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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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  • Manager’s and a group of doctor’s POV: you are a nurse and it’s your job and duty to do that.

    They’re completely right. If you disagree strongly enough, the only honorable thing you can do is quit. You are not making any kind of statement, or being “rebellious”, by insisting on doing a half-assed job. You’re simply being dishonest and providing inadequate care.

    Nurses are overworked and spread too thin, but that’s not something your current behavior will fix, or even protest.

    Plus, we know better than him what’s good for him.

    They should. That’s their job, and what they went to school for. It is not a nurse’s place to override their decisions (except in emergencies, of course). That’s what you signed up for when you took the job. Hell, listening to your manager is a basic requirement of most jobs, healthcare or otherwise. That’s Employment 101.

    Patients are often stubborn, ignorant, and it’s possible that several of them wouldn’t be in the hospital in the first place if they took their health seriously.

    If you take someone’s autonomy so seriously that you’re willing to respect and tolerate their “bad choices”, that’s perfectly fine, but nursing is by no means the right job for you. It’s not the mindset that upsets me - it’s that you’re working in the worst, least compatible field possible. I hope you’re able to find something else soon.

    • This reply seems like management/ hr reply… just as salty as op.

      It’s so perfectly fine to respect someone’s autonomy there is a form they can sign- refusal of care. Explain the situation, sign form or take meds. Or, here’s another form- and there is the door. Forcing anything on a competent adult is battery I believe, no matter how beneficial.

      Like OP said, chart and move on.

      People are weird and react weird to some people. Ask another nurse to try, or ask to swap patients.

      Also, sometimes nurses do know better. They see the patient as a whole, and a lot more than the doctor.

      Also x2, managers are there mostly in a non medical (and non union) capacity, but to make sure the hospital runs as profitably as possible.

      • This is definitely not a manager or HR reply this reads like a reply from a fellow nurse or doctor.

        This is not the field to fuck around and provide inadequate care in, to make moral judgement against medical ones. This is a field with lives literally at stake and there is no room for people who don't take that seriously. Full stop.

        • A doctor! You compliment me, sir. My family would be so proud!

          Nah, I’ve just been a patient a few times, and think that people should do the job that they’ve agreed to do, especially when lives are at stake. I agree with you completely.

        • what is a nurse supposed to do in case a patient does not want to take the medication though? waste their time with an adult baby or actually do their job by helping other people? of course that information needs to be written down and forwarded to the doctor but seriously, what do you suggest a nurse does in that situation?

      • Yeah, I am salty. Some nurses are antivaxxers, ffs. People look to them for their “expertise”, but nurses often have little or no medical education, and some don’t even accept proven medical science. I have no doubt that a few nurses have helped kill people, by reinforcing their bad decisions and ignorance.

        If a nurse knows more about a patient than a doctor, then have a conversation with the doctor. Don’t just roll your eyes and let the doctor keep making decisions that aren’t helping the patient. A lot of hospital accidents happen because of poor communication. Don’t perpetuate the problem.

        Yeah, the healthcare-for-profit system is fucked. That doesn’t address the core issue, though, which is a nurse giving themselves permission to ignore management/experts and do their job poorly.

      • They didn't say force them to take the medicine. Just make sure they do. No one's autonomy is being taken.

        • "making sure they do" is the same as "forcing them" if the patient doesn't want to.

          • They are not the same at all. OP said they want to write that they left the pill with the patient. Make sure they take it. Don't assume they will.

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