[RN4NICU]

Originally Posted by studentnurse74

We aren't even allowed to use the word non-compliant. It's too negative. That bothers me, just like the word client instead of patient! They will always be my patients! I'm taking care of them, not cutting their hair!

Who won't let you use the word noncompliant? I truly hope that there is a better rationale than "it is too negative"!

That is a dangerous limitation to put on you. Documentation of noncompliance is what protects nurses legally. It shows that we are doing we are supposed to do, but that the patients (or "clients" ) are cooperating. That shifts the legal responsibility for any negative outcome from the nurses back to the patient, which is where it belongs if the patient is noncompliant with the plan of care. I would look into having that side of things addressed. It is not a good precedent to set. The chart is a legal document - not a newspaper article. The focus should be on documenting what is actually happening, not keeping up appearances. If student nurses are being taught otherwise, they will graduate and enter the profession not knowing how to (or realizing that they should) protect themselves, legally. That is just unacceptable.

[jnette]

Hey Klone.. relax... I enjoyed it, too !

I especially then enjoyed those that followed, thought up by the posters.

Carry on.. we all need to let off steam now and then when the head has been stuck in the books for months on end.

As for the "nocompliant" being too negative, I remember that being addressed in my nursing books as well.. it was no longer thought to be appropriate as it was deemed "judgemental" I forget right now what they were replacing it with.. will have to go back and look it up.

[HappyNurse2005]

I've come up with a diagnosis for my kids: Motivational Deficit Disorder.

LOL, I occasionally suffer from Motivational Deficit Disorder, too.

[talaxandra]

I'm right there with you on the energy field disturbance thing: check out Jef Raskin's article, "Humbug: Nursing Theory" (http://jef.raskincenter.org/publishe...ryForSite.html)

The problem with labelling behaviour 'non-compliant' is that the judgement implicit in it is that the patient is the subject of, rather than a participant in, health care decision making.
Don't get me wrong, I'm as frustrated as the next nurse by the renal patient who breaks their fluid restriction and come in six litres over loaded and needing urgent dialysis , and there's a woman who comes in several times a year with DKA because nobody's gonna f#$%ing tell her she can't eat what she wants.
But sometimes patients have different priorities than their health care team. Like the guy with myasthenia gravis and an impaired gag who'll risk aspiration pneumonia to taste his son's birthday cake. or the renal patient who doesn't want to give up his Italian heritage, however high the potassium level in tomatoes. Or the woman with schizophrenia who knows that smoking has risks but can't handle the side-effects of her meds otherwise.
Just a thought

[gwenith]

One of the funniest spoofs of Nursing diagnosis I ever read was the "Holistic Nursing" where the patient was seen as a collection of holes into which nurses placed tubes such as catheters, N-G tubes...............

We can and should every so often hop on that white horse and charge the sacred windmills that dot the academia of our profession. We need to do this sometimes to bring a sense of reality to what can become a exercise in jargon.

[jnette]

Originally Posted by gwenith

One of the funniest spoofs of Nursing diagnosis I ever read was the "Holistic Nursing" where the patient was seen as a collection of holes into which nurses placed tubes such as catheters, N-G tubes...............

We can and should every so often hop on that white horse and charge the sacred windmills that dot the academia of our profession. We need to do this sometimes to bring a sense of reality to what can become an exercise in jargon.

True enough... I wholeheartedly agree.

[BETSRN]

Originally Posted by klone

Ineffective denial...as opposed to EFFECTIVE denial?
Disturbed energy field
Impaired environmental interpretation syndrome
Health-seeking behaviors (the horror!)
Impaired home maintenance (I'm guilty of that one! If only I could do a collaborative intervention with Merry Maids)
Ineffective protection
Noncompliance
Wandering

Some of these just made me chuckle, and made me wonder about the people who come up with them.

Are those NANDA approved nursing diagnoses? I never heard those (of course I ahev been away from school for 20 years now). We nurses would all agree with you: you rarely ever run into nursing diagnoses after you graduate!

[RN4NICU]

Charting noncompliance is not being judgemental, it is an observation of fact and legally necessary (IMO). You get some shmuck that is not compliant with the treatment regimen that decides to sue when serious complications occur - the only leg you have to stand on when said shmuck tells the court "I didn't know any better - I'm not a doctor or a nurse" is documentation that the patient DID know what he/she was supposed to do but refused to do it. Otherwise, some dumb-a**ed jury will hand them over a settlement out of sheer ignorance. Yet if there is documentation in the legal record, the patient no longer gets the benefit of the doubt because there is no longer any doubt - the teaching WAS done and the patient WAS noncompliant and DID cause his/her own complications.

I will continue to use it. But again, just my opinion (and my license to protect).

[BETSRN]

Originally Posted by RN4NICU

Charting noncompliance is not being judgemental, it is an observation of fact and legally necessary (IMO). You get some shmuck that is not compliant with the treatment regimen that decides to sue when serious complications occur - the only leg you have to stand on when said shmuck tells the court "I didn't know any better - I'm not a doctor or a nurse" is documentation that the patient DID know what he/she was supposed to do but refused to do it. Otherwise, some dumb-a**ed jury will hand them over a settlement out of sheer ignorance. Yet if there is documentation in the legal record, the patient no longer gets the benefit of the doubt because there is no longer any doubt - the teaching WAS done and the patient WAS noncompliant and DID cause his/her own complications.

I will continue to use it. But again, just my opinion (and my license to protect).

You can chart all your teaching without using nursing diagnoses.

[jnette]

Originally Posted by RN4NICU

Charting noncompliance is not being judgemental, it is an observation of fact and legally necessary (IMO). You get some shmuck that is not compliant with the treatment regimen that decides to sue when serious complications occur - the only leg you have to stand on when said shmuck tells the court "I didn't know any better - I'm not a doctor or a nurse" is documentation that the patient DID know what he/she was supposed to do but refused to do it. Otherwise, some dumb-a**ed jury will hand them over a settlement out of sheer ignorance. Yet if there is documentation in the legal record, the patient no longer gets the benefit of the doubt because there is no longer any doubt - the teaching WAS done and the patient WAS noncompliant and DID cause his/her own complications.

I will continue to use it. But again, just my opinion (and my license to protect).

I wholeheartedly agree with you.. I was merely pointing out that in several of my nursing school books it was mentioned that the term "non compliant" is no longer going to be considered appropriate, as it bears negative/judgemental connotations. Still haven'y gone back to see just what acedemai was replacoing it with, but I do know that it either is ALREADY or is BEING revised/reworded.
So what happens to patient accountability?

Guess it's now every one's responsibilty but the patient's to improve his/her health status.