what are the conservatee rights in SNF?

[tankee]

In this case a pt. has a mental disability, not compliant with medications, very loud, gets easily agitated.. etc.

hello nurses, I hope you can help me with this issue my question are in SNF settings.

Psychiatric MD says if patient is under/on conservatorship, it is ok to hold them to give IM medication. is it true?

Can a conservatee in SNF has the right to refuse medications? or they dont have the right at all to refuse medication and we can hold them to give IM meds?

Thanks

or if you can lead me to the site that will give answers to my questions and the conservatee rights.

[CapeCodMermaid, RN]

I had a discussion with a DPH surveyor 3 days ago. She agreed with me that a Roger's guardianship does NOT allow you to force anyone to do anything. I can't speak for other states, but in Massachusetts it's clear. No means no.

[morte, LPN, LVN]

I had a discussion with a DPH surveyor 3 days ago. She agreed with me that a Roger's guardianship does NOT allow you to force anyone to do anything. I can't speak for other states, but in Massachusetts it's clear. No means no.

then what good is it?......i am not sure a state surveyor would be the best source of a legal opinion.

[CapeCodMermaid, RN]

Someone has to give permission to administer anti psychotic medication. A competent resident can give permission, a health care proxy (if invoked) can, and a guardian with a rogers section can. The permission does not mean the person can be forced. Since the DPH can cite my facility if I don't follow the rules, I will believe what they tell me. My facility has more than 75% of its residents on anti psychotic medication. We have more than 30 Roger's guardians. We DO NOT nor will we ever force someone to take medication. We cajole, persuade, educate, and bribe. But, we do not force. We are all responsible for our own actions and for our own nursing practice.

[Havin' A Party!, ASN, RN]

then what good is it?......i am not sure a state surveyor would be the best source of a legal opinion.

Agree with this logic. That's why I worded my earlier response so conditionally.

Again, if the resident is deemed incompetent, and the family, MD, conservator, and legal authority (judge, mediator, hearing officer, or whomever) have considered the totality of the situation (including the patient's refusal, and the need a temporary restraint) and determined that the medication is to be administered (because it's in the best interest of the conservatee's health), then I fail to see the problem.

One issue that could legitimately be brought up is a conservatee's prior declaration (living will) against certain medical care. However, if that were the case, then the RG shouldn't be granted in the first place.

Interesting discussion.

[Junebug903, LPN]

I hate this. I just learned about this conservator thing 2 nights ago. I just returned from Japan and working again in California. The patients don't have ANY rights? I just don't get it. I don't care if they don't have all their faculties...they still have human rights. Holding a patient down to administer medications and a bolus feeding with them upset and saying no, no, no....is wrong. If it continues, find another way...idk this really bothers my personal moral and ethic code.

[ktwlpn, LPN]

We cajole, persuade, educate, and bribe. But, we do not force. We are all responsible for our own actions and for our own nursing practice.

isn't it frustrating when you are practically standing on your head to encourage a resident to accept a med or tx and someone accuses you of using excessive force? It's a thankless job

[lifelearningrn, BSN, RN]

I have to side with those who say NO, you CAN NOT hold the pt down and force medications simply because the conservator says it's okay. Yes, the patient DOES still have rights. In psychiatric, things might be different (especially when there is a danger to oneself and/or others) but in a LTC setting, it would be assault.

[Havin' A Party!, ASN, RN]

... It's a thankless job

Huge part of nursing, IMHO.

Very few thank you's... but a boatload of:

Why didn't you ______?

You're required to _______

It's been brought to my attention that ________

Ensure that this ____________ is complied with

It's your responsibility to ___________

(I could go on, but you've all seen the multiple memos / inservices from your DONs.)

[NurseQT]

In the state of WI we cannot force a patient/resident to take medication, we cannot hold them down, trick them, or hide the medicine in food. It is still a person's right to refuse their medication.

EXCEPT, when there is a court order to administer medications. I've only experienced this once since becoming a nurse. Never had to hold the patient down to give an injection. We just hid her meds in pudding and didn't tell her what was in the pudding!