we recently had a similar pt experience as the OP.... came in with CHF, on dopamine gtt, could hardly breathe or maintain sats on cannula with massive generalized edema. well guess what... was refusing assessments, new meds, lasix, foley, xrays, labs... u name it, the pt refused it. treated us like sh*t, becoming verbaly, emotionally and in some cases physically abusive. they would put on the call light CONSTANTLY, staff would enter and be screamed at for "bothering" them... the pt complained to the CEO that every nurse, tech, lab person was incompetent and no one was doing anything to help them get better... even contacted the BON on some nurses--- of course the claims were unfounded, as every nurse charted everything (thank GOD). the pt was argumentative with every doctor who was on the case, "fired" them all, but then wondered what the problem was when it was said by the attending that if they were going to refuse everything and "fire" every Dr on the case, including him then he could go home since the pt was pretty much not allowing anyone to do anything. one day the IV, which they refused anyone to assess, let alone change, infiltrated. the pt would NOT allow me to intervene with Regitine, stating it was MY fault the IV went bad. the pt would not even allow me to try to explain why this was important, the fact that the skin would become necrotic, etc... the pt didnt want to hear it from the attending when he came up to explain it. all of us documented EVERYTHING!!! pt was also refusing to leave until they were "all better"... stating they would be here as long as they needed to be. well our NM got involved along with administration and social work with no solution. eventually, they left; almost a month after this nightmare started. im sure they are sitting at home OD'ing on sodium, since you know, we about killed the pt by witholding it from them (how DARE us!!) i guess all the Dr's notes state "will not admit, or will not consult, will not treat", etc.
also had an incident happen where a pt tried to sue us over altering their Rx upon discharge. usually our docs all do electronic Rx's, but it was busy one days so he wrote on a Rx pad instead. we copied it like with every script and come to find out that obviously the pt altered their scrpit for Vicodin on the way to the pharmacy and blamed us. yeah.... rrrrright... obviously they didnt even have a case. but the facility APPOLOGIZED for the 'inconvienence'... WTH???!!!
i love the fact that we can be treated like less than dirt and people can get away with it, and we all just have to 'deal with it.' its sad to say, but it literally makes my day when i get one thank you or a compliment from one patient.