One of the most frustrating things about nursing

[blondy2061h]

All the technological advancements, all the miracles of modern medicine, all the scientific innovation. And ultimately we can't save people from themselves.

[A&Ox2RN]

When I was in school, I assumed that patient non-compliance was primarily an education problem; once the patient understands the importance of following their medical regimen and the likely outcomes if they don't, they will generally do their best to protect their health.

Now that I've been working for a while, I've concluded that while this is true for some people, non-compliant people just aren't interested in learning. They don't want to hear it, they just want us to fix the problem. As if their body was a car with a couple broken parts; replace the parts and the problem goes away. I have learned to assess someone's willingness and ability to learn about their problem.

To a patient admitted for R/O SBO with N/V & surgery planned for tomorrow afternoon: "no, you can't eat anything. Nothing by mouth, because that's what the doctor ordered. Why? Because yes, we have your nausea controlled by zofran and reglan, but that hasn't fixed your problem. If we give you food now, and you *dont* throw up, you'll get even worse." Some people get it, other people get ****** cause they haven't eaten in a day and they feel better now.

[rnsrgr8t]

Early on in my PNP career when I was getting frustrated with a family/patient that was being non-compliant, one of the MD's I work with gave me some very good advice. "All we can do is give them our educated advice/recommendations. It is up to them if they choose to listen to what we recommend or not. If we have done that to the best of our ability (including helping with barriers to doing what we recommend etc), it is not our fault/responsibility". Very good advice.

[LakesRN]

I'd love to hear any stories that tell about clients who did learn to save themselves from harmful influences, about nurses who helped clients find the motivation to change, and how that affected the nurse's motivation in his or her work.

What does save people from themselves? I don't think it's the gear, techniques or pills of modern medicine. Consider that the epidemics affect us as much as our clients: DM2, prostate and breast cancers, depression, obesity, etc. Consider also that the causes are modern, such as endocrine disruption caused by ingredients in cosmetics, vinyl flooring, pesticides, the plastics in cans and bottles, the plasticizers in thermal printer receipts; the side effects of many of our "miraculous" medicines; hardly any physical activity in our work; hardly any physical activity in our free time; sickening food at almost all restaurants and in the average American diet; and the advertizing and social influences that makes suckers of us all. We are all in the same boat. We all drink the KoolAid. It's hard for me to change my own ways of doing things, and I'm not fighting addiction, abuse in my household, poverty or discrimination.

[destova]

Like the pt dumped on the hospital by local police for detox that cried and cried about wanting to be clean, about her dad being the one that got her started on drugs, about the children she'd lost to cps... thanked anyone who walked into her room for helping her get clean.

Then she tricked a brand new aide into letting her out of restraints to use the bathroom and promptly left the hospital, still in her gown. Came back a few hours later, high as a kite, saying she just had to say goodbye to a "pos" friend of hers that lived up the street. (There was a known and frequently busted drug apartment nearby).

The beautiful part? The minute her high self got back in bed she started in on the "thank you for saving my life" speech... sigh

So sad. I so badly wanted to tell her that if she wanted her life saved, she'd have to be the one to do it.

[SHGR, MSN, RN, CNS]

I’d love to hear any stories that tell about clients who did learn to save themselves from harmful influences, about nurses who helped clients find the motivation to change, and how that affected the nurse’s motivation in his or her work.

What does save people from themselves?

I have a few, but you're asking me to write a Master's thesis!