Everyone encounters angry people. And everyone gets angry from time to time. Patients get angry. Nurses get angry. Everyone “loses their cool” or “hits the roof.” It may be uncomfortable to handle anger, but it is a necessary task. On the positive side, sometimes dealing with anger or other emotions can strengthen and enrich a relationship.

Anger is an emotion–nothing more and nothing less. It’s a very powerful emotion that can stem from feelings of frustration, hurt, annoyance, or disappointment. It is a normal human emotion that can range from slight irritation to strong rage.

Sometimes anger can even be a good thing. When people are treated unfairly, anger can motivate them to do something about their situation and stand up for themselves. The hard part about anger is learning what to do with these strong feelings, and how to handle these strong feelings in others.

Patients often get angry when they:

• Become frustrated, don’t know what to expect, or have a culture shock in the healthcare arena
• Are afraid of the diagnosis, treatments needed, and/or outcomes of care
• Don’t get their way, or have a feeling of loss of personal control
• Feel overlooked, such as when they are not included in their care planning discussions
• Are discouraged with themselves when they don’t understand something, think they could have done something better, and/or are not getting better as fast as they had hoped

Here are some hints for handling a patient who seems frustrated, angry, and on the way to becoming violent:

• Avoid threatening behavior. Threatening behavior may increase, fear, or prompt assault.
• Avoid shouting. If the person is not listening to you, raising your voice may not help. A person with schizophrenia may be preoccupied with inner voices (auditory hallucinations).
• Avoid criticizing. This might make things worse and escalate the situation.
• Avoid baiting the patient. Don’t do anything to encourage wild or impulsive behavior.
• Avoid standing over the patient. Keep a comfortable distance and put yourself at the same level as the patient. If he or she is seated, seat yourself.
• Avoid eye contact or touching. This might be perceived as threatening.
• Give the patient some sense of control combined with a sense of safety. Often the presence of others is reassuring.
• Don’t back yourself or the patient into a corner.

Editor’s note: This excerpt is from the next book in the Stressed Out series, Stressed Out About Difficult Patients. It will be out in September.