Patients who refuse to cooperate with medical/nursing treatment....

  1. I have just about had it with patients who think the hospital is a joke. I took care of a patient recently who basically refused to cooperate with the medical/nursing treatment and plan....This patient is morbidly obese (and no I am not exaggerating), one of the worst cases of cellulitis that I have ever seen in his lower extrimities....receiving antibiotics Q4....goes outside to smoke at least every 2 hours....then gripes at the nursing staff because his meds are late....(I, for one will NOT chase a pt down in a smoking area to give medication)...stated his PICC was infected and demanded it pulled (no S/S of infection, no redness, no edema)...(we pulled it)....requested to go to another department to see child who was being treated (an adult child with a minor problem according to the patient)....refuses to keep his legs elevated....never content with his food....multiple requests for coffee, blankets, etc....I just wanted to go in and say "Look here, buster...I can't help you until you are willing to help yourself...and I cannot heal your legs in 12 hours.....and if you don't like it we have this little procedure called leaving AMA, and would you like to try it? I will be more than happy to fill out the forms.....


    People like this just make me livid....I wanted slap the s*it out of him, but I figured the mess would be too huge for me to clean up......This pt is probably going to end reporting me and the nurse before me, but I really don't give a crap....I refuse to bow down to non-compliant, arrogant, I can't wipe my own nose patients.....I have drawn my line in the sand....
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  2. 47 Comments

  3. by   New CCU RN
    Sorry to hear bout this literal waste of space. Some patients are just like that. I had one guy last night who at the age of 30 was ruling in for his second MI (secondary to cocaine use) I flat out told him the drugs were destroying his heart. He laughed at me and said if he had the money hed be doing them everyday.

    Meanwhile this man has no job, is contributing nothing to society, is on welfare although he SHOULD be out in the workforce. His medical bills are paid by you and I ...... and he will be out on the streets in a few days..using his coke again. Gotta love it.
  4. by   deespoohbear
    Yeah this guy is on Medicare disability and acting like the healthcare people OWE him....give me a break....Me and my husband are out breaking our backs daily so he can squander our hard earned money...while some really deserving soul who desperately needs to be on disability can't get a dime of assistance because of some freakin' loophole.....
  5. by   CANRN
    I had a patient once who refused to following ordered treatments, bedrest, etc. We documented all refusals. The doctor was made aware, walked in and told the patient unless he followed his plan of treatment, he was going to be discharged. The next day, same thing, refused to follow orders, the doc d/c'd him.
  6. by   ?burntout
    oh yeah.....hear ya loud and clear.......

    oh and don't you just love when your copd patients go outside and smoke and then come back, calling for a breathing tx., because...............they can't breathe!!
  7. by   New CCU RN
    It's too bad we can't have a three strikes your out type system.
  8. by   susanmary
    It can be very frustrating dealing with noncompliant patients. I do my best to take care of patients, educate them, etc. -- but it is ultimately up to them whether or not they are compliant (hence all the frequent fliers in acute care.) We all have free will & with free will comes consequences. Do I wish all my patients were adherent to their plan of care -- absolutely! But ... I don't take it personal ... let the doc know ... and document. It's their choice ... their health. They own their behavior. I own mine.
  9. by   extremebean
    was just thinking about this on the way home, but from a different angle...........for some reason tonight we had so many kids in the ED who's parents had bought them in: "fix my kid, make them feel better, ect,".............but then they are refusing treatments right and left........."oh, no not an x-ray,,,,,,you're not putting a needle i my kid". give them rationales till i'm blue in the face, but they are denying these kids treatment still.........like susanmary mentioned, with adults they own their behavior, but these kids don't get to decide. i have trouble understanding what they thought we'd do in the ED. were we just going to stare at the child and come up with some magic dx and wonder med that is pleasant to administer and tastes like sweets??
  10. by   traumaRUs
    I'm an ER RN too and I gotta endorse all of what you guys say.
  11. by   ERNurse752
    Yeah, really...drives me nuts wondering why they waltz in, refuse everything, and then get mad because we didn't do anything???

    My official diagnosis: TSTL (too stupid to live...)
    (sorry...worked last night)
  12. by   deespoohbear
    Yeah, like the patient that walks in complaining of chest pain. Those are words that make most nurses go into high gear....I immediately start doing a 12 lead, insert an IV, get labs drawn, the whole 9 yards....but then patient is like "whoa, I didn't want all this." What the heck did you come in for then?

    If the patient doesn't want to comply with the prescribed treatment and/or nursing plan, send them home. Ought to be some kind of rule protecting healthcare workers from lawsuits and such when patients refuse to help themselves...(I am not talking about terminally ill people who don't want anymore treatment other than comfort, or sick, elderly folks who just want to be left to die in peace....I am talking about your 40 y/o non-compliant PIA's....)

    I feel sorry for the kids whose parents refuse reasonable treatment for their child....they don't have a choice....parents ought to be slapped....
  13. by   SmilingBluEyes
    So frustrating. The sense of entitlement W/O responsibility is so pervasive, it makes me ill. THESE people are the ones don't have a "right" to healthcare IMHO.
  14. by   wolfie
    Working as an ED nurse I came across this alot and it's very frustrating. To relieve myself from all the frustration I first had to not take it so personally which was hard. Second I just adopted the attitude that this is the United States and they have the right to be stupid. It helped alot with my anger level.:chuckle

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