How do you get your patients to do what they have to do? - page 2

by brian Admin

6,465 Views | 18 Comments

Patients can be stubborn at times. You give them a task and they ignore it. What do you do to get your patients moving? Please share with us the task that they are suppose to do and what it is you do to get them to complete... Read More


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    I found that surprising them works Part of my job is it sit down with a patient 1:1 to asses their mood, thought content, etc. If they refuse the 1:1 I use 1 of two methods... 1- I just say ok, thats fine and thanks for saving me from needing to chart ( its easier to chart refusals), and if they decide later that they want to talk I will be here until ( end of shift time) I use this one with my more irritating patients, who think that saying no will become a power struggle, when I answer like this, it surprises them and they usually do sit down wiht me at some point during the night. 2- I say I understand that you dont want to talk, but can I ask you the 5 questions I have to chart on so I dont get in trouble, a lot of times they say yes and then I always finish up with anything you would like to talk about and 75 percent of the time they end up talking to me.

    Also I have found that for whatever reason I can get patients to do things others cant. Not sure how I do it, just have always been able to.
    VivaLasViejas likes this.
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    If you find out let me know. I'm tired of pts coming in and complaining that their inhaler's not helping and you can't even see them through the cloud of smoke clinging to them. And don't lie to me, I know you don't smoke "just one cigarette" a day.
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    Threaten them, of course. No....kidding

    I present the options and let my patients decide. It's their life, their goals, not mine. Many times, people will make choices that are ill advised, but they have the right to refuse and live at risk.

    HOWEVER, safety for myself as well as other patients must also be a factor, so I will not allow someone's decision making to compromise the rest of us. There have been instances where I have had no choice but to use restraints or call for police protection, but this is rare, and after all other interventions have been unsucessful.

    I find that building a trusting relationship really helps everyone involved. If patients truly value your opinion, they will be more inclined to follow their plan of care. Still, I remember this: it's their life, their value, not mine.
    VivaLasViejas likes this.
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    Quote from GrnTea
    The facility can certainly say, "If you don't wish to adhere to the medical or nursing plan of care, then you will be discharged." Hospitals are not hotels.
    Dude, I mean this in the nicest and most respectful way because I believe you've been a nurse for longer than I've been alive -- but when was the last time you worked acute care?

    Hospitals ARE hotels. Press-Ganey means everything. You, and PT, and OT, and speech can document up the wazoo about patient refusals and it doesn't mean a damn thing.
    ~*Stargazer*~ likes this.
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    Educate, encourage. If that don't work, document the refusal.
    joanna73 likes this.
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    Just give them a stern look, and say, "you must comply...YOU VILL COMPLY!"

    Lovin' me some of those nursey words.
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    Sometimes I have pedi patients who won't go to bed, and their parents are not there to enforce it. I understand they might be lonely but they also need to rest and can't stay up watching Good Luck Charlie all night long. So I tell them they can keep the TV on but I get to choose the channel. I usually choose C-Span. Within a few minutes the kids are asleep.
    KelRN215 likes this.
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    I'm but a student... That being said, at least with the IS, what I've found that sometimes makes it a bit more palatable (so to speak) for patients to use them is to educate them (and remind them they don't want pneumonia), and to use it x times per hour, or use it just once for every commercial they see on TV. That way it just doesn't sound so burdensome... after all, it's just once every TV commercial. If they do use it that way, they really end up doing it about 12 x/hr.

    As for getting the patient to answer those mental status questions, I usually prefaced (with difficult patients) them with this: "Just let me ask you these really stupid questions that I ask everyone, and answer them as best as you can and I'll get out of your hair for a bit." After all, if you've been asked those same questions over and over again, you see them as being just "stupid questions."
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    Please do not TELL your patients what to do unless they are mentally impaired. Be their advocate explain WHY we are doing what we do
    and its research based not hospital policy. Involve them in their care by allowing them to coordinate schedule with you. Engage them
    with clinical information; get their feedback. Speak with them about their care and plan of care, not at them or to them. When you discuss /collaborate with them with relaxed body language, seated if possible. Ask them is a good time for them to discuss, would they like their significant other there. And please ask them how they would like to be addressed or called.


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