What would you do if this was your patient?

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Hi, I work as a dialysis nurse for less than a year. We have a young patient who hates coming for treatment so what he tries to do is .. He would try to remove 3.5kg for 2 hours. After a while when he starts having cramps and hypotension, he will ask staff to take him off from the machine. I've read that this will cause cardiac distress in the long run. I tried to educate him and his wife but they won't listen. They think they know better about dialysis than the rest of us. One day, I spoke to our nurse manager and told her I don't want to put him on anymore because I want to protect my license. Am I overthinking the situation or did I do the right thing? What would you do if he's your patient? Thank you.

Specializes in Dialysis.

This is ridiculous! The staff ALL need to follow Drs orders when putting patient on the machine. If his prescribed time is 3 hrs, he must be set for 3 hrs!

Then, if he wants to sign off AMA, it won't reflect badly on the staff. The other issue is that he won't get all his fluid off, and may end up in Pulmonary edema requiring a trip to the ER for an emergent treatment

Sometimes, these hard headed patients have to experience the consequences of their behavior before they become more compliant.

Document every single statement made by this patient and his attempt to bully staff.

A care plan meeting needs to happen, also staff education in always following Drs orders!

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I would write up the staff that are nit following doctors order....let the patient cut his time and sign an a ma form...all you can do is kerp educating the patient because at the end of the day if the state surveyors came in and seen what yall are doing guess who would be in BIG trouble...

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Thank you all for the insight. Unfortunately, he still keeps on doing what he's doing. I'm just relieved I'm not part of it. It means I'm not putting my license at risk.

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Thank you all for the insight. Unfortunately, he still keeps on doing what he's doing. I'm just relieved I'm not part of it. It means I'm not putting my license at risk.

Good for you. Most clinics/companies let pts get away with this stuff, because they want to money the tx brings in. Good for you for not having to deal with this guy anymore.

I wouldn't worry about the other staff going along with him. Their licenses, their worry.

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Good for you. Most clinics/companies let pts get away with this stuff, because they want to money the tx brings in. Good for you for not having to deal with this guy anymore.

I wouldn't worry about the other staff going along with him. Their licenses, their worry.

Exactly, very well said. Thank you.

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