title: Managing the care of complex, difficult patients in the medical-surgical setting.
abstract: The increasing medical, psychological, and social complexity of hospitalized patients is a serious concern. Most staff nurses are inadequately prepared to deal with the complexity of these patient's issues. The difficult patient is described as having a medical condition requiring hospitalization and who also exhibits problems such as pain, substance abuse, and issues such as anger, manipulation, or noncompliance which are difficult and challenging behaviors. An overview of the most troublesome patients seen in the inpatient setting today and some clinical direction on how to best manage these patients are presented.
authors.affiliation: Medical College of Virginia Hospitals, Virginia Commonwealth University, Richmond, USA.
authors.forename: E F
authors.initials: EF
authors.lastname: Morrison
authors.forename: A
authors.initials: A
authors.lastname: Ramsey
authors.forename: B A
authors.initials: BA
authors.lastname: Synder
mesh_terms: D000223:Adaptation, Psychological; D000378:Agonistic Behavior; D000786:Anger; D006801:Humans; D007388:Internal Medicine; D007389:Internal-External Control; D008257:Machiavellianism; D017008:Negotiating; D009723:Nurse-Patient Relations; D009732:Nursing Care / Q000379:methods* / Q000523:psychology*; D010358:Patient Participation; D013527:Perioperative Nursing; D013041:Specialties, Nursing