Unit 3 Section 3Exercise 8Dealing with ‘difficult patients’The angry patient
Clinical correlate 10: The angry patient
Read the following student clips describing a first encounter with a hostile patient. Then answer the discussion questions and view the video clip.
Student 1 The other day at the clinic, I had the first occasion where I felt officially threatened by a patient. He was a middle-aged African-American gentleman who my doctor had already smirkingly told me would be "quite interesting" and, as I finished my history-taking and physical, he started calling me a "no-good racist" for giving him a partially clean bill of health whereas he was determined that something was wrong with him. Perhaps I took too direct an approach when I told him that his "condition" was really just a scar and that it may or may not improve with time. Frankly, I think there were other psychological issues afoot. Nevertheless, as he kept prattling on that I was "against him" and that "he never got a fair shake from white doctors", I was far from comfortable in the small examination room, especially since he was between me and the door. The situation eventually resolved but it will be something I remember from this experience for quite some time.
Student 2 Not that I ever feared for my safety or anything, but I did have a similar encounter in that a patient did become irrationally angry with me and actually threaten to hit me. She was a seventy year old patient presenting with shortness of breath and chest pain. After getting her history and performing a physical exam, I concluded that she wasn't in any acute danger and would be alright waiting for her physician. Unfortunately, the doctor was running significantly behind schedule and she became extremely frustrated, saying "I'm getting the hell out of here." I tried to slow her down and explain the necessity of ruling out serious pathology, but she was determined to take off. As she went for the door I made one more plea for her to stay, to which she said something to the effect that she was going to smack me if I didn't get out of her way. Given that she wasn't exactly the most physically imposing person in the world, I couldn't help but chuckle under my breath. However, looking back on her reaction helped me realize that as much as we might want to care for and support our patients there will certainly be times where we'll need to consider our safety and well being.
View the following video clip with psychologist Jean Gearon. 
Study questions
1. How would you handle an encounter with an angry, even threatening patient? What could make the situation worse?
2. View the following video clip, which offers one approach to the hostile patient. Hostile patient video clip: Gearon How does it compare you’re your approach?
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