No, you can't do that!

Nurses General Nursing

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I am just curious how other facilities handle patients and their family members that refuse most of the care while in the hospital. I am referring to declining the use of the gait belt, refusing IV fluids, refusing vitals, refusing lab draws, but demanding specific medications. I am guessing the answers may be different for nonprofit and for profit hospitals so please share that in your answer as well.

Specializes in L&D, Cardiac/Renal, Palliative Care.
I have actually ridden in the back of an ambulance with a family member so my guess is the EMS heard the "discussion" and opted for the family to be up front. In the situation I posted about the EMS people refused to let the family member ride with them at all based on the family members behavior.

In this case it was just the policy of the company for safety reasons. I was just glad I hadn't been the one to tell her that, usually it IS me putting my foot in my mouth :coldfeet:

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This just reminded me of a diabetic patient that I had in the hospital that called me on the phone to report she was having chest pain. So, a rapid response was called and the woman refused EVERYTHING. No to the VS, no to the bloodwork, no to the EKG, no to the nitro, etc....lady, you came in here for a necrotic toe, but would rather be toe tagged than cooperate with us when you may be having an MI. Eventually after trying to reason with the patient the MDs gave up and allowed her to kick us out of her room. Her words, "I'd be fine if all of you would just get the hell out of my room". Guess she didn't know that chest pain is one of the few things that will get you to see a doctor-FAST.

She left AMA but it was a few days later.

Maybe she just didn't want to die alone.

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When my Mom was terminal, I was so beside myself that I was rude to staff and critical of a doctor who did a procedure and then obtained the permit afterwards. I was angry that Mom's internist and her GI doc both missed the cancer that eventually took her.

I know it was not the fault of staff, but I was just in a very hard place. I was losing my beloved mother. Was it fair to Mom that her doctors had failed her? Was it staff's fault? Was it my fault?

As an RN, I couldn't help but see things as an RN would see them. As the child of a dying mother, I was going through

hell.

I was not loud or violent or threatening, which is not how OP's family member was. That would not have been acceptable.

I must say that no one really tried to help me, no one really tried to express their understanding about my experience.

They were good to my Mom, but I could have used some help, too.

For OP - where is your manager? Your hospital lawyer? A Judge to terminate this family member's POA or whatever?

It's a balancing act to deal with demented patients and their kids. We can't always make everyone happy. We live in

a pretty rough world and sometimes things just hurt.

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This was not a psych patient but an elderly patient with dementia that came in with AMS. When I tried to discuss the Beers list of medications that were counterproductive to what she was trying to accomplish, she yelled over me. This poor patient was on several meds on the Beers list. The admitting diagnosis said poly pharmacy yet she expected us to give haldol until "he went to sleep" She thought he just needed to rest.

Dtr could have used a beer or 2, LOL. Often. No, really, she needed some help to deal with her emotions. Where was her pastor? Rabbi? Social Worker? Whoever? The hospital failed her to a

degree, it seems like, by not getting her some help.

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"You either have the worst headache in your life - in which case you would agree to a firing squad, not only for that needle in your back for a few seconds, - or you do not have the worst headache in your life, in which case I have no reason to bother".

Neurology pearl of wisdom :)

You do know that she was terrified, right?

And that she probably felt the irritation from you.

And that she picked up on you not wanting to be bothered to try to help her emotionally, not just physically.

People are more than a body. We have to deal not only with the numbers and the signs & symptoms, but also the emotions. Fear. Terror. Rage.

not saying it's easy or never frustrating. But it is real and we do well to recognize and address these feelings.

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Dtr could have used a beer or 2, LOL. Often. No, really, she needed some help to deal with her emotions. Where was her pastor? Rabbi? Social Worker? Whoever? The hospital failed her to a

degree, it seems like, by not getting her some help.

Unfortunately she was unable to have a rational conversation when many different staff members tried to help her. I do not know where her support system was and the staff truly tried to help her but if it wasn't haldol she did not want to hear it. It was sad.

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Specializes in nurseline,med surg, PD.
When my Mom was terminal, I was so beside myself that I was rude to staff and critical of a doctor who did a procedure and then obtained the permit afterwards. I was angry that Mom's internist and her GI doc both missed the cancer that eventually took her.

I know it was not the fault of staff, but I was just in a very hard place. I was losing my beloved mother. Was it fair to Mom that her doctors had failed her? Was it staff's fault? Was it my fault?

As an RN, I couldn't help but see things as an RN would see them. As the child of a dying mother, I was going through

hell.

I was not loud or violent or threatening, which is not how OP's family member was. That would not have been acceptable.

I must say that no one really tried to help me, no one really tried to express their understanding about my experience.

They were good to my Mom, but I could have used some help, too.

For OP - where is your manager? Your hospital lawyer? A Judge to terminate this family member's POA or whatever?

It's a balancing act to deal with demented patients and their kids. We can't always make everyone happy. We live in

a pretty rough world and sometimes things just hurt.

I hear that. My mom was on hospice and I made some rude remarks to the staff, because I was UPSET. I later apologized. Yes Kooky, sometimes things just hurt.

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Specializes in ED, ICU, PSYCH, PP, CEN.

I'm almost wondering if an elder abuse complaint to the proper agency might be in order.

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I'm almost wondering if an elder abuse complaint to the proper agency might be in order.

It was discussed, not sure if it a complaint was filed with adult protective services.

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