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Dealing with the Difficult Patient Part 1: The Patient in Pain October 23, 2011
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Lorrie Middleton, RTT About the Author
Lorrie Middleton, RTT

We have all had to deal with them; difficult patients. They come in many forms, but here in this first part, we will be talking about the patient in pain. I am a retired Radiation Therapist and there is NOTHING more uncomfortable than an x-ray or radiation therapy table. You have a patient in pain and you need them stay still. How do you accomplish this?
  1. Pain medicine
  • Do they have pain medicine?
  • If so, when did they take it last?
  • When are they due to take it again?
  • Do they have it with them?
  • Is that particular medicine working for them? If not ask Physician for more or alternate meds so exam or treatment can happen.
  • Reschedule procedure if possible to a time when they can be premedicated.
2. Problems
  • Ask the patient…they know what they can do and how to move and not to move.
  • Is it the position you need them to be in?
  • Is it anticipation of pain or does it already hurt?
  • Can they bear it for just a short time (do procedure or treatment in steps)?
  • Are they afraid and not really in pain?
  • Is it the hardness of the table making them hurt, see if there is any possible way to make table more comfortable?
3. Distractions
  • Play some music to keep their mind off their pain, use their own CD or tape or have some on hand for these kind of situations.
  • Talk to them through the intercom-
    • Talk to them every so often, let them know how much longer the procedure will take
    • Encourage them; let them know how well they are doing
    • Tell them what is going on (ex. 1st part of treatment)
  • Pray with them or ask them to pray through the procedure
4. Communication
  • Explain to patient what will happen during procedure
  • Explain as each step happens
  • Communicate while patient is still as comfortable as possible (before procedure starts)
  • Except for special circumstances, speak to patient directly-keep family members in waiting room
  • Explain what is going on even to patients who do not seem to know what is happening
  • Know your patient so explanation will comfort, not scare
There are no fool-proof methods. These are just a few suggestions to help the patient in pain. Every circumstance is different. The methods listed are tried and true, but will not work in every situation. Just remember, treat your patient the way you would treat your dad or mom, husband or wife or the way you would want to be treated. Every human being deserves to be treated with dignity.

Lorrie Middleton
Lorrie Middleton is a retired Radiation Therapist with over 30 years experience. As an Army brat, she has lived all over the world and around the country, although she has spent the most time in Connecticut, where she was trained and her family resides. Lorrie is a mother of two, step-mother of two, and grandmother of three, and is married to her soul mate. She is now a permanent resident of Florida and loving it.


The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
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