Simple steps to calming agitated patients

By | 7 November, 2016
  1. Approach in a disarming manner (empty-handed, measured pace, respects for physical and psychological space, judicious use of eye contact).
  2. Identify yourself fully, including your name and title.
  3. Demonstrate benevolent intent (“How can I help you?”).
  4. Clearly articulate your own and your team’s goals with regard to the situation (“My job is to help you” +/- “We need to make sure that everyone is safe here.”) and, if appropriate, explicate the absence of ulterior motives (e.g., “I don’t benefit in any way from you being treated poorly.”).
  5. Demonstrate that you are willing to let go of assumptions from previously constructed narratives (“Please tell me what happened”).
  6. Identify with the patient’s suffering whenever possible (I or someone I cared about suffered similarly), while allowing for differences in individual experiences (“Thank you for sharing this with me because, as a doctor, I don’t often get to experience things from the perspective you just gave me.”).

  1. Ask what actions you might be able to take to improve the situation.
  2. Articulate your powers and their limitations (“I can give you something for anxiety, but unfortunately I don’t feel comfortable with giving you IV morphine.”).
  3. Articulate relevant expectations and rules.
  4. Promise to make changes, as appropriate, and provide a precise timeframe (“I will put the orders in the chart within the next 10 minutes”).
  5. Ask/demand reciprocation in terms of change in the patient’s behavior.
  6. Ask to be held accountable for your promises, and articulate a contingency plan that involves you (e.g., “If, for whatever reason, you don’t see a change as promised, please make sure to ask for me by name, Dr. Smith”).
  7. Confirm mutual agreement, shake hands on the “deal” where appropriate and express appreciation for their patience/cooperation.
Author: Mark Yoffe, MD

Mark Yoffe is a practicing internal medicine doctor who writes about medical books and education.

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