Nightowl_RN

@BuckyBadgerRN: I see the resident spelling police has descended upon the one spelling mistake I think I have ever made in 30 years. I posted this message while in a rush and was less concerned with the accuracy of spelling than the meaning behind the message. Yes, I am well aware it is HIPAA not HIPPA. I will not hesitate to say I am thoroughly annoyed by your response. I posted a serious question and was hoping and looking for serious, thoughtful responses. Here is a clue. Stick to the topic. That is all.

This is a good response, and it addresses the question from a broad theoretical standpoint. This is more along the lines of what I was looking for. Thank you kiszi.

@toomuchbaloney: You are obviously assuming I/we have not considered this already. "WHY the patient is refusing is the problem and MUST be addressed ASAP."

Right. exactly. and of course that had been addressed (i.e., proper pain management). Her narcotic dosages had been bumped up several times. This is an individual with a history of addiction and substance abuse (NOT to imply this means she doesn't deserve "Proper pain management"!) Again, more I could say about the situation, but due to privacy concerns, I'm going to withhold. The situation seems to be resolving, I'm happy to report.

A resident where I work has been refusing care. I don't want to say too much and risk violating Hippa but in general, This resident is somewhat new to our facility and as of late has been repeatedly refusing to be turned, changed, repositioned. She takes a LOT of pain medication but apparently it is not helping to alleviate the pain sufficiently to allow us to provide the necessary care. we have been documenting, documenting, documenting care refusals. I want to make sure this is approached correctly, before it potentially turns in to something much bigger. Can anyone please offer their thoughts.