difficult patients Archives

The Pitfalls of Being the ‘Nice’ Patient: A Nurse’s Perspective

Image Brent Keane/via Pexels

I have often heard health care professionals in various environments say, “If you’re nice to the nurses and doctors who take care of you, you’ll get better care.” As a bedside nurse myself, I understand the sentiment. No busy health care worker loves being met with antagonism or pressing demands that don’t strike us as critically urgent.

But when my husband and I both became patients with serious illnesses last year, we learned the clinical pitfalls of being the nice patients. I am left wondering how patients should be expected or permitted to advocate for their own care without worrying that they will be frowned upon or brushed off because they’re perceived as “difficult.”

First cautionary tale.

In early 2022, I discovered a small lump under my right breast that I initially wrote off as a cyst. Surely, I told myself, as a woman in her mid-40s with no risk factors for breast cancer, this had to be benign. A screening mammogram in May 2022 gave me an all-clear, and I went on my way.

But by November, I knew the lump had grown. I reached out to my PCP to ask for a diagnostic mammogram, and he emailed back a casual reassurance. “I know you’re worried, but […]

Hui-wen Sato, MSN, MPH, RN, CCRN2024-02-07T16:57:09-05:00February 6th, 2024|Nursing, nursing stories, patient experience, Patients|15 Comments

A Measure of Contentment: One Patient’s Daily Ritual

By Annelisa Ochoa for AJN

“A Measure of Contentment,” the August Reflections essay in AJN, describes the daily ritual of a resident in a long-term care facility. As author Nancy Ngaruiya shows us, nurses and other health care providers can sometimes notice, and support, the small pleasures and routines that make life worthwhile for patients.

Of this patient, she writes:

We make our own happiness. We define what makes us content, what actions help us find that happiness. Sometimes the recipe takes just a few ingredients. Even in an environment where freedom is limited, where rules dictate when to wake up and go to bed, what days of the week we will get assistance with a full bath and who will do it, what meals and activities are or are not available, he has defined what makes him content, perhaps even happy.

The patient in question happens to be one of those who often get frustrated, who aren’t always grateful or helpful—those who tend to be labeled as “challenging” or “difficult” by overworked providers. It’s easy to notice only the frustration of people who’ve watched their worlds shrink bit by bit as their freedoms and abilities diminish along with their health.

Jacob Molyneux, senior editor/blog editor2016-11-21T13:01:02-05:00August 3rd, 2016|Nursing, nursing stories, patient experience|2 Comments

Want to Achieve the ‘Greatest Good’? Listen to Your Patients

Ethical dilemmas abound in nursing practice. Consider these commonplace scenarios:

* An angry patient threatens to leave the hospital against medical advice. Should you hold him against his will?

* A cancer patient fears chemotherapy. Should you give less detailed information about the effects of anticancer drugs?

* An obese home care patient with pressure ulcers refuses to cooperate in turning. Should you turn her anyway?

Such conflicts between the patient’s wishes and the nurse’s perception of the patient’s best interests occur regularly. That doesn’t make these ethical dilemmas any easier to resolve, but how nurses approach them can significantly affect clinical outcomes. Taking the time to listen to patients—and to integrate relationship skills with principles of ethical practice—can help nurses achieve solutions that are both ethical and appropriate for individual patients.

ky olsen/via Flickr

That’s from the February issue of AJN, in which nurse–ethicist Doug Olsen (who has in the past written for this blog on ethical issues related to mandated H1N1 vaccinations for nurses) offers a thoughtful discussion that may resonate for all nurses who’ve ever faced a situation like those in the above examples. It may seem obvious or cliched to say that listening to patients can help solve apparently intractable problems—but just because listening as a skill is hard to measure doesn’t mean that it’s not sometimes effective where more rigid tactics would fail.

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