How should a health care worker respond to an angry and frustrated patient?

Sometimes patients and family members appear to become angry for no reason: One minute they’re friendly and chatting, and the next they’re distressed. There’s always a reason, whether it’s immediately apparent to you or not. Pain and fear can cause anger, but so can worry, and sadness. If they’re in the hospital, patients and their family members are often facing concerns and an array of emotions they’re not used to. Be patient and listen to them. Whether the anger seems irrational or not, whether they seem to be generally disagreeable or not, you can find empathy for their situation, and you need to show it.

To empathize well, you need to put yourself in your angry patient’s position, and imagine how you would be feeling with a broken arm or kidney disease or 104° fever. Angry family members are often just worried for their son, mother, or grandfather. If you can put yourself in their shoes, you’ll be more empathic about their situation, and anger, and so you can validate their feelings while addressing their specific concerns.

Being sick, experiencing pain, or waiting for a test or procedure can lead to angry patients and families. Many nurses and healthcare teams struggle with how to effectively handle angry patients and families. This can lead to ineffective communication, a disruptive workplace and safety issues.

Here are 8 effective ways to handle angry patients and families

1) Be empathetic.

• Put yourself in the patient and family’s shoes. Think about the situation from their perspective. Would you want to be stuck in the hospital for days and cared for by different strangers? What if you were restricted to NPO (nothing by mouth), can’t sleep, waiting for hours or in a lot of pain? What if you wanted answers that you weren’t getting? Try to understand the challenge of being vulnerable and think about how their family feels too. After all, they feel very limited as far as how they can help their loved one.

2) Listen.

• Sometimes patients and families need to vent. After all, patients and families want to be heard, so be sensitive to this and do not interrupt them. Allow them to share their feelings. Maintain good eye contact and give a few simple head nods as they share their experience. After you listen, paraphrase what you heard back to them. This helps validate their feelings and will help them feel understood.

3) Be sensitive to space and touch.

• Provide angry patients and families personal space and do not touch them. Allow them to vent from a comfortable distance, and refrain from even a gentle touch. When possible, get eye-level with them and lean in towards them slightly. This non-verbal gesture shows them respect and care.

4) Apologize.

• When you apologize, you are not stating you are at fault. You want to apologize that the patient or family members feel the way they do – apologizing doesn’t imply you did anything wrong. Many times, we walk into emotionally charged situations and we had nothing to do with the incident or issue. Stating you apologize that they feel a certain way helps to deescalate the situation and shows professionalism.

5) Set expectations.

• Defuse situations before they escalate. If you feel the situation is becoming hostile, get help immediately. Although patients have a right to be involved in their medical decision-making, they cannot use that right for any unreasonable demands. If the patient threatens you physically or you fear for your safety, don't hesitate to contact security or the police. For more immediate assistance, consider establishing a code phrase that indicates when a staff member needs help.

6) Ask open-ended questions.

• An open-ended question encourages a meaningful answer using the subject's own knowledge and/or feelings. It is the opposite of a closed-ended question, which encourages a short or single-word answer. Close-ended questions can make a bad situation worse. Open-ended questions are also more objective and less leading than closed-ended questions. Use open-ended questions, such as:

“How can we move forward”

“Tell me more about…”

“Can you tell me what you need?"

"Do you have some suggestions on ways to solve this?”

 7) Deep Breathing.

• Deep breathing increases the supply of oxygen to your brain and stimulates the parasympathetic nervous system. As a result, this promotes a state of calmness and reduces anxiety and anger. Taking a moment to breathe also provides some time to think about your actions, words, and follow-up.

8) Have Gratitude.

• It is important to remember that although we can’t change adversity, we can change the way we react to it. Dealing with angry patients and families is challenging and can impact safety and performance. It is important to keep a healthy mindset. This can be accomplished by thinking about positive things that happened and what you are most grateful for. In other words, little things are big things. Thinking about what you are grateful for will help decrease the stress hormone, cortisol and increase neurotransmitters, serotonin and dopamine.

In summary, working in healthcare requires emotional intelligence, resilience and stamina. Having finesse in defusing and managing anger will help keep the focus on getting the patient healthy and protect you from unwarranted legal action or stress-related health issues. Understanding how to handle emotionally charged situations is a valuable learning moment that can build your confidence level, preserve your patient relationships and promote a healthy workplace environment.

About the Author

Cheri Clancy, MSN, MS, RN, NEA-BC, CPXP, is the founder of Cheri Clancy & Associates LLC, a coaching and training firm that uses hard sciences as a catalyst for soft-skill leadership development. In addition to presenting, coaching, and consulting, she is an adjunct faculty at Rutgers University and an author.

Critical Conversations in Healthcare, Second Edition, provides scripts and scenarios to facilitate better, more effective communication in healthcare settings. Chapters feature do’s and don'ts, reflective questions, and practical tools to help you improve your on-the-job interactions. Whether you are a new nurse at the bedside or the CEO of a major healthcare facility, this fully revised second edition will show you how to: