Dealing with difficult patients

Dealing with difficult patients is one strain that doctors have to deal with every day. It is therefore the role of physicians to learn how to deal with it so that as not to compromise their duties. This paper analyses a case study concerning two patients. They both suffer similar problems with their knees and so they are both required to climb two steps to position themselves appropriately for examination. Both patients are reluctant to make the climb due to the pain they experience at their knees when attempting to do this. When the student requests the supervising radiographer to assist the first patient, the patient is abusive and disrespectful. Eventually, the patient is examined after the student radiographer assists her into position. On the second case, though reluctant, the patient offers to try and climb the steps after the student offers to manage her differently in another room. This report intends to investigate stressful situations the radiographer meets during his work, their effects, and how to take care of his wellbeing before and after such encounters.

The two cases are not unique. It is very common for radiographers and other health practitioners to meet such cases in which they eventually feel insulted in their attempts to serve their patients. Apart from examining the patient, the radiographer also has the role of making the patient feel comfortable with the examination[1]. If need be, the radiographer needs to explain to the student what is required of her and what it comprises. He is required by law to act to the best interests of the patient[2]. Failure to be professional may lead to situations such as the one seen in the first case. Cases of unprofessionalism include: discrimination, being disrespectful, carelessness and others[3].

The first case shows a situation where the patient, who is overweight, feels disrespected when the student radiographer suggests she be assisted to climb the steps by the supervising radiographer. The patient is probably one who suffers stigmatization due to her weight. According to research, many overweight patients do not get the same patients as other patients[4]. To solve this issue, it is the role of medical practitioners to ensure that the same care is given to all patients alike. Failure to give the same kind of service to all patients amounts to unprofessionalism and may lead to disciplinary action.

There are many other situations where the patient may feel discriminated or stigmatized. Stigmatization may arise as a result of a difference in the health problem suffered by the patient. This especially happens when dealing with patients suffering from chronic diseases and communicable diseases. Good examples of diseases that have led to stigmatization include HIV/AIDS, diabetes and others. Other grounds that have been used as bases for stigmatization include culture, age, and weight[5].

To deal with such cases, the best way to deal with patients who have such problems is to give alternative methods of dealing with such patients as in the second case. Some patients will feel appreciated by this while others may opt to work with the radiographer under his initial terms. The point here is to ensure gets the best possible service and at the same time ensure that the patient feels appreciated. Above all, it is important that the radiographer ensures that he does not appear as if he is engaging in acts of stigmatization as this will amount to stigmatization and unprofessionalism.

Alternatively, the radiographer may also require asking for the opinion of the patient especially in a case. This would come in the form of requesting if the patient would require further assistance. This way, patients will be more willing to seek healthcare without fear of stigmatization[6]. However, it is important that the radiographer ensures that the patient understands exactly what is expected of them. This way, patients will see the sense of concern from the radiographer and, therefore, the stress that is associated with situations such as this will be avoided.

While dealing with patients such as these, radiographers need to care of their own well-being. Dealing with difficult students, more often than not, results in psychological stress. This if not taken care of, may result in the radiologist not being able to deliver on other patients[7]. The support may be obtained from colleagues by sharing the situation with others and listening to their opinions[8]. Discussing the incident will also help calm the effect of the incident.

Another option that may be used to deal with the effects of dealing with stress that may result from such issues is for radiologists to give themselves time to recharge. If a situation takes toll of a radiologist’s concentration, t may be necessary for them to take some time off. This time may be taken to just think about the issue and work out ways that can be used to handle similar situations in the future[9]. Resting will relieve the stress to some extent. The organization with whom the patient is working should participate by giving the worker some time to recharge.

Alternatively, radiographers should consider engaging a third party neutral support mentor or coach to help you handle the situation[10].  This will offer the required expertise and thereby help the radiographer to move forward. The option of having a coach or mentor prevents the situation from getting out of hand. This, however, only happens when the situation becomes too much for the radiographer to handle alone or with the help of colleagues and family[11]. To assist with this, medical institutions should be ready to invest in support programs for their workers.

Radiographers may also opt to get themselves to not get too emotionally connected to their jobs. Jobs in the health industry sometimes seem to be too stressing due to the fact that they involve saving patients from life threatening situations. Getting too emotionally connected to the industry however prevents the radiographer from delivering. Delivery is the she sole purpose of the profession and failure to deliver will lead to wastage of resources and even a risk to life, which they are supposed to protect[12].

Radiographers may also engage simple methods of handling stress. This would include retreating to something that the radiographers in question enjoy and try to work out. Exercise is known to relieve stress provided it has not got out of proportion. Good examples include joining sports clubs or exercise groups.  Others may opt to get into activities such as travelling, reading and even writing. On the other hand, they should avoid destructive behaviors that are associated with stress relief such as drug abuse, alcoholism, and tobacco smoking[13].

In the worst cases, the radiographer may require to consider the motivations behind his decision of choosing his career. In most cases, his motivations are bigger than any problems he may encounter. If it involves serving people and helping save lives, it will be worth his effort to serve every patient happily and will the carefulness he deserves.

