When Enough Is Enough
People are as variable as snoflakes, this isn't news, but it is true. You never find two alike in response to medical care. I don't see this as a negative, but as a positive for the most part.
Our jobs as health care professionals is to take all those variables (which can be considerable!) and whip them into a care plan that will suit the individual need of each patient. Things that must be taken into consideration range from the big stuff, like timing of antibiotic IV therapy, to the time patients wake up.
I've found people in the North West tend to sleep later. More than I can count don't get out of bed till 10:30 or so. I'm not sure how they function in a work situation. Back in Tucson, most of the people were early risers. We could finish our rounds by noon.
That's not the issue though, the issue is patient compliance. Of course we need to take the individual into thought when planning our care of them, and we do. We have the patient agree on paper, exactly what they'll be responsible for, and what staff will be responsible for.
There's the odd person who for whatever reason, decides after the agreement that they will not be responsible for this or that. Sometimes we can work with their requests, sometimes not. It depends on the Home Health agency involved. My agency is not very flexible in this regard.
Then there's the patient who no matter what you try to do, decides to do everything their own way. Sometimes this can be applauded, because you know the individual, and you know they know themselves and what works for them. Most of the time it doesn't work out that way. It gets to the point that you can not work with this patient, no matter what.
When this unfortunate turn of events occurs, the patient is discharged from the agency for non-compliance.
It does not affect future events - they can be readmitted at a later date. That is unless they have made it a habit of acceptance, then non-compliance. In this type of case, the agency won't touch them, and refers them to another agency.
Working with non-compliant people is a drain on the nurses. It saps our energy, wastes our time, and generally makes working with them unbearable. That's when enough is enough, and the nurse files paperwork, and the patient is discharged.
For me, it doesn't take long to reach this "outta here" mark. There are people that want my help, welcome it, appreciate it, and work hard to help themselves. In a perfect world, all patients would be like this.
The world is far from perfect.
Maybe I should send the next one a big plate of caramel brownies?
Our jobs as health care professionals is to take all those variables (which can be considerable!) and whip them into a care plan that will suit the individual need of each patient. Things that must be taken into consideration range from the big stuff, like timing of antibiotic IV therapy, to the time patients wake up.
I've found people in the North West tend to sleep later. More than I can count don't get out of bed till 10:30 or so. I'm not sure how they function in a work situation. Back in Tucson, most of the people were early risers. We could finish our rounds by noon.
That's not the issue though, the issue is patient compliance. Of course we need to take the individual into thought when planning our care of them, and we do. We have the patient agree on paper, exactly what they'll be responsible for, and what staff will be responsible for.
There's the odd person who for whatever reason, decides after the agreement that they will not be responsible for this or that. Sometimes we can work with their requests, sometimes not. It depends on the Home Health agency involved. My agency is not very flexible in this regard.
Then there's the patient who no matter what you try to do, decides to do everything their own way. Sometimes this can be applauded, because you know the individual, and you know they know themselves and what works for them. Most of the time it doesn't work out that way. It gets to the point that you can not work with this patient, no matter what.
When this unfortunate turn of events occurs, the patient is discharged from the agency for non-compliance.
It does not affect future events - they can be readmitted at a later date. That is unless they have made it a habit of acceptance, then non-compliance. In this type of case, the agency won't touch them, and refers them to another agency.
Working with non-compliant people is a drain on the nurses. It saps our energy, wastes our time, and generally makes working with them unbearable. That's when enough is enough, and the nurse files paperwork, and the patient is discharged.
For me, it doesn't take long to reach this "outta here" mark. There are people that want my help, welcome it, appreciate it, and work hard to help themselves. In a perfect world, all patients would be like this.
The world is far from perfect.
Maybe I should send the next one a big plate of caramel brownies?
posted by KennewickMusing at
7:33 AM
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