Jackie Jacobs is a charge nurse in a busy intensive care unit. She prides herself on being able to get along well with almost everyone on her team. But when she sees Amanda’s name on the evening’s work schedule, she braces herself for the inevitable confrontation that will arise when she gives Amanda her patient care assignment.

Amanda has a reputation for being a difficult person. She’s also an experienced and competent critical care nurse capable of caring for complex patients. Tonight, Jackie has many new graduates working in the unit. She will need to assign Amanda two challenging patients. She anticipates Amanda will immediately criticize her judgment and complain about her to anyone who will listen throughout her shift.

Charge nurses like Jackie have a unique challenge because they lead teams and manage patients, even though they have little formal power. When all is working well on the unit and with the team, this isn’t a problem. But when a staff member, patient, physician, or family member is difficult to keep happy, your role as a charge nurse may become much more challenging. Learning to work with difficult people is both an art and a science.

How difficult people differ from the rest of us

We can all be difficult at times, but some people are difficult more often. They demonstrate such behaviors as arguing a point over and over, choosing their own self-interest over what’s best for the team, talking rather than listening, and showing disrespect. These behaviors can become habits. In most cases, difficult people have received feedback about their behavior at some time, but they haven’t made a consistent change.

Part of what motivates difficult people is that they can wear people down and get what they want. A nurse like Amanda probably has learned that by complaining, she can avoid challenging assignments even if these are in the best interests of patient care. (See Is she a bully or a difficult person?)

Difficult personality types

Leadership consultant Louellen Essex identifies four types of difficult personalities. You can probably identify the personality types of some of the difficult people you deal with from the list below.

• The Volcano is abrupt, intimidating, domineering, arrogant, and prone to making personal attacks. Using an extremely aggressive approach to get what he or she wants, the Volcano may behave like an adult having a temper tantrum. Volcanos don’t mind making a scene in a public place.
• The Sniper is highly skilled in passive-aggressive behavior. He or she takes potshots and engages in nonplayful teasing. Snipers are mean spirited and work to sabotage their leaders and colleagues.
• The Chronic Complainer (like Amanda) is whiny, finds fault in every situation, and accuses and blames others for problems. Self-righteous, Chronic Complainers sees it as their responsibility to complain to set things right—but rarely bring solutions to the problems they complain about.
• The Clam is disengaged and unresponsive, closing down when you try to have a conversation. He or she avoids answering direct questions and doesn’t participate as a team member.

Changing your response

You may not be able to change a difficult person’s behavior, but you can change how you respond to it. By learning to disengage effectively, you can avoid getting hooked into the difficult-behavior cycle.

When responding to a difficult person, you have several choices—doing nothing, walking away, changing your attitude, or changing your behavior. Doing nothing may not be the best choice because over time it can lead you to become increasingly frustrated (as Jackie has become with Amanda). Walking away may not be an option if you need to work closely with the person. Changing your attitude and learning to view the behavior differently can be liberating.

Ultimately, though, changing your behavior is the most effective approach because the difficult person then has to learn different ways of dealing with you.

Tips for coping with difficult people

Below are some great tips from life coach and speaker Stephanie Staples.

• Don’t try to change the difficult person. Generally, difficult people have well-established behavior patterns. Any behavioral change will come only if they take accountability for it. You can point out the undersirable behavior, but it’s not your responsibility to change it.
• Don’t take it personally. Their behaviors reflect where they are personally, not anything you might have said or done. They may be ill or tired, or they may have extreme emotional problems. When you see an explosive reaction to a minor situation, you can be sure the person is experiencing strong underlying emotions.
• Set boundaries. Let the difficult person know you’ll respect him or her, but expect to be treated with respect in return. Don’t tolerate yelling or heated conversations in public places. If necessary, tell the person you need to remove yourself from the situation, or wait until the person is able to have a discussion without an angry reaction.
• Acknowledge the person’s feelings. You may not agree with the person’s viewpoint, but you can acknowledge that he or she appears angry or unhappy. With a chronic complainer, you’ll need to move from the complaint to problem solving.
• Try empathy. Recognize that it must be difficult to be stuck in a place of negativity or anger. Empathy can sometimes help deescalate an explosive situation. Difficult people sometimes just want to be heard but don’t have the skills to communicate that in a more appropriate way.
• Hold your ground. Teach others how to treat you. Don’t open the door to challenges. With snipers, you may need to expose their behavior publicly to other team members.
• Use fewer words. With difficult people, less conversation may be more effective. Use short, concise messages to drive your point home, and set a time limit on how long you’ll engage in the discussion. Avoid using the word “attitude” because the person will view this as subjective. Instead, focus on the behavior.

Although these tips aren’t guaranteed to work every time, you’ll find them helpful in many situations. Remember—in the end, the only behavior you can truly control is your own.

Rose O. Sherman is an associate professor of nursing and director of the Nursing Leadership Institute at the Christine E. Lynn College of Nursing at Florida Atlantic University in Boca Raton. You can read her blog at www.emergingrnleader.com.