Alert patients who refuse meds.

[Caffeine_IV]

How do you handle your A&Ox3 patients who don't want to take their meds?

Ex. HIV+ patients on antiretrovirals refusing d/t nausea even after zofran/phenergan ; pt with some type of infection refusing antibiotics because of the side effects.

I know they have the right to refuse of course but how much time do you spend encouraging them to take the meds or receive the IV antibiotics? Do you offer them again at a later interval?

I hate to be mean but on a very busy night I honestly do not have time to beg adult patients to take needed medication. I've dealt with these scenarios and the patients were very aware of the condition and informed by the doctors the importance of their treatment and I also followed with the same encouragement.

What else can you do?

[talaxandra]

*pitcher

Every time I read about Press-Gainey it makes me more glad I work in Australia!

I'm conflicted about 'compliance' because there's a whole lot of subtext packed into the concept. On one hand I agree that competent people should be able to weigh their alternatives, and agree that HCP's are biased - often without being aware of it - toward health as the superordinate priority patients should have. On the other hand, it's immensely frustrating to see people repeatedly represent with issuesthat could be managed or avoided by adherence to a recommended program, like fluid restiction in renal failure. And I've managed to meander off topic, which was - the extent of persuasion when competent patients decline prescribed medication...

[Ruby Vee, BSN]

look i have a frequent flyer non compliant dialysis patient who demands a stack of saltines, a water picture and a picture of ice on the side to boot... you refuse, she demands the nursing supervisor and cals us all out on her right to refuse... i politely bring the dilaudid, zofran, phenergan, benadryl,,,,, with as much food and ice as i can... she is barfing in a bucket demanding saltines and ice......

here, have it baby, puke it all up, just to do it all again because you demand it and the supervisor is more concerned with press gainey scores than your icu stay which won't be paid for due to your non compliance.... have at it....

let me get you another picture of water as the house sup tells me to do...

we can no longer refuse.... these idiots do this at home, you can't change them, why fight it? ... here have at it honey.

geez, i wish a picture of ice and a picture of water would satisfy my manipulative, noncompliant, fluid-restricted patients! unfortunately, they demand the real thing!