Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

How to Show Empathy When Patients Express Anger


There are strategies that can be used effectively when patients express anger.

I was taking care of Mr. Smith, a stage 4 colon cancer patient admitted with abdominal pain. Since it was my first time seeing Mr. Smith, I spent time talking with him to get a sense of why he had been admitted. After spending 15 minutes or so, I learned that Mr. Smith was living alone. Over the past few months, his health had deteriorated, especially after being told by his oncologist that there weren’t any promising treatment options for his terminal cancer. As Mr. Smith spoke, I noticed the negative body-language wall go up—minimal eye contact and a raised voice when he realized that he was staying the night for further workup of his abdominal pain. I knew that the situation was rapidly escalating and could lead to Mr. Smith leaving against medical advice.


Here are some steps that I take when communicating with a patient who feels angry:


1.Maintain eye contact.

Even though the patient doesn’t engage in eye contact, this shows that you are concerned and trying to connect.


2.Listen actively.

It sometimes takes a conscious effort to stay silent and let patients vent. But this can make them feel heard and valued.


3.Don’t take it personally.

Patients experience many hardships while at the hospital. Try to maintain a reflective stance. Avoid saying things like: “I understand where you are coming from,” since that could backfire as we probably don’t really know how complex their life situation may be. Instead, say something like, “I’m sorry you feel that way,” and “I’m here to help you get through this.”


4.“How could I make this hospitalization easier for you?”

You might be surprised with the answers, as it could be as simple as minimizing blood draws at night to get more sleep.


5.Give some space.

It can be best not to spend more than an hour talking to the patient when things get heated. Politely excusing yourself and informing that patient that you will check on them later can be helpful in de-escalating the discussion.


Mr. Smith was unfortunately still distraught after going through the steps above, but agreed to stay another night to complete the workup.


The next morning, I expected him to demand to leave. However, I was pleasantly surprised by his apologetic demeanor. He expressed thanks for taking the time to listen, and explained he was feeling anxious the previous day and did not mean to get angry.


Mr. Smith taught me that empathy when talking with angry patients can go a long way. Patients go through a lot of struggles and stressors when admitted to the hospital. As caregivers, we need to be constantly aware of this and tailor to their needs and emotions.