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submitted 10 months ago* (last edited 10 months ago) by [email protected] to c/[email protected]

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The medication is a blood thinner, the patient is a competent adult not in delirium, A&OX4. There are 2 ways to see this:

Manager's and a group of doctor's POV: you are a nurse and it's your job and duty to do that. Plus, we know better than him what's good for him. These people have built their identity around working in healthcare and to them this means I have to stay in the room and make sure the patient takes the medication.

My POV: nursing is not a calling but a job. What my manager and these doctors think is stupid:

the patient is a competent adult not in delirium, A&OX4. He's old enough to know what happens if he doesn't take the medication because we have told him a number of times already. I'm not his father and I'm not ready to treat a competent adult like a child.
I have other patients and I'm not going to waste my time watching a patient silently until he decides to take the medication. I'm charting that I left the medication next to him and told him he needs it and why and that I have other patients to take care of.
It is stupid to watch a person while doing nothing when I should be working with my other patients. It's also invasive as f*ck.

I see it like this: my manager and this group of doctors are not ready to respect a person's autonomy whereas I'm not ready to ignore this same autonomy, even if it means a negative outcome. Respecting a consenting adult's autonomy means respecting his bad choices as well. I feel this group of doctors and my manager are not ready to respect any patient's autonomy.

At this moment, this is a hill I'm willing to die on. AITA?

ETA: I wrote about a group of doctors, because there are other doctors that don't give me hard time if a patient refuses his medication, they simply chart it and move on. I like working with doctors like this because I feel they don’t judge and respect the patient's autonomy as well.

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[–] [email protected] 2 points 10 months ago (2 children)

I'm not a nurse, but I think the way you're charting is the correct way to protect your license. If they're A&Ox4 then there's probably not a legal/regulatory reason to sit and watch them, but it's also probably not out of bounds for hospital policy to require staff to observe and confirm any intervention (including meds) provided while under their care.

Now, whether they're going to take into account how much cumulative time/work that adds to the nurses and then staff accordingly is another story... (Hint: they won't)

[–] [email protected] 3 points 10 months ago

I don't think so, I mentioned this scenario in another answer, imagine they took the pills to the patient at 7, the patient only took them at 10, but the chart says he took it at 7. The next day the doctor looks at his chart and decides enough time has passed and a surgical procedure can be done to the patient. Because he took it at 10 that's not true and because he's on blood thinners there are complications and the patient dies. Who's legally at fault? The doctor has a paper trail to explain why he did what he did, this leaves the blame entirely in the hands of the person who signed a paper saying the patient took the pills at 7.