The medication is a blood thinner, the patient is a competent adult not in delirium, A&OX4. There are 2 ways to see this:

Manager’s and a group of doctor’s POV: you are a nurse and it’s your job and duty to do that. Plus, we know better than him what’s good for him. These people have built their identity around working in healthcare and to them this means I have to stay in the room and make sure the patient takes the medication.

My POV: nursing is not a calling but a job. What my manager and these doctors think is stupid:

  • the patient is a competent adult not in delirium, A&OX4. He’s old enough to know what happens if he doesn’t take the medication because we have told him a number of times already. I’m not his father and I’m not ready to treat a competent adult like a child.

  • I have other patients and I’m not going to waste my time watching a patient silently until he decides to take the medication. I’m charting that I left the medication next to him and told him he needs it and why and that I have other patients to take care of.

  • It is stupid to watch a person while doing nothing when I should be working with my other patients. It’s also invasive as f*ck.

I see it like this: my manager and this group of doctors are not ready to respect a person’s autonomy whereas I’m not ready to ignore this same autonomy, even if it means a negative outcome. Respecting a consenting adult’s autonomy means respecting his bad choices as well. I feel this group of doctors and my manager are not ready to respect any patient’s autonomy.

At this moment, this is a hill I’m willing to die on. AITA?

ETA: I wrote about a group of doctors, because there are other doctors that don’t give me hard time if a patient refuses his medication, they simply chart it and move on. I like working with doctors like this because I feel they don’t judge and respect the patient’s autonomy as well.

  • Nibodhika@lemmy.world
    25·
    10 months ago

    It doesn’t, you take the pills to the person, if they don’t take them immediately ask them to take the pills now, if their answer is a refusal chart it and leave, if their answer is something like “I’ll take them later”, explain that you need them to take it now, if they still refuse chart it and leave (with the pills obviously), possibly come back later, you have other patients to take care of and can’t waste time on a staring contest. But if you give pills to someone, put it in the chart that they’ve taken them at X time but they actually took it 3 hours later, doctors might act on that chart and cause problems to the patient and hospital. E.g. if the patient will have some surgery the next day the time they took their blood thinners is extremely relevant, the patient can’t be expected to know this, you as a nurse might know, the doctor who will read the chart and decide on the procedure knows but might be acting on wrong information if you didn’t watched the patient take the medicine. If the next day the doctor sees a refusal to take the medicine at the appropriate time he might choose to alter or stop the procedure, explain to the person why he’ll have to stay another day at the hospital and that this time he better take the pills at the appropriate time or he’ll have to stay another day, and not risk putting someone’s life in danger because a nurse decided to write a random time for when the patient took the pills. Think about it this way, if you wrote that the patient took the medicine at 7 but he actually took it at 10, and he died or had complications because he was still on blood thinners during surgery, who do you think will be to blame? The patient who was not told the medicine had a specific time? The doctor who has a paper signed by you that the medicine was given at 7? Nope, 100% the nurse who wrote the wrong time on the chart will be solely liable for this.

    When I read the question I thought it’s stupid, he’s an adult, but the more I think about it the more it makes sense that nurses should chart only when they’re sure.