How do you handle fluid restrictions

[russianbear]

So I'm a new nurse. I recently had an issue with a patient who is on dialysis. She is non compliant at home and finds herself frequently hospitalized. The issue we had was the physician ordered a 1200 mL fluid restriction. This patient also has a substantial psych history which was obvious by her behavior. She tried all types of manipulation, distorting facts, and staff splitting. She even became aggressive and security was called. Later my manager told me we don't have time to educate patients, we just do whatever they want and send them on their way. So, why even have orders like that? The nephrologist was cool and knows her non compliance, but there are others that would tear you up if they see someone on such a restriction getting 2,000 or more mL per day. How do you handle such encounters?

[That Guy, BSN, RN, EMT-B]

Your manager being a pushover for the safety of the pt needs to be addressed by someone higher up than you. I have gotten in to it with more pts than not about not eating or drinking before potential surgery. Educating them on the safety and health risks to which they still want to argue. You can hate me if you want to, yell at me all you like, but it doesn't change the fact Im trying to save your rude ass from complications.

[sailornurse]

Manipulative patients will find ways around rules. I once caught my patient drinking water from the shower head. It took me a few days to figure out that he took long showers every evening, filled urinals once or twice on my shift, yet I only brought in fluids by the glassful. (on fluid restriction no water pitcher was in the room )or we wrote on them with marker FLUID RESTRICTION on the top lid/sides & put them on window sill/shelves.

[russianbear]

I was criticized for trying to educate her on how dialysis patients can overload quickly. We don't have time for that. If they want to be non compliant and be admitted over and over and over its their choice.