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Thread: Nurses have a legal right to reason with patients who refuse

  1. #1
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    Nurses have a legal right to reason with patients who refuse

    There seems to be a lot of people who think that if you remind a patient of what the doctor said or if you tell them the consequences of their refusal that you're abusing the patient.

    Reasoning with a patient is not the same as forcing them.
    If a patient does not remember what the doctor's order was, you have the right to remind them, ie, an eye surgery patient can take a shower with their eyes shut.

    If I talk about having tried to reason with a patient, I sometimes get accused of forcing them to do something even if I'm talking to R.N.s who should know better.

  2. #2
    Super Moderator cougarnurse's Avatar
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    If I might ask, Stardust....are you going for your RN, LPN, or CNA?

    The reason I ask is I would say you are re-inforcing what the patient was told/taught; patient teaching is patient teaching, no matter what our title is.


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    Regular patient care issues that are handled best via thorough documentation. "Discussed upcoming cataract surgery with patient including perioperative procedures required by Dr. XYZ- see perioperative list on patient chart. Pt. unclear regarding required pre-op procedure and will require step by step cuing through process. ABC, RN.

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    Quote Originally Posted by cougarnurse View Post
    If I might ask, Stardust....are you going for your RN, LPN, or CNA?

    The reason I ask is I would say you are re-inforcing what the patient was told/taught; patient teaching is patient teaching, no matter what our title is.

    I have worked as a C.N.A., and med tech. I notice anytime when I start reasoning with a patient who refuses, I get lectures and interruptions about not forcing them or that they "have a right to refuse." I get surprised when I hear this coming from R.N.s who should know better.

    I saw a girl get kicked out of the building she was working in when she did not change her demented patient out of wet clothes.
    "She has a right to refuse," didn't work as an excuse because you're supposed to get help from the staff. It's understandable when you don't have help and they're fighting you off because then you really can't help it.

    On demented patients, I notice they are calmer for the rest of the day when you make them get changed and cleaned up

  5. #5
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    People are never to be forced and do have the right to refuse in reasonable circumstances but exactly what does that mean? Those who are alert and oriented can and do refuse medications and/or procedures and it is perfectly fine for them to do so. Make sure they fully understand what it is that they are refusing and then clearly document the facts only. On the other hand, it gets a little "dicey" when we're working with people who live in an "altered mental state" especially when they sometimes appear oriented. Allowing someone who is demented to wear soiled clothes because she refused to be changed would be viewed by the court as elder neglect. Health care workers experienced with dementia know how to get the hard stuff done without too much trouble. Stardust uses a good example.

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