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:
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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.
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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.
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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.
I don't get this, why is there a delay at all? The times I've been in the hospital, they hand me the pills and a cup of water, there's no expectation that I can choose when to take the pill, it's immediate.
This is the typical case I think too. Usually so that nurse charts it straight away. This is so that another nurse wont give the same pill/dose during shift changes and so that if something happens and a doctor needs to administer alternative medication, they know what's in the patients system already.
I've never heard of a nurse having to sit there waiting for the patient to randomly choose a time to take it.
Oh, it happens plenty. Let's just say the nursing home nurses have it down to a science to speed folks up with all the patients they're administering medication to. Usually part of our report to other nurses on shift change, and what strategies we're using. Some folks want to talk, some folks are trying to exercise the very little control they have in a situation where their life has completely spiraled out.
For a 40 year old, I have a come to jesus moment. I say you need this for your a. fib, or whatever, or you're gonna throw a clot and have a stroke. If you don't want to take it, that's fine, but that's a choice you're gonna be making. I tell them that we administer medications at set times to maintain effective prophylaxis. I'll jot a quick note, and if I have the time call the whoever ordered it and inform them of the refusal. If they want to place an ORDER for me to leave medication by the bedside, I will. But that's what it would take for me not write a refusal to take medication on the time it's ordered as anything but a refusal.
Whenever I administer medication I tell the patient what they're taking as I hand it to them, and say, "Can you take this for me please?" I hold my hand out ready to take the empty pill cup from them so I can throw it away. There's no room for interpretation of anything other than "take this now."
See, that's what I was thinking. Even if the patient doesn't want to take it, most will because they don't want to inconveniece you.