Anyone who works in health care has had a difficult discussion with a patient, resident, client, family member, significant other, or a person’s chosen representative. Most times these conversations with angry individuals, our customers, come without warning. The first few encounters in your career can feel like a personal attack.
THERE ARE THREE COMMON WAYS WORK-PLACE ISSUES ARE RESOLVED:
- You assume responsibility for the issue regardless of fault and do your best to resolve the issue.
- The mistake is yours. You resolve the issue and closure is obtained.
- The issue is not your fault but you still resolve it and find closure for the person who is upset.
How to deal with CHRONICALLY UPSET PEOPLE
Then there are the people who are chronically upset. They change issues as soon as a solution is offered in order to keep an ever-present level of tension and contention. People who are chronically upset have something deeper than the voiced issue driving the conflict. In healthcare, it is usually a loss of control.
Loss of control occurs across the spectrum of healthcare. Any one of the following issues can make someone feel like they have lost control of their health, and even their lives:
- A devastating accident
- Their diagnosis
- Loss of prior health
- Inability to care for themselves or their family member
- Loss of independence
- Persistent pain
In addition, people important to person you care for often feel a loss of control as they grieve healthcare related changes in their loved one. It is a near unconscious habit to want to live in the best of times. However, the journey of life has a smattering of really good times, is peppered with some good times, but mostly consists of less than perfect times. Situations that stoop below less than perfect times provoke emotions that are often manifested in anger, anxiety and agitation, or hyper vigilance. A lot of the time it is manifested with a mix of reactions and behaviors. These emotions and behaviors are not consistently normal for most people, which means there are ways to help them move in a direction of feeling more control over their life.
Six ways to handle Difficult Situations
The first thing you can do is listen. The single most important thing you can do to help someone who irritated, frustrated, or feeling a loss of control is to make and take the time to listen to that person. Repeat back to them what you have heard at regular intervals so that they know you have heard them and heard them correctly.
Offer empathy and compassion for their experience. Empathy and compassion in times of stress is the foundation to a productive relationship. It can instill a level of understanding and trust that cannot be achieved in any other way. You or I may not have experienced the exact situation as the person we are interacting with, but we have enough life experience to make relatable connections and have experienced similar emotions.
I have yet to meet someone who has not experienced a time in their life where they felt like they had lost control in their lives. If you haven’t experienced it, you have witnessed it in your healthcare job.
People don’t seek healthcare because they can resolve their own health issue. As a matter of fact, it is usually a surprise for them despite many warning signs. So how can you help? Work with them to identify things they can control. Someone who is new to an assisted living facility may be mad because they had to move out of the home and neighborhood they have lived in for 50 years. While they can really not control the fact that they are not able to live without help anymore, they are in control of the furniture configuration in their apartment, the pictures on the walls, the knick-knacks that they decorate with.
Someone who has just been newly diagnosed with cancer may feel a grave loss towards their health and be lashing out at everyone around them in order to have some sense of control in their life. Having an honest discussion about how much treatment they want to seek and where their threshold for seeking treatment ends can provide enough validation to empower them to make a decision that suits them as an individual. Hence, giving them back some control over their life.
Work with the person to rebuild and find life purpose that gives them a sense of control and self-worth. This could be accomplished by identifying or providing opportunities for them to use other talents or skills in the environment they are in. If it is a family member who feels very connected to their parent that you now care for, it may mean letting them guide and participate in care. It could be as simple as making the effort to keep them informed and involved in decision making. Importance and control go hand in hand.
Negotiate for an acceptable outcome. Remember that you are negotiating because the other person is emotionally invested. They feel threatened or feel like they are losing something. We are all people and things that make us angry or irritated are because our emotional well-being is being threatened in one way or another. Keep this in the forefront of your mind while trying to resolve the issue. You can then find an acceptable solution that will de-escalate the threat.
Bring other members of your team or community in to help find a resolution. Loss of control can occur as a result of physical, spiritual, emotional, or moral injury. Identifying the true source of the issue can help you bring in others who may have different tools to address the issue. This is particularly helpful in situations where as hard as you try, you cannot please the other person.
WE ARE ALL HUMAN
It is human nature to want control in your life. We all want to be autonomous and empowered to live our best lives. Despite our best efforts the unpredictability of life often gets in the way. Being an innocent bystander in a contentious situation can leave you feeling as out of control as the other person. As healthcare professionals we don’t have to assume responsibility for the issue. We really only need to work at facilitating a resolution. People are unique, interesting, and each person is an individual with something to offer life each day. We can focus on helping others live their best life and avoid escalating situations rooted in the loss of control.
Holly Carlson MS, RN, CCRN is a freelance writer and owner of HDC Consulting. Holly is a registered nurse with 25 years of healthcare experience in both acute and post-acute healthcare environments. Her experience includes direct care, organizational leadership, facility management, and organization culture development.