Conflict Resolution and Communication Strategy for Dealing with a Difficult Patient

QUESTION

A 72 year old male client with a diabetic foot wound is admitted to your unit. The client is awake, alert, & oriented x3 & has orders to be OOB to the bedside commode with a 1 person assist.
The client complains that the UAPs do not come immediately & has stopped using his call light & now yells from the room when he needs to use the commode. When the staff are in the room, he curses at them and tells them they are stupid and slow. The staff report that they respond as quickly as they can and that the client is often already on the commode when they arrive, but is still yelling.

Is avoidance (assigning different staff to care for the patient) an appropriate conflict resolution strategy in this situation? Why or why not?
Will you as the manager/leader encourage the nursing assistants to confront the
patient directly?
What coaching or role playing might you use with them if you choose this approach?
Devise a strategy that will address the issue, including what is and what is not negotiable.

ANSWER

 Conflict Resolution and Communication Strategy for Dealing with a Difficult Patient

Introduction

Dealing with a difficult patient presents challenges for healthcare teams. This essay discusses conflict resolution strategies and effective communication techniques to address the situation of a 72-year-old diabetic foot wound patient who exhibits disruptive behavior and dissatisfaction with response times.

Is Avoidance an Appropriate Strategy?

Avoidance, or simply assigning different staff to the patient, is not an appropriate conflict resolution strategy. This approach may alleviate immediate tension, but it does not address the underlying issues causing the patient’s frustration. It can also lead to fragmentation in care and decreased staff morale. Instead of avoidance, a more constructive approach is needed to address the patient’s concerns and improve the patient-staff relationship.

Encouraging Direct Confrontation

Encouraging nursing assistants to confront the patient directly is an option, but it needs to be handled with care. The focus should be on assertive communication, not confrontation. Nursing assistants can be encouraged to calmly address the patient’s concerns, express their commitment to providing prompt care, and seek understanding of the patient’s perspective.

Coaching and Role Playing

To prepare nursing assistants for direct communication, coaching and role playing can be employed. This involves simulating scenarios where nursing assistants practice responding to the patient’s complaints assertively and empathetically. Role playing helps them gain confidence in managing difficult conversations, allowing them to maintain professionalism while addressing the patient’s frustration.

Conflict Resolution Strategy

Negotiable

1. Response Time Explanation: Nursing assistants can calmly explain that they respond as quickly as possible but may be occupied with other patients at times.
2. Empathetic Acknowledgment: Acknowledge the patient’s concerns and frustration empathetically, validating their emotions.

Not Negotiable

1. Disrespectful Behavior: The patient’s use of foul language and disrespectful behavior towards staff is not acceptable and should be addressed promptly.
2. Call Light Usage: Nursing assistants should encourage the patient to use the call light for assistance, reinforcing that yelling is not a respectful or effective form of communication.

Conclusion

Avoiding the situation is not a viable solution. Encouraging assertive communication and providing coaching empowers nursing assistants to address the patient’s concerns effectively. A conflict resolution strategy involving explanation, empathy, and clear communication will contribute to improved patient-staff interactions, enhancing patient care and overall unit dynamics.