Adults Who Can't Swallow Pills

Specialties Emergency

Published

Where I work now we seem to have cornered the market on adults who can't swallow pills. I'm not referring to children or eldery people with dysphagia. I'm talking about gagging and crying like they were four or something. They whine and beg you. "Please don"t make me take that pill. I can't swallow it, I never have been able to."

I swear I see at least one a week. I've tried everything, even crushing pills in applesauce. They just can't swallow the med. Of course they don't want an injection or a suppository either.

Anybody else run into this in the ED?

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.

Yep, there is a difference between "adults who can't swallow pills" and "adults who WON'T swallow pills".

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Originally posted by Medic946RN

Wow!

Didn"t know this would be such a big thread when I started it. I was really surprised that many adults cannot swallow pills. I hadn't seen anywhere else...

Then DEMAND that you make them better. Oh I'm sorry I forgot to get my magic wand out of my locker...

you and the patient are in limbo, they don't refuse the med, but "can't" it, you can't DC them, they don't want to go home until they're fixed.......(sigh) As Homer Simpson says "Whaddya gonna do?"

:devil: i have a magic wand......;)

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Specializes in Emergency/Critical Care Transport.

LPN2be2004 and MLOS:

You're right there is a difference between can't and won't but it's a matter of semantics.

The patient that won't take the pill claims they can't do it. I don't really think their being uncooperative, but seem to expect to be cured without the benefit of medication.

It's not the 23rd century I can't pass a Star Trek medical tricorder over them and rectify their malady.(PS will somebody at NASA get off their duff and invent one of those things?)

Sometimes it's like arguing with my six year old. (I don't reccommend arguing with six year olds they're way too smart :D)

"Do you want to feel better?"

"Yes"

"Then take the medicine"

"But I don't like it"

"Then you won't get any better"

"But I want to get better"

"Then take the medicine"

"But I don't like it."

I just get to the point where we're at an impasse. I've never had one of these pt's want to sign out AMA or threaten to go to another hospital for treatment. They don't want the medicine but they want results.

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Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.
Originally posted by Medic946RN

LPN2be2004 and MLOS:

You're right there is a difference between can't and won't but it's a matter of semantics.

The patient that won't take the pill claims they can't do it. I don't really think their being uncooperative, but seem to expect to be cured without the benefit of medication.

I realize some people expect that if they say they can't swallow pills that the magic wand is somewhere in that cabinet in the corner just for them.

But sometimes the conversation goes like this:

"Ok, here is your medicine "

"Ma'am, i can't swallow pills. Can i split them down first?"

"You can't swallow pills??? How stupid. For God's sake you're an ADULT, either swallow them or don't take them at all! I don't have time to play your mother!"

And that's what happened the last time in the ER that i admitted that i can't swallow pills. That conversation i just listed is a problem. It was embarrassing ENOUGH to be 25 (at the time) and say "i can't swallow pills" KNOWING that the response would be like hers (although i did not anticipate it being loud enough for 3 other pts. in the same room to hear, or expect degradation, but got it anyway).

I'm just saying that i see both sides of the somewhat-fence, but that i'd never have the same reply that my ER "nurse" gave me, because i know what that's like.

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Specializes in ICU.

Perhaps again it is the matter of semantics sometimes you need humour at a time like this. i.e.

"Sorry I can't swallow anything that is masquerading as dinner plates like those two pills are - can we break them up??"

"You SURE these are not for the horse??? Okay give me a couple of spoons and an industrial chainsaw and I will see if I can get them down to the size my throat will accept."

Here is one trick that sometimes works - hold the pill between your teeth and take a swallow of water as you get the water into your mouth open your teeth to let the pill be washed in with the water and then swallow quickly with any luck it is just like swallowing the mouthful of water itself and it overrides the instant gag.

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Originally posted by Medic946RN

LPN2be2004 and MLOS:

You're right there is a difference between can't and won't but it's a matter of semantics.

The patient that won't take the pill claims they can't do it. I don't really think their being uncooperative, but seem to expect to be cured without the benefit of medication.

