Good bedside manner is not always enough to effectively manage all patients in the Emergency Department
Patients in the emergency department (ED) can sometimes present a spectrum of challenges for the healthcare team, ranging from uncooperative or combative behaviors to manifestations of anxiety and fear. These diverse attitudes and behaviors can add complexity and stress to the already demanding environment of the ED. While good bedside manner is certainly an important aspect of patient care, it’s not always enough to effectively manage all patients.
When healthcare providers feel empowered to take a creative approach to manage difficult patient situations, they can improve patient care, reduce stress and burnout among staff, and create a more positive work environment in the emergency department
Challenges in the Emergency Room
When dealing with difficult patients in the emergency department, healthcare providers may face a range of challenges and frustrations that can make it difficult to provide effective care. Some common challenges include:
1. Uncooperative behavior
Patients may be uncooperative or noncompliant, which can make it difficult to provide the care they need. They may refuse to follow instructions, resist medical treatment, or simply be unresponsive.
2. Aggression and violence
In some cases, patients may become physically aggressive or violent towards healthcare providers or other patients. This can jeopardize the safety of healthcare providers and others, impeding timely and effective care. According to OSHA data, healthcare workers are four times more likely on average to suffer from serious workplace violence than those in private industry. Furthermore, according to the Emergency Nurses Association, almost half of emergency physicians report being physically assaulted at work, and about 70 percent of emergency nurses report being hit and kicked while on the job.
“Healthcare workers are four times more likely on average to suffer from serious workplace violence than those in private industry”
3. Communication barriers
Language barriers or other communication issues can make it difficult to effectively communicate with patients and provide the care they need.
4. Anxiety and fear
Patients grappling with anxiety or fear due to their medical condition or the hospital environment pose challenges in delivering effective care. Traditional approaches, such as empathetic listening or a gentle touch, may prove unresponsive.
5. Noncompliance with treatment
Some patients may refuse to comply with prescribed treatments or medications, which can lead to a worsening of their condition and potentially result in readmission to the emergency department. According to one report about hospital readmissions, “In 2018, there were a total of 3.8 million adult hospital readmissions within 30 days, with an average readmission rate of 14 percent and an average readmission cost of $15,200.” Preventing avoidable readmissions to the hospital is important to help to ease financial burdens on the healthcare system as well as stress on healthcare workers.
6. Time constraints
Emergency departments are often busy and fast-paced environments, which can make it challenging to provide the extra time and attention that some patients may require.
By acknowledging and understanding these challenges, emergency department staff can better prepare themselves for managing difficult patient situations and develop effective strategies to overcome them. In the following section, we’ll explore some creative strategies and techniques that can help to manage patients and overcome these challenges.
Strategies for Managing Difficult Patient Situations
When it comes to managing difficult patient situations in the emergency department, traditional approaches like good bedside manner may not always be enough. Here are some creative strategies and techniques that emergency department staff can use to manage these challenges:
1. Use distraction techniques
Patients who are anxious or fearful may benefit from distraction techniques to help take their minds off their medical condition. This can include providing them with music & headphones, engaging them in conversation about non-related topics, or providing them with a handheld game or puzzle.
2. Empower the patient
Foster cooperation by empowering patients with a sense of control over their care. Involve them in decisions and offer choices, enhancing their engagement in the treatment process.
3. Communicate clearly
Communication is key when it comes to managing difficult situations in the ED. Staff should speak clearly, use simple language, and be patient when trying to communicate with patients who have communication barriers. Patient experience software such as Vital is on the rise to help improve patient communication in the ED. Available in multiple languages, this app gives patients and caregivers real-time updates about wait times and the status of their visit to help patients to feel well-informed. Easily printable bedside education products, such as those from PEPID, can also ease a patients anxiety by providing them with easy to understand language and illustrations regarding their diagnosed conditions and treatments.
4. Create a calming environment
Patients who are anxious or fearful may benefit from a calm and quiet environment. Staff can create a calming environment by using soft lighting, providing comfortable seating, and reducing noise levels.
5. Use humor
Sometimes, a touch of humor can go a long way in diffusing a tense situation. Staff can use humor to help patients feel more at ease and build rapport with complex patients. Laughter is a proven stress reliever with positive health benefits such as improving your immune system and relieving pain.
6. Involve family members
Family members can be a valuable resource when it comes to managing difficult patients. Staff can involve family members in the care of the patient, and encourage them to provide emotional support and reassurance.
7. Practice self-care
Dealing with difficult patients can be emotionally and mentally draining. Staff should prioritize self-care and take breaks when needed to prevent burnout and ensure that they provide the best possible care to all patients.
By practicing and implementing these creative strategies and techniques, emergency department staff can effectively manage difficult patients and provide them with the care and support they need. It’s important to note that these strategies may not work for every patient, and staff may need to adjust their approach based on the unique needs and behaviors of each patient.
Implementation
When implementing creative solutions for managing tough situations in the emergency department, there are several tips that can help to ensure success. One important tip is to provide training and education to staff on how to effectively manage these situations. This can include a variety of methods such as role-playing exercises, workshops, and online learning modules.
Another important tip is to develop clear protocols for managing difficult patient situations. Protocols should be flexible enough to allow for individualized care but also provide a clear framework for managing difficult behaviors and situations. It’s also important to regularly evaluate the effectiveness of creative solutions over time. Staff should review patient outcomes and feedback to determine what is working well and what needs improvement.
Collaboration with other departments, such as social work or psychiatric services, can also be helpful when managing difficult patient situations in the ED. These departments may have additional resources and expertise that can be leveraged to manage challenging behaviors and provide support to patients. In 2020, there were 6.2 million visits to the ED In the United States, with mental, behavioral, and neurodevelopmental disorders as the primary diagnosis. During 2015-2018, there was an annual average of 203 ED visits per 100 homeless persons. The social work and psychiatric departments in hospitals can assist these patient populations in ensuring that appropriate care and resources are given.
In conclusion, when healthcare providers feel empowered to take a creative approach to manage difficult patient situations, they can improve patient care, reduce stress and burnout among staff, and create a more positive work environment in the emergency department. However, it’s important to remember that every patient is unique and may require individualized care. Additionally, implementing these solutions will require ongoing evaluation and refinement to ensure they are effective in practice. By implementing the outlined tips and maintaining a creative and collaborative mindset, healthcare providers can elevate patient care and continue to make a positive impact in their communities.
References
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