Dealing with an uncooperative patient?

Getting a patient to cooperate is entirely dependant upon what they find objectionable. Some object to what might come across as non-medically-necessary procedures/etc.- the key to getting them to cooperate is to get them to understand the necessity... You just have to figure out WHY they are objecting- and work to resolve that. MHO

Exactly! And if that doesn't work...Vitamin H (Haldol) or Vitamin T (Taser)!!!

1. Are they confused or disoriented? 2. Do they understand what you are asking them to do? If the answer to both those questions is yes then you have a situation where the patient has the right to refuse and to be uncooperative. I try to explain the situation to them,why they are getting that particular med, treatment or test but if they refuse, I just document that they have refused. If it is something like a test, procedure, etc, I write a note to the MD in the progress note. If they will not be compliant with their diabetic diet, I just let the doc know (but not in the middle of the night). If it is an emergency situation I just call the doc. After 31 years of this kind of stuff, I have stopped trying to get people to do what is good for them. I DO MAKE SURE that I have fully documented their refusal. This is KEY in case they have a bad outcome. If they want to sign out AMA, just sign this form and you can go. They are adults and they have the right to be stupid.

Pts have the right to refuse care and we must respect that. All we can do is provide adequate health teaching and let them make their own decisions. I hate the term "non comliant". I think they have their own way of thinking about their destiny (as long as they are lucid) Who are we to impose or judge. I prefer the term "informed consumer" . if they are health taught appropriately and enough, I think this is fair, informed and most importantly.....respectful

I agree. All you can do is educate and let them make their own decisions.

While I agree that patients have every right to refuse treatment I question (to myself) WHY are they here seeking treatment? I usually inform them them that this IS the treatment for their problem but that they have the final say.

I won't let anyone leave who is under the influence of alcohol or drugs. I will call the police to have them picked up. I did a case in Houston was allowed to leave after narcotic pain medications because she SAID her husband was there to drive her home but no one saw him. And of course he was not really there. She drove herself right into the front of a very large truck and sustained a major head injury. These was LOTS of documentation on the charts and on all her old charts that she had been told not to drive under the influence of pain meds but she made her choice. And unfortunately, the hospital paid the price for her stupidity.

As has been noted in previous posts...patients have the right to decline treatment, therapies, etc. Our job is to make sure that the person has the information needed, in a form that is understandable to them, and that their questions have been adequately answered. Beyond that, we simply need to document appropriately and make sure that the prescribing professional is notified of any changes the patient makes to his/her medical plan of care. They are not prisoners or props, they are patients and they do have a voice in their medical care.

Remember you are the patient's advocate, not the facilities/MDs.

Ensure they have the most accurate up to date information possible and back them up.