An ophthalmic technician's guide to dealing with difficult patients

It is important to learn coping skills and practice great customer service in the ophthalmology clinic. We may be working with healthy people coming in for their general eye exams, or we could see distressed patients with ocular emergencies that are causing a lot of pain.

I will give some ideas that may be useful the next time a challenging or difficult patient comes through your office door. A "difficult patient" isn't meant to sound like a bad thing. It's simply a patient who may require some extra care, and if you're not prepared to provide this care, you might be tempted to get your feathers a bit ruffled. Challenging/difficult patients could be any of the following:

Here are some tips to stay cool and collected, no matter who walks in the door to the clinic.

The initial greeting, or calling the patient back to the exam room, can really set the tone for the entire visit. It is always good practice to greet patients with a smile. Consider asking your patients how they are doing, as long as you're able to take a moment to listen to their grievances, share enthusiasm for their life events, or fawn over some pictures of grandkids.

The patient may be coming in for a routine eye exam or they could be experiencing an ocular emergency. No matter what the reason for the visit, all patients deserve the same respect and care.

If the patient is in a lot of pain or uncomfortable, try to get them to the privacy of an exam room as soon as possible. Try to reassure and comfort the patient as you're gathering information for the doctor. Also, it's important to be as efficient as possible when getting this patient ready to see the doctor.

When a doctor requests ophthalmic imaging, it is very important to get the highest quality image possible, so the doctor can correctly document and diagnose any medical condition.

These patients can be young and unable hold still, or they could be nervous or scared. Some are elderly patients with a number of reasons that make it difficult to hold still.

Explain what the strange machine does, explain what they will see when looking inside the strange machine, and explain why it's important to get a good or quality image.

Unfortunately the old air puff or pressure test is still being used in some clinics. Its legacy continues to haunt everyone who has had it done to them. Usually, people are at ease as soon as they know nothing is going to shoot at them.

Some situations may require more than one technician. For example if an elderly patient that has tremors or has severe ptosis of the upper lids, you will need another technician to help hold the patient steady or hold those bothersome eyelids out of the way.

Another important thing to be aware of is whether the patient needs additional assistance. When greeting a patient with a wheelchair, meet them in the waiting room and ask if you can help with the maneuvering of the chair. There could already be a family member, friend, or a nurse assisting, but your gesture of offering additional help will always be appreciated.

Sometimes, as an ophthalmic technician, you will run into some people who get labeled as "difficult patients," but they really just don't want their eyes touched, or anything even getting near their eyes.

Again, I have had a lot of luck just explaining everything to them and the reason why we perform tests and measurements.

It also helps to keep the patient talking; it helps get their minds off of what is going on. Ask them about themselves, their work, their family, or even their weekend plans, if they are willing to talk about them.

Everyone is very different when it comes to their health and body, and what they can and can't handle. A reaction can happen when a person least expects it. Some people can't handle the sight of blood, or even looking at a needle.

Whatever the case may be, it is important to pay close attention to how your patient may or may not be reacting to your actions. Some reactions may need some intervention. A person can actually faint if their reaction is severe enough.

If the reaction worsens, you might need to assist the patient in holding their head between their knees, or even help them lie on the floor with their feet elevated on a chair. An important thing to remember is not to rush the patient in standing up. If rushed, the reaction will come back as quickly as it came on.

Remind the patient to take it slowly and take their time getting up.

Ophthalmic technicians are pros at instilling eye drops, but even we pros are challenged at times. There are always the patients that try to squeeze their eyes shut, look away, or move a lot.

Every clinic, and its routine in working up patients, is unique. In our clinic, we check pressure using tonometry, using the numbing fluorescein drop first. This makes instilling the dilation drops a lot easier.

No matter what, try to be empathetic to what the patient may be feeling. I had a patient come in for a routine eye exam, which, as we all know, is generally a pretty painless visit. His first words were telling me how horrible his last experience was at his last eye exam, which was more than four years ago, and that he would rather have his prostate examined.

So I thought to myself, "this one might be a hard one to crack." Luckily, he had Harley attire on, so I had something to ask him about. I explained everything as I was doing during the workup. I also asked him what kind of Harley he rode. As soon as he started talking about something he loved, his mood changed entirely.

After seeing the doctor, I walked him to checkout and he said thank you, and he would be back in a year. I was very happy that I could help make his visit a more positive one.

As with any job, the more practice and experience you gain, the more easily you can deal with whatever challenges and difficulties come your way. Keep checking back for more information to be the best ophthalmic technician possible!