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November 9, 1984

Managing the Care of the Difficult Patient in the Emergency Unit

Author Affiliations

From the Emergency Unit, the Division of General Medicine and Primary Care, the Department of Medicine, The Charles A. Dana Research Institute and The Harvard-Thorndike Laboratory, Harvard Medical School (Dr Makadon), and the Department of Social Services (Ms Ryback), Beth Israel Hospital, Boston, and the Department of Psychiatry, Cambridge Hospital, Cambridge, Mass (Dr Gerson).

JAMA. 1984;252(18):2585-2588. doi:10.1001/jama.1984.03350180039027

An approach to managing the care of "difficult" patients in emergency units is presented in both theoretical and practical terms. Understanding the conflicts these patients create and how these are exacerbated in an emergency unit setting can often lead to straightforward plans for management. These plans should emphasize consistency as a way of both setting limits and reassuring patients and should set reasonable expectations for health care providers working with these patients. Clinical examples are given to illustrate the use of these principles.

(JAMA 1984;252:2585-2588)