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.

  • southsamurai@sh.itjust.works
    0·
    10 months ago

    Well, while the patient’s bill of rights isn’t exactly a universal law, the fact that you said the patient is a competent adult makes the rest of the post unnecessary.

    Now, you may or may not be required to document patient compliance with care, that is a different issue. If you are required to do that, then you follow facility procedures.

    But from the rest of what you said, you’re allowed, per facility standards, to document you giving the patient the meds. That means anyone else can pound sand. And, if I was the patient, the blast of shit they’d catch for trying to force you to treat me like some kind of idiot might be entertaining.

    A legally competent patient doesn’t need to have their med compliance observed because that’s their fucking right. Now, I get it, if the patient isn’t compliant with treatment, the doctor/s would need to know. But, unless there’s reason to believe that, why should you be treating the patient like an idiot?

    Patient autonomy trumps damn near anything else, including facility policy, though they may well have to fuck right off to another facility if they’re refusing care.

    Stand your ground because advocating for your patient is the greater good here.