No Stupid Questions

My POV: nursing is not a calling but a job.

Well, if you think of it that way and your bosses are telling you to do a certain thing, you should do that thing. If you're not doing the thing your bosses are telling you to do then maybe you're not doing your job.

Sorry if that's not what you wanted to hear, but I don't see what other reasonable interpretation there is here.

This is my job. I don't want to do my job. Should I do my job?

Yes, you should do your job.

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.

You can't chart he took it if you don't see him take it. You have to wait or chart a reason the med was delayed. Why does your ehr even have a box for "left it next to him"?

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.

Maybe it's not about whether the patient takes the medication or not rather you are visually confirming and documenting that they took it or refused it. Should there be a mishap or lawsuit involving this person the hospital would use that person's reluctance to follow medical advice as a defense. Just playing devil's advocate here, I'll bet a lot of hospital policies are written to protect from liability

Yes, you should verify whether they've taken it.

With medication it tends to be pretty important to know what was taken, when it was taken and how much was taken. Leaving the meds with the pt means you can't know for sure when and how much was taken, or if anything was taken at all. And that's a problem. How's a doctor supposed to make any decision with care if they don't know for sure whether the patient has been getting the meds as ordered?

OP, your facility should have written guidelines about what to do in this situation. Following those would be much more sensible than relying on internet randos for advice, because it won't get you fired.

Jesus Christ. What a psychopath. You're talking about dying on a hill when it will be others who die for your belief.

Isn't that a non-negotiable rule? I thought you always give patients medication on time and watch them take it. In the 2 weeks I've been an intern at a hospital, I've seen more than one person not take it or save it for later or wanting to wait for the next meal until eating the pill and then forgetting about it, or doing whatever with it. We were supposed to make sure and I don't think there were exceptions to the rule. And honestly, doctors don't tell patients if it's important to take the medications before a meal or after, or 3h before a medical procedure and if it's really important to do it right. Patients don't even know, are sick and do silly stuff. Some of them have dementia, some look alright but aren't.

It's not "their autonomy". Patients are sick, overburdened with information from doctors and suddenly 5 different medications to take. They are sometimes ill and experience pain. They're not in a normal situation where they would always make good choices. I think you're letting them down if you rely on the patients to do it right in that situation.

So don't re-invent medicine and have your own take on it. As you said it's just a job. If it's part of the job to make sure some procedure is carried out correctly, do it. Not every stupid rule is super important, but be sure the rules you don't follow aren't the ones that are 'written in blood'.

We other people also have things in our jobs we don't like. Or that are sometimes not really necessary in certain situations. If you're a professional, you just always do it right and always try to follow standard procedure.

It is a job and at a job you follow instructions you get even if you think they are stupid.

Seems more like a question you should direct at your manager and coworkers, but you know you won't like their answers, so you're asking here where we lack context lol.

Work in a hospital, not a nurse. Usually nurses bring meds with water and hand then to the pt. They either check on the lines, pumps, etc or chart for a minute or two. Then ask if there's anything they need. By then they usually have taken the meds and the RN leaves. There's only so many times you can tell a pt why they need to take them. I work with psychiatric pts and usually, if they refuse the RN just notes that they refused.

Imo it depends on the patient. If the patient says they take the meds but their signs - vitals, telemetry, routine labs, PE, etc show otherwise - then it’s your responsibility to confirm or deny patient medication adherence.

I’d like to say a functioning healthcare team means that the top level providers will trust their nurse’s judgement about the patients they are in charge of.

But at the end of the day this is about treating patients and ensuring that a standard of care is met. Part of that standard is allowing for shared decision making, non paternalistic care, etc.

But again, it is your responsibility to know what is happening with the patient. It’s not really that you’re forcing the patient to adhere, it’s to confirm if they take it or not.

If not taking medication is a frequent problem with them, I'd call for a psych evaluation. Could be as simple as the medication is making their mouth itchy or stomach hurt and they aren't explaining that or connecting the dots.

What hospital do you work for?

I ask because I want to know which one to avoid should I ever need to go.

What if they hoard the meds and then take them all at once?

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)