........ just get to the point where we're at an impasse. I've never had one of these pt's want to sign out AMA or threaten to go to another hospital for treatment. They don't want the medicine but they want results.

sometimes i wonder if the patient wants us to "mother" them. i wonder this because of the number of patients that come in and won't swallow pills, let you insert ng tubes, foleys, allow blood work, etc unless you practically beg them. "aw come on, don't you want to get better? you will feel better after we decompress this obstruction...."

i don't even think they are just being obstinent. i think that there are a certain type of patients that almost want to be told what to do. i am not slamming anyone, just making an observation. i wonder what their home lives are like. who wears the pants in the families. we all know that the patients home lives are a major impact on why they come to the er in the first place. how many times have you had a pt come in for r/o mi and refuse all blood work until the wife (or husband if a female) comes in and lays down the law?

wow!:p

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Specializes in Emergency/Critical Care Transport.
Originally posted by LPN2Be2004

"Ok, here is your medicine "

"Ma'am, i can't swallow pills. Can i split them down first?"

"You can't swallow pills??? How stupid. For God's sake you're an ADULT, either swallow them or don't take them at all! I don't have time to play your mother!"

LPNbe2004: I am sorry you got treated that way. If my pt asks if they can be crushed. split cut in half, put in pudding/applesauce. That's fine with me. I am more than willing to help. But in my original post I referring to the ones who won't even attempt that because "it taste's bad." or "I just don't like them."

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magik, you are a true realist...

i cringe when i hear the whining, begging and pleading from patients about the bloodwork, the po meds, foley, etc. (though an NG HAS to suck, it still doesn't give someone license to be rude)...

it's like WE came to THEIR home and forced these things onto them...

my favorite were the 3 brothers (all still living at home, ALL in their 30s) and their mom (the patient) coming in asking me for every little thing every 3 minutes, whining and crying over their mom (she had pneumonia, small fever, good SAO2)...OH MY GOD...talk about being a fly on the wall in THEIR home (she must still wipe their behinds:stone )

And the mom just LOVED every BIT of attention she was getting

Carrying on and attention seeking like some of the stories posted here is simply LAME...It shows a general lack of respect for oneself, detracts from any shred of dignity you may THINK you have, and is just plain embarassing...Get over it...

sean

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If the post is just about a plain refusal to take any meds, any route, then I can agree that they are being difficult.

But, if it's about being an adult and not being able to swallow pills, any size, then I hope I never run into any of you, with such an insensitive attitude, when I go to the doctor's! I am 33 and GAG when trying to take a pill, capsule, etc. No matter what I do. When I eat, I chew my food forever, until it is nice and small.

And yes, it is very embarassing to ask for a liquid form. That is why I hate to go to the MD's.

It's not that i am trying to be difficult, but that's just me!!!!

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Originally posted by athomas91

i had a mom bring in her kid (3 y/o)

because - she doesn't like the amoxil...she won't take it...can you give us zithromax - she likes that one....

i literally asked her --- who is the parent here??? MAKE her take it...she will learn....

I used to put my kids dose of amoxicillin in strawberry flavored milk.........they were never the wiser and at least they took it.

As for other meds, whenever they complain about having some kind of pain or are feeling hot from a fever, if I offer them something for it (like motrin) and they refuse cause they don't like the taste, then I tell them not to complain when they feel bad. It's not that I'm not concerned about my children but I don't want to listen to them whine about it if they're not going to do something that can help them. I know where you guys are coming from, it's bad enough to have to deal with it from kids, but when it's grown adults, it does tend to get on your nerves.

Back to kids and medicines though. We have a pharmacy here that puts flavoring in liquid meds for a small fee. Hey, whatever works!!

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Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.
Originally posted by NHLPN

If the post is just about a plain refusal to take any meds, any route, then I can agree that they are being difficult.

But, if it's about being an adult and not being able to swallow pills, any size, then I hope I never run into any of you, with such an insensitive attitude, when I go to the doctor's! I am 33 and GAG when trying to take a pill, capsule, etc. No matter what I do. When I eat, I chew my food forever, until it is nice and small.

And yes, it is very embarassing to ask for a liquid form. That is why I hate to go to the MD's.

It's not that i am trying to be difficult, but that's just me!!!!

Well said.

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i find it very disheartening and quite offensive that anyone would think that any of us would have a problem w/ those who literally had some physical difficulty in taking a pill....come on people - we are nurses - if we were that blackhearted - would we still be nurses??? i think not....we are talking about those pts who want to be healed - but don't want that pill, don't want that shot....

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