Care of the Difficult Patient »

A stay in hospital is a traumatic experience for most patients; however, some patients may be more difficult than others to care for, because of mental distress and ill health, historic substance abuse, demanding family members or abusive behavior, for example. "Difficult" patients place extra demands on nurses professionally and personally. Developing the skills required to deal with difficult patients is therefore vital to the smooth running of any hospital ward.

Chapter 1: Mental Status Examination
1. Parts of a Mental Status Examination
2.Appearance
3.Behaviour
4.Emotion
5.Speech
6.Thoughts
7.Perception
8.Reasoning
9.Orientation
10.Memory
Chapter 2: Substance Abuse
Chapter 1.The Patient who Demands Narcotics
2.Physiologic Dependence on Narcotics
3.Narcotic Withdrawal
4.Narcotic Analgesics
5.Benzodiazepines and other Seditive Hypnotics
6.Benzodiazepine Comparison
7.Interventions for Excessive Drug Use
8.A Nurse's Experience
Chapter 3: Delirium
1.Agitated Delirium
2.Haloperidol for Agitation in Delirious Patients
3.Delirium - Clues to Diagnosis
4.Alcohol Withdrawal and Alcohol Withdrawal Delirium
5.The Duration of Delirium
Chapter 4: Psychiatric Diagnoses
1.Mania
2.Schizophrenia
3.Somatoform Disorders
3.Factitious Disorders
4.Personality Disorders - Borderline Personality - Antisocial Personality
Chapter 5: Setting Limits
1.Guide to Setting Limits
2.Enforcing Limits
3.Sitters and Restraints
4.The Contract
Chapter 6: The Nurse's Authority
1.Professional Identity and Confidence
2.The Nurse's Authority
3.Potential Boundary Violations
4.Staff Meetings, Staff Plans, Staff Interventions
Chapter 7: The Feelings Evoked in Nurses by Difficult Patients
1.Clinging, Demanding, Rejecting, Denying
2.Manipulation
3.Rejection of Offered Care May be Manipulative
4.Sexually Inappropriate Behaviour
5.Nursing Interventions for Manipulative Behaviour
6.Anger
7.Violence