I need to feed my animals!

How do you deal with inpatient patients? "I need to feed my animals" with a picture of three goats

The other day, I read a post that was supposed to be funny on a nurse group over on Facebook. There was a cartoon of a patient being impatient about how long they had to wait – they had animals to feed!


Having grown up in a rural area, and having farmers in my family, I didn’t get the joke. This is a common concern when you work with farmers. It’s their livelihood, and often times, there is no one to take up the slack for them. They take better care of their livestock than they take of themselves.
There were quite a few comments, mostly lol’s and emojis, but there was one in particular that struck me. The author of the comment said something along the lines of “Why do these people come in anyway? We’re short staffed, we can’t promise when we’ll see them. I’m sick of this crap!”


One of the things I recommend to my students when dealing with difficult people is to consider winding back the clock. What is the person’s background? What has brought them to this point in time? What matters to them?
It can really be frustrating when we try to help someone, but they reject that help. We’ve spent a lot of time, money, and effort to learn what the right answers are for patients. It’s shocking when we have compassion for someone, but they not only reject our attempts to help, but might even claim that we’re hurting them!


I don’t think that anyone believes that an answer to this dilemma is to be rude to our patients, or to harden our hearts to their problems. We all want to be treated with respect, and I’m sure that we would all say that one of our values is to treat others with respect, too.
But what is the answer? A patient comes to us, and our expectation is to treat their chief complaint, after all, doesn’t a person’s health come first? Shouldn’t that be their first priority?

Pro tip: lots of people prioritize many things in their lives above taking care of themselves.

Could that be you, too? I have to admit to being a really bad patient when it’s my turn to need health care.


It’s important to ask our patients what matters to them: what are their priorities, limitations, and support needs. Those things might be different from what we think they should be, but including those things in our plan of care can make a big difference.
I’ve developed an acronym to help me keep on track with patients and the other people I serve. It’s inspired by the nursing process, so it’s easy to remember:


Remember to C.A.R.E.
Connect – first connect with ourselves. Take a breath and check in with what we’re feeling. If a patient is pushing our buttons, make a note of that.

Assess – what does that feeling mean for your interactions with that patient? Does it make it more difficult to work with them, or when you take a moment to understand that what might be your priority isn’t the patient’s priority?

Respond – the moments we take to connect with ourselves and assess what we’re feeling, can make all the difference for us to respond instead of react. When we’re reactive, we can say things we instantly regret (don’t ask me how I know that!).

Evaluate and end – take a moment, even if it’s at the end of the day to check in with yourself. How did the interaction go? How did you feel about it? Equally important is to end the interaction. Know that we’ve done our best, and it’s ok to let it go. We can be free to move forward with the next interaction, or being fully present with our family, friends, pets, or ourselves.


What are the kinds of patients you have the most difficulty with? How do you deal with difficult patients? What are your reminders to stay true to your values?