Charge Nurse Series Part 5 - Managing Difficult People

By Rose O. Sherman, EdD, RN, FAAN

Charge nurses have a unique challenge in work environments because they have to learn to lead teams of staff and manage patients with little formal power. When all is working well on the unit and with the team, this is not a problem. But when a staff member, patient, physician or family member is a difficult person to keep happy, the role of charge nurse becomes more challenging. Learning to manage difficult people is both an art and a science.

We can all be difficult at times. The difference with difficult people is that they do it more often. It becomes a pattern of behavior. They may have been given feedback about their behavior, but have not made a consistent change. Part of what motivates difficult people is that they often are able to wear people down, and get what they want. You may not be able to change the behavior of the difficult person, but you can change how you respond to it. By learning to effectively disengage, you will avoid getting hooked into the difficult behavior cycle.

Difficult Personalities Types

Dr. Louellen Essex had identified the following 4 different types of difficult personalities:

The Volcano – these individuals are abrupt, intimidating, domineering, arrogant, prone to personal attacks and are extremely aggressive in their approach to get what they want.
The Sniper – these individuals are highly skilled in passive-aggressive behavior, take pot shots, engage in non-playful teasing, are mean spirited and work to sabotage leaders.
The Chronic Complainer – these individuals are whiny, find fault in every situation, accuse and blame others for problems, are self-righteous and see it as their responsibility to complain to set things right.
The Clam – these individuals are disengaged, unresponsive, close down when you try to have a conversation, avoid answering direct questions and don’t participate as members of the team.

Tips for Dealing with Difficult People

You can probably identify the personality types of some of the difficult people you deal with from the list above. The bigger challenge is how do you respond to the behavior. Here are some great tips offered by Stephanie Staple:

1. Don’t try to change them – generally with difficult people, you are experiencing well established patterns of behavior. Any change in behavior with a difficult person will only come if they take accountability for it. You can point out the behavior, but it is not your responsibility to change it.

2. Don’t take it personally – the behaviors that you witness from difficult people are more a reflection of where they are personally than anything you may have said or done. They may be sick, tired or have extreme emotional problems. When you see an explosive reaction to a minor situation, you can be sure that there are strong underlying emotions that the person is experiencing.

3. Set boundaries – let the person know that you will respect them but expect to be treated with respect in return. Don’t tolerate yelling, and if necessary tell the person that you need to remove yourself from the situation.

4. Acknowledge their feelings – you may not agree with their point of view but acknowledge that they appear to be very angry about a situation.

5. Try empathy – recognize that it must be difficult to be stuck in a place of negativity or anger. Empathy can sometimes help to de-escalate explosive situations.

6. Hold your ground – remember that you teach other people how to treat you so don’t open the door to challenges.

7. Use fewer words – less conversation is often more effective with difficult people. Use short, concise messages to drive your point home and set a time limit of how much you will engage in the discussion. Avoid using the word “attitude” because this will be viewed as very subjective – focus instead on the behavior.

While these tips are not guaranteed to work every time, you may find them helpful in many situations. The real key to managing difficult people is managing your own reaction to the situation. In the end, the only behavior that you can truly control is your own.

Your ideas are important so if you have additional advice on how to deal with difficult people, please share it with your comments.

Read to Lead

Louellen Essex and Associates (2006) DealingwithDifficultPeopleWorkbook

Staples, S. (2011). Handling Difficult Patients and Co-Workers. Nurse Together Website