a patient to have phlebotomist draw their blood, store it in the blood bank and ask a doctor to use it when the patient goes for surgery. It is the safest since the donor and recipient are identical hence there cannot be new infections or transfusion reactions.

The procedure for different types of autologous transfusions is the same. The only difference is the time for drawing out the blood.

The patient donated blood before surgery for safe storage in a blood bank until there is a need to use it during surgery or after that. It is an option only for the elective (non-emergency) surgery. The advantage of pre-operative donation is that it minimizes or eliminates the need of using somebody blood during or post-surgery. The disadvantage is that it will require advanced planning that might delay a surgery. Some of the medical conditions might prevent a pre-operative donation of the blood products.

This type of transfusion takes place through recycling of the patient’s blood during surgery. The surgery team filters the blood that spills out after incision and put it into the body during surgery. It can be done during elective or emergency surgery. The advantage of intra-operation transfusion is that it minimizes the need to use blood by other donors. Eliminating a large amount of blood during recycling is possible. The limitation of the Intra-operative autologous transfusion is that doctors cannot use if the patient has an infection or cancer because it will cause new infection.

This transfusion is almost similar to Intra-operative autologous only that recycling of the blood as after and not during the surgery. Surgery team collects the blood lost during incision for filtering and returning to the body. Post-operative autologous applies to elective and emergency surgeries. However, it is not applicable when cancer or other infections are present.

The patient donates blood during surgery before the start of the procedure. The surgeons replace the units with IV fluids, and after surgery, they filter the blood and return it to the body. It is only for elective surgeries. The process dilutes the blood for the patient to lose less concentrated blood during surgery. The disadvantage is that surgeons can only remove a limited amount of blood. Another limitation is that it is subject to certain medical conditions.

Patients who plan to donate their blood and receive it after surgery should know that the number of units that doctors can collect is limited to their volume and health status. Health service providers will determine if a patient has enough blood to tolerate changes in blood volume and if there are existing infections.