Managing Disruptive Patients _ ________________________________________________________________
When asked the question about marital status, David replies, “I’m single, who wants to know?” and gives Bonnie a wink. He then asks her what her marital status is.
2. David may be nervous about having to be admitted to the hospital. The behavior he is exhibiting might demonstrate an attempt to gain control of an unfamiliar situation. He is manipulating his healthcare professional in such a way that gives him the upper hand, in his opinion at any rate. Or David might simply be used to this sort of interaction under any circumstance. Whatever his reasons for this manipulative behavior, David will have difficulty getting his needs met in this manner. Instead of gaining the support and help he needs, he alienates people and causes them to avoid him. 3. Given the fact that Bonnie is becoming extremely anxious and feels like she is losing control of the interview, taking a break is not an inappropriate decision. Although there are other ways to deal with the situation, Bonnie has found a way to interrupt the seemingly downward turn that the interaction was taking. Bonnie finds her supervisor and tells her that she is very uncomfortable with David. She asks if she can be reassigned to a different patient and let Joe, another provider on the unit, take over for her with David. The supervisor tells Bonnie that it would be better if she learned to manage patients with manipulative behaviors and that, for now, the assignments remain as they are. The supervisor does spend a bit more time with Bonnie and asks her what, specifically, is making the interview so uncomfortable and what she thinks would be the best thing to do about her discomfort. Discussion Question: 1. Is the supervisor making the right decision in having Bonnie continue to work with David? Discussion: 1. At least for the present, the supervisor seems to be making the right decision. Bonnie will encounter all sorts of people in her career as a healthcare professional and will not have the luxury of changing assignments every time she is uncomfortable with one of them. She needs to develop the skills to work effectively with all types of behaviors exhibited by patients. Given his manipulative behaviors, the patient has made her uncomfortable, but her supervisor sees this as a good learning experience and offers support by talking over the difficulties Bonnie is encountering.
Self-Assessment Quiz Question 13
What is the best response for Bonnie to make at this point? A) “That’s really none of your business.” B) “Hey, I’m asking the questions here!” C) “That is not the purpose of this interview.” D) “If I tell you, will you start just answering what I ask?” The correct answer is C. Rationale : The appropriate response is to be straightforward with- out being rude or flirty or create a bargaining situation. Bonnie is becoming increasingly uncomfortable and decides she needs to take a short break from this interaction. She tells David she needs to check on something and will be back as soon as she can. As she leaves the room, David calls out, “You hurry back, you sweet thing, I’ll miss you while you are gone!” Discussion Questions: 1. Why is Bonnie feeling so uncomfortable? 2. Why is David behaving the way he is? 3. Is Bonnie making a good decision to “take a break”? Discussion: 1. More than likely, Bonnie is uncomfortable because David is behaving inappropriately, and she is unsure what to do about it. Although David is cooperating by answering the questions, he is making remarks that undermine Bonnie’s confidence in her ability to provide competent care. He is putting their relationship on a personal, rather than professional, level, and is treating her as a potential date, not his healthcare provider. As a new provider, it is normal that Bonnie does not yet have complete confidence in her abilities. On top of that, as a recently divorced woman, she possibly has doubts about her desirability as a woman. Because his behavior is inappropriate for the setting, Bonnie cannot be sure what David means by his flirtatious remarks; does he actually find her attractive or is he teasing her? With the ambiguity and Bonnie’s lack of experience, it is not unusual that she would become anxious in her interaction with David.
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