How do you get your patients to do what they have to do?

Conqueror+, BSN, RN · Nov 14, 2013

When I worked geriatrics I would tell them that their son/daughter ______ would have my hide if they weren't up/dressed/pt'd/fed/medicated by the time they came to visit. Worked 95% of the time. With adult patients I lay it out for them as far as consequences and they accept or reject. It's their health.

RNfaster · Nov 14, 2013

I set goals with the patient and often post them to the white board. I explain rationale for compliance. Sometimes, I also enlist aid of provider when pts are not compliant. I also work with family to help ensure goals are aimed for / met. --And as pt participates, I offer praise and encouragement.

imintrouble, BSN, RN · Nov 14, 2013

Threaten them with a foley.

For everything.

nurseprnRN, BSN, RN · Nov 14, 2013

I know this is a jokey thread, but you know what? If it were posted without the cartoon you'd have a dozen posts from nurses whining about how they have to make patients do this or that and the subterfuges they have to go through to make the patient do things s/he doesn't want to do but they are suppose to do... Says who?

Heads up, folks: A patient has the absolute right to refuse to accept care, medications, or follow your prescription for activity or anything else. There have been lawsuits about this, and the patients win. The facility can certainly say, "If you don't wish to adhere to the medical or nursing plan of care, then you will be discharged." Hospitals are not hotels.

But you can't "make" anyone do things they don't want to consent to do, and it's unethical to try.

Kipahni, RN · Nov 14, 2013

I give them an option all the time " Your doctor has ordered for you to ambulate 3 times today. What times do you want to do them?" or " I can give you a bath now or in 2 hours you pick" or "Do you want your pain meds now or with your bed time meds." A book that really help in this subject is "Speak Peace in a World of Conflict" by Marshal Rosenburg

cardiacfreak, ADN · Nov 15, 2013

I work on a Progressive Care Unit and we get a lot of post-op CABG patients, sometimes they don't like to use the incentive spirometer, I can't make them but I do educate them on the reason for using it, also I inform them on what can happen if they don't use it. The patient has a right to refuse any treatment, so all I can do is educate on why it is important and the consequences if they don't. The patient is in charge of his/her own healthcare.

KelRN215, BSN, RN · Nov 15, 2013

I know this is a jokey thread, but you know what? If it were posted without the cartoon you'd have a dozen posts from nurses whining about how they have to make patients do this or that and the subterfuges they have to go through to make the patient do things s/he doesn't want to do but they are suppose to do... Says who?

Heads up, folks: A patient has the absolute right to refuse to accept care, medications, or follow your prescription for activity or anything else. There have been lawsuits about this, and the patients win. The facility can certainly say, "If you don't wish to adhere to the medical or nursing plan of care, then you will be discharged." Hospitals are not hotels.

But you can't "make" anyone do things they don't want to consent to do, and it's unethical to try.

In the adult world, I agree with you and I've certainly taken the liberty to not follow what I felt to be bad medical advice in my personal life. But, alas, I am a pedi nurse and the same doesn't hold true. There are limits to what parents can refuse for their child. When parents do things like refuse to give their child prescribed seizure medication, we call that medical neglect. I have a child with an open case with DCF for this very reason. There have been cases where parents were charged with murder because they let their daughters' type 1 diabetes go untreated and the girls died. If a JW parents tries to refuse a blood transfusion for their child on religious grounds, the hospital will get a court order to administer blood over the parents' objections. I once saw parents state that they would refuse treatment for their daughter's (very treatable) cancer. The oncology team was all set to take the case to court and they were very confident that the courts would side with them, but the parents eventually consented.

SwansonRN · Nov 15, 2013

Fluttering my eyelashes usually works

Conqueror+, BSN, RN · Nov 15, 2013

I know this is a jokey thread, but you know what? If it were posted without the cartoon you'd have a dozen posts from nurses whining about how they have to make patients do this or that and the subterfuges they have to go through to make the patient do things s/he doesn't want to do but they are suppose to do... Says who?

Heads up, folks: A patient has the absolute right to refuse to accept care, medications, or follow your prescription for activity or anything else. There have been lawsuits about this, and the patients win. The facility can certainly say, "If you don't wish to adhere to the medical or nursing plan of care, then you will be discharged." Hospitals are not hotels.
But you can't "make" anyone do things they don't want to consent to do, and it's unethical to try.

Oh yes they are (half jokingly)

Mandychelle79, ASN, RN · Nov 15, 2013

I found that surprising them works :) Part of my job is it sit down with a patient 1:1 to asses their mood, thought content, etc. If they refuse the 1:1 I use 1 of two methods... 1- I just say ok, thats fine and thanks for saving me from needing to chart ( its easier to chart refusals), and if they decide later that they want to talk I will be here until ( end of shift time) I use this one with my more irritating patients, who think that saying no will become a power struggle, when I answer like this, it surprises them and they usually do sit down wiht me at some point during the night. 2- I say I understand that you dont want to talk, but can I ask you the 5 questions I have to chart on so I dont get in trouble, a lot of times they say yes and then I always finish up with anything you would like to talk about and 75 percent of the time they end up talking to me.

Also I have found that for whatever reason I can get patients to do things others cant. Not sure how I do it, just have always been able to.

T-Bird78 · Nov 15, 2013

If you find out let me know. I'm tired of pts coming in and complaining that their inhaler's not helping and you can't even see them through the cloud of smoke clinging to them. And don't lie to me, I know you don't smoke "just one cigarette" a day.