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Nurse refusing a combative patient question.

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I’m currently on a travel assignment and a staff member (new grad) refused to take a combative patient who has been refusing his meds for 3-4 days, she felt like she couldn’t deal with him.  The charge nurse told her she cannot refuse a patient. I intervened and said it is her right to refuse and she should be reassigned to someone else. I then said that the bigger issue is the patient refusing his meds for multiple days and I asked if a provider has been notified and how the patient needs a physician assessment ASAP. Charge nurse told me I am wrong, that according to the ANA, a nurse cannot refuse.  I told her that’s incorrect and she called house super  on me and the nurse refusing. House supv jusr rolled his eyes. Nobodt addressed the meds/physician thing.

 Nurses  just blow my mind sometimes. Where is the compassion, understanding and flexibility with your coworkers in this field? 

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Been there,done that has 33 years experience as a ASN, RN.

5 Followers; 6,340 Posts; 70,485 Profile Views

My understanding of the ANA stance is ... nurses have the professional right to accept or reject  a patient that puts the nurse at serious risk for harm.     Who cares what the ANA says anyway... they are not at the freaking bedside.  The nurse could still  be written up or fired. 

You were spot on.. the patient needed to be certified, medicated and restrained.

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Leader25 has 37 years experience as a ASN, BSN, RN and specializes in NICU.

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On 5/22/2020 at 7:25 PM, raindrop said:

ses  just blow my mind sometimes. Where is the compassion, understanding and flexibility with your coworkers in this field? 

There is none...N-O-N-E.....,LMAO ,o my ANA ? really ,LOL once you take report you can not refuse,but someone should show her how it is done.

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Nurse SMS has 9 years experience as a MSN, RN and specializes in Critical Care; Cardiac; Professional Development.

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When I would have a patient who was difficult and I knew I could not tolerate them, I would request at the end of my shift not to be reassigned to that patient. If I came in and was still assigned, I would go to the charge nurse immediately, before getting report, and ask for it to be changed. Nobody wants a difficult patient; therefore those who did their "turn" with that patient should be released for someone else to have a turn.

The ANA stuff is nonsense and if the patient is refusing care, the physician needs to make a decision about placement or discharge rather than letting them take up a bed that someone else probably needs and wasting everyone's time. If refusing care but getting to stay were logical my hospital would be full of homeless people needing 3 hots and a cot every single day.

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babyNP. has 12 years experience as a APRN and specializes in NICU.

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Thank you for standing up for that new nurse. She will never forget it and I hope will be empowered to help other new nurses in the years to come as I'm sure she will see this situation again...

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TriciaJ has 39 years experience as a RN and specializes in Psych, Corrections, Med-Surg, Ambulatory.

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On 5/22/2020 at 4:25 PM, raindrop said:

 Charge nurse told me I am wrong, that according to the ANA, a nurse cannot refuse.  

ANA?  Do they actually have any jurisdiction anywhere?  If the charge nurse started waving around the state's Nurse Practice Act, she might be worth listening to.  ANA.  Really. 🙄

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Tenebrae has 8 years experience as a BSN, RN and specializes in Mental Health, Gerontology, Palliative.

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I work in acute mental health and we often get patients who are very full on. 

When the charge is doing allocations I have said before approx 1/2 way through my days on "look, I need a break from patient X today"

Its never been an issue

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