In conclusion, radiographers and other medical practitioners often have to deal with difficult patients. These patients react in different ways to the attempts by the radiographer to assist them. Sometimes, however, the patients have a right to their difficulty as they may arise as a result of the radiographer exercising unprofessional behavior. This may come as a result of the doctor being discriminative while dealing with patients with different orientations of behavior, belief, culture, or even health situation. When this happens, it is advisable for the health practitioner to apologize and get into terms with the patient. However, sometimes the patients are just difficult to handle and their behavior only seems to make the work of the professional difficult. Whatever the case, once it happens; the radiographer is met with stress, sometimes so big he requires some time out or some psychological attention. In such a case, the professional requires to engage in activities that will help relieve the stress.

References

Kelly D. Brownell, PhD, and Rebecca M. Puhl, PhD. (2006). Stigmatised patients right to equal treatment. Virtual Mentor. Ethics Journal of the American Medical Association, 8(5), pp 296-302

Physician stress: Results from the physician work life study. Stress and Health 18: 37–42 DOI: 10.1002/smi.917

Rosenstein A. H., and Mudge-Riley M., (2010). The Impact of Stress and Burnout on Physician Satisfaction and Behaviors. Physician Executives Journal. P20

Shadowfax, MD (21^st Jan, 2013). Dealing with Psychological Stress of being a doctor. KevinMD.com Available at: http://www.kevinmd.com/blog/2013/01/dealing-psychological-stress-doctor.html

The American Registry of Radiologic Technologists (2013). Standards of Ethics

Lindforsa S., Eintreib C., & Alexanderson K. (2009) Stress factors affecting academic physicians at a university hospital. Work 34(2009) 305–313  DOI 10.3233/WOR-2009-0928

Puhl R., & Brownell K. D., (2001). Bias, Discrimination, and Obesity. Obesity Research, 9(12) pp788-805

Rajan P., Bellare B., (2011). Work Related Stress And Its Anticipated Solutions Among Post‑Graduate Medical Resident Doctors: A Cross‑Sectional Survey Conducted At A Tertiary Municipal Hospital In Mumbai, India. Indian Journal of Medical Sciences, 65(3)

Poonpetcharat P. (2010). Teaching exchange: Role-play series on the difficult patient approach in the family medicine residency programme at Ramathibodi Hospital, Thailand. Education for Primary Care 21(2010) pp248-251

Pomm H. A., Shahady E., Pomm R. M., (2004). The CALMER Approach: Teaching Learners Six Steps to Serenity When Dealing With Difficult Patients. Family Medicine, 36(7) pp467-469

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[1] Pomm H. A., Shahady E., Pomm R. M., (2004). The CALMER Approach: Teaching Learners Six Steps to Serenity When Dealing With Difficult Patients. Family Medicine, 36(7) pp469

[2] The American Registry of Radiologic Technologists (2013) p1

[3] Puhl R., & Brownell K. D., (2001). Bias, Discrimination, and Obesity. Obesity Research, 9(12) pp794

[4] Kelly D. Brownell, PhD, and Rebecca M. Puhl, PhD. (2006). Stigmatised patients right to equal treatment. Virtual Mentor. Ethics Journal of the American Medical Association, 8(5), p299

[5] Pomm H. A., Shahady E., Pomm R. M., (2004). The CALMER Approach: Teaching Learners Six Steps to Serenity When Dealing With Difficult Patients. Family Medicine, 36(7) pp468

[6] Kelly D. Brownell, PhD, and Rebecca M. Puhl, PhD. (2006). Stigmatised patients right to equal treatment. Virtual Mentor. Ethics Journal of the American Medical Association, 8(5), p300

[7] Shadowfax, MD (21^st Jan, 2013). Dealing with Psychological Stress of being a doctor. KevinMD.com Available at: http://www.kevinmd.com/blog/2013/01/dealing-psychological-stress-doctor.html

[8] Physician stress: Results from the physician work life study. Stress and Health 18: 37–42 DOI: 10.1002/smi.917

[9] Kelly D. Brownell, PhD, and Rebecca M. Puhl, PhD. (2006). Stigmatised patients right to equal treatment. Virtual Mentor. Ethics Journal of the American Medical Association, 8(5), p299

[10] Rosenstein A. H., and Mudge-Riley M., (2010). The Impact of Stress and Burnout on Physician Satisfaction and Behaviors. Physician Executives Journal. P20

[11] Poonpetcharat P. (2010). Teaching exchange: Role-play series on the difficult patient approach in the family medicine residency programme at Ramathibodi Hospital, Thailand. Education for Primary Care 21(2010) pp249

[12] Poonpetcharat P. (2010). p251

[13] Rajan P., Bellare B., (2011). Work Related Stress And Its Anticipated Solutions Among Post‑Graduate Medical Resident Doctors: A Cross‑Sectional Survey Conducted At A Tertiary Municipal Hospital In Mumbai, India. Indian Journal of Medical Sciences, 65(3)