Difficult Nurse-Patient Encounters

Our new featured article is titled “A Qualitative Study of Difficult Nurse-Patient Encounters in Home Health Care” by Mary Kate Falkenstrom, PhD, RN, AOCN. Visit the ANS website to download this article at no charge while it is featured, and return here to share you comments and feedback!  Here is Dr. Falkenstrom’s message about her work:

It is wonderful to have an article published in ANS and for the article to be featured in the Editor’s Picks. This is the first article to be published from the data. I am forever grateful to the nurses who participated in the study and shared their experiences. I am also grateful to the nurses and organizational leaders who were willing to share the study

Mary Kate Falkenstrom

invitation with others. Their support of nursing scholarship provided access to a diverse sample of registered nurses from Connecticut, Massachusetts, and Rhode Island. I have the utmost respect for nurses in all practice settings but especially for nurses who practice autonomously outside the walls of traditional healthcare facilities.

As an advanced practice nurse and administrator, I had the privilege to work with highly competent, compassionate, and dedicated home healthcare clinicians for over 17 years. Their level of professionalism was validated by patients and caregivers in letters, patient satisfaction surveys, and comments shared during phone and face-to-face encounters. But, incidents did occur where patients and caregivers would communicate dissatisfaction with a clinician. These encounters were described to me by the clinicians as being associated with intense anger, excessive expectations, and lack of understanding of limitations in the home healthcare setting. Strategies that were effective in defusing anger or negativity in other encounters were reported as not effective in these types of encounters. My concern for clinician safety in the field and the potential that an unwitnessed encounter could have serious performance implications for a nurse-employee led to a focus of research on patient encounters. As more and more volatile encounters are spotlighted in the media, healthcare as well as other industries will need to explore the human-to-human encounter and propose research-derived strategies that individuals can use to manage non-constructive and destructive encounters.

Thank you for taking the time to read the article. I hope the content is of value to your practice—Mary Kate Falkenstrom