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.
You say nursing is only a job to you and not a calling, and yet here you are taking on career risk to yourself just so you can respect the autonomy of a patient whose autonomy is being disrespected by everyone else.
I love you for existing. As an adult, I would feel far safer under your care knowing that you would treat me as an adult.
Because as everyone knows, the actively harmful version of this “treating adults as children” philosophy in medical care is when they don’t believe what you’re saying, claiming you’re trying to get attention.
What you’re fighting against is simple indignity. But the side effect of your fight is that people are protected from medical negligence as well.
Thank you so much. I won’t blame you either way, but I will love you dearly if you continue to take personal risks for the well-being of your patients.
As far as i know the actual reason for doing this is to know with certainty if they took it or not. This is important for complications such as allergies or over/underdosing medication because you can’t be sure what and how much is in their system right now.
In short, get over yourself and watch them take their meds. It’s not because they are children, but because you need reliable certainty to treat them further without additional risk.
They want to know IF the patient took it and not that you provided it or forced it down his throat
If something happens to the patient they need to know if he took the medication.
If you only chart that you provided the patient with the medication then they dont know if he took it or they might be under the impression that he took it and if he gets complications from not taking it then they might not give him the dose he needs since they will be afraid of over medicating.
As well as if he did take the medication and got complications from the medicine it self they won’t know since they don’t know if he actually took it.
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.
My partner is a med tech. Unless it states otherwise on their chart/care plan, she always makes sure those meds get taken. It can be uncomfortable or awkward, but depending on the residents level of ability there is no way to determine their safety, whether they remember to take it, etc. Is it unfortunate that we can’t trust their autonomy? Yes, but it’s also necessary. For her case, these are residents who are paying for this service, and while in the moment they are upset that she lingers while they take their meds, it’s the service they pay for.
Basically, yes. All med techs at her job always deliver then watch the resident take the meds. The only time this isn’t the case is if the residents care plan specifically mentions it’s okay for the resident to take their own {labelled medicine} by leaving it with them.
Of her 80 residents that amounts to be about 3 people who she is able to just leave the meds for. This is because these are people who are in assisted living for physical problems, not mental decline. It’s not always that these people do or don’t know better, it’s that they may just not be in a place mentally to do it for themselves, even if they have moments or even are mostly lucid.
I’d say it’s more from the perspective of these people are paying for that service and it’s not so much their own lack of autonomy but your provided care.
