Dear Healthcare Team…From the Difficult Patient | Patient Centered Care and Trauma Informed Care for Pediatric Patients

There's always at least one challenging patient. Maybe the department where you work encounters many difficult patients over the course of a shift. Maybe on your floor there's one patient and family in particular that proves challenging for everyone. How do you handle these patients? Do you try to discharge them as quickly as possible? Get a co-worker to take over their care? Make sure you don't ask any questions that could open the door to a lengthy conversation?

While reactions like these are understandable, doctors and nurses practicing trauma informed care understand that, more than likely, the challenging patients are scared, had previous traumatic medical experiences, or have many stressors outside the walls of the hospital. Practicing trauma informed care teaches you that what your difficult patients are probably saying sounds a lot like this mom:

Dear Doctor,

To you, Addie is a patient. But she is my baby. You don’t know this, but she has spent the last nine years enduring medical procedures, appointments and hospitalizations. When she sees you, all of those memories come with her. Your white coat is a symbol of blood draws, x-rays, pokes and prods. Please don’t take it personally if she gives you the stink-eye. I’m sure without the white coat, she’d love you.

Or maybe your patient is saying this:

Dear Phlebotomist,

The reason Addie’s screaming and holding onto me before her blood draw is not because she’s a bratty 9-year-old who can’t handle a little pain. It’s because during the last draw, the nurse couldn’t find the vein and after both arms, three veins and being held down by aides, this is what she remembers as you come at her with a needle.

All patients and families, including the those who present as challenging as well as those who follow all medical advice to a "T", need doctors and nurses who will care for them with a trauma informed lens, screen for traumatic stress reactions, and listen empathetically to their answers. Doing so will mostly likely lead to reduced stress for you and your patient, a better patient-physician relationship, and improved medical treatment adherence and outcomes.

Join the conversation on our Facebook page to share how you care for challenging patients and families with a trauma informed lens.

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