Lazy patient

Published

Am I obligated to clean up a patient when they are perfectly capable of doing it themselves but are just lazy/want someone else to do it for them?

(Physical therapy has determined he is capable of doing it himself)

16 minutes ago, ppham said:

What if they're physically and cognitively capable of cleaning themselves up but decided to not to? You did all the things you could like educate, coach, set them up, compromise, etc. Let's assume the patient is ready for discharge, but as we all know the discharge process can take a while sometimes. So in this case, the patient still won't clean themselves up, then what? You are just going to leave the patient sitting in stools/urine until then? Something to think about, perhaps...

I've never encountered this situation. I hope it doesn't happen to you often. If the above patient was ready for discharge I couldn't in good conscience send them home like that. I wouldn't blame whoever was taking them home for being upset.

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Specializes in Nurse Leader specializing in Labor & Delivery.
19 hours ago, Kooky Korky said:

BTW, I think Harry will live to regret what he and Meghan are doing by giving up their titles. He is still a prince, by birth, but is no longer a duke, earl, or whatever.

Man, but you do go off on some weird tangents.

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2 hours ago, klone said:

Man, but you do go off on some weird tangents.

Maybe it’s the Kooky part! Ha! ?

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Specializes in ICU.

Sometimes I am successful in encouraging reluctant patients to wash up just by saying: "you will probably feel better... you will look nice and fresh for your visitor today...." *hands patient supplies*

Not going to waste my breath trying to convince or argue with an independent adult who requires no assistance with ADLs. I feel strongly that nurses need to maximize patient independence. Sometimes allowing the patient to do what they are capable of doing takes up more of my time, but it is SO important to promote independence.

My organization will pull central lines and have patients sign an AMA form when they refuse regular hygiene. Why should the health care organization be liable for that CLABSI? I think it is awesome.

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Specializes in retired LTC.
20 minutes ago, elephantlover said:

My organization will pull central lines and have patients sign an AMA form when they refuse regular hygiene. Why should the health care organization be liable for that CLABSI? I think it is awesome.

I'm impressed. Wonder how they view the PG reports?

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Specializes in ICU.
10 minutes ago, amoLucia said:

I'm impressed. Wonder how they view the PG reports?

It is a rare exception when things escalate to pulling lines. With education on risks, people are more often than not willing to comply with CLABSI bundles. To my knowledge, my organization was free of CAUTIs and CLABSI in 2019.

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Specializes in retired LTC.
36 minutes ago, elephantlover said:

It is a rare exception when things escalate to pulling lines. With education on risks, people are more often than not willing to comply with CLABSI bundles. To my knowledge, my organization was free of CAUTIs and CLABSI in 2019.

Kudos to your facility re inf control. I like the NO -NONSENSE approach.

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Specializes in retired LTC.

OP - are you still around? How about checking back in?

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34 minutes ago, amoLucia said:

OP - are you still around? How about checking back in?

I was just about to ask for the update then I got to this post.

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On 2/7/2020 at 10:20 PM, Katie622 said:

Am I obligated to clean up a patient when they are perfectly capable of doing it themselves but are just lazy/want someone else to do it for them?

(Physical therapy has determined he is capable of doing it himself)

Do work in an interdisciplinary team environment? PTs are a valuable member of a care team to evaluate the physical functional status of the patient - that is their scope of practice. There could be some underlying psychological or non physical factors that might be the culprit. I suggest you document and report your findings to the primary care provider.

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One of the many woes of bedside nursing. Assuming that the patient is lazy and not just tired and needs help -

Imagine if you tell this patient "no."

Shields up. Red alert.

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Specializes in retired LTC.
On ‎2‎/‎9‎/‎2020 at 5:42 PM, brownbook said:

I've never encountered this situation. I hope it doesn't happen to you often. If the above patient was ready for discharge I couldn't in good conscience send them home like that. I wouldn't blame whoever was taking them home for being upset.

An extension can be requested, but there are rules re timeframes anticipating discharge plans. That's why disch planning with all parties involved need to be brought up to speed. And done ASAP.

brownbook - you wouldn't have much of a choice. Facilities CAN BILL for days not covered beyond insurance approved time.

It's a very sticky wicket when a pt isn't meeting expectations and doesn't want to go home/rehab/SNF. And yes, freq families are caught in the cross-fire.

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