by Valarie Juntunen

Created on: August 30, 2009   Last Updated: August 31, 2009

Before we can deal with an angry patient, we must understand the deeper meaning behind anger. Anger is the irrational attempt to manipulate a situation. The question of how to deal with an angry patient actually becomes a question of whether or not we will allow ourselves or the safety of our patient to be manipulated.

Manipulation is often seen in a negative light; however, according to Webster, manipulation is really a form of management or control, albeit by dubious methods. Often anger is a last-ditch effort on the part of our patients to try and exert some sort of control over a situation.

Anger is an emotion that overwhelms all feelings of insecurity, pain or doubt. In many cases an event that may have normally irritated or caused concern will escalate into anger or rage, catching even the patient off-guard. Other times the anger comes from deep within the subconscious with the patient being completely unaware of why they are so angry.

Whatever the apparent cause of the anger, as a nurse, you must understand the psychological undercurrents and address these rather than just the symptom of anger. Otherwise, it would be like treating a patient with only morphine for appendicitis. The morphine will cure the pain but the underlying condition is still present and will need to be dealt with at some point.

The first step in addressing an angry patient is to try and build a rapport. The best way to do this is to try and isolate the patient from distractions. Turn off the television or ask the patient to move to an area of privacy. In some cases, the patient may be too upset to move. In that case, seek assistance from other staff members in moving those around the patient to a better location.

Remember to restrain your own emotions. It is natural for your anger to rise to that of the patient's since the patient's anger has taken away some of your control. Sometimes it is helpful to understand that the anger you are feeling is exactly how the patient is feeling. It even has the same root cause: loss of control.

Mild fear is another healthy biological reaction to anger in others. However, you should avoid showing your fear or apologizing in situations that do not warrant it, as this can actually increase the anger directed at you. Fear is one sign that the manipulation is working, which positively reinforces the angry behavior. Instead, listen to your fearful emotions, if the fear becomes very pronounced, excuse yourself from the situation and seek immediate assistance

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