Nurses, have you ever spent time thinking of how to deal with non compliant patients? As new nurses gain more and more experience, they come across infinitely more varied situations and patient personalities. As a lot of veteran nurses would attest, one of the most frustrating to deal with are non compliant patients.
A non compliant patient is a patient who does not listen or follow medical advice or treatment recommendations. There are two kinds of non compliant patients.
- The patient who is being deliberately non compliant
- The patient who is NOT being deliberately non compliant
Knowing which type your patient falls under is useful in trying to enlist cooperation.
Below are some tips on how to deal with non compliant patients. These tips lean more towards preserving a nurse’s sanity and ensuring that you know what to do when faced with a non compliant patient.
The below tips are NOT magical cures for a stubborn patient.
Tip #1: Gain insight on the reasons for patient’s non compliance
There are different reasons for a patient’s non compliance. If a patient is not being deliberately pig-headed, here are the usual reasons for not following instructions:
- Patient was not properly educated and does not understand the underlying medical issue and the risks involved
- Patient has a condition that causes misunderstandings like a hearing disability or a mental barrier
- Patient does not have insurance coverage or money to pay for the recommended medications, treatments, or tests
- Patient thinks the treatment is embarassing, uncomfortable, or even (culturally) taboo
- Patient simply forgets
Quite common though are patients who are simply and deliberately non compliant. Here are the usual reasons:
- Patient is contrary or stubborn; does not care for explanations provided by medical staff
- Patient has no faith or trust in medical diagnosis and treatments
It is by far easier to find a fix for the patient who is NOT deliberately non compliant. Nurses are a resourceful bunch and can surely find alternative solutions for some of the items above.
For the deliberately non compliant though, they will surely test your patience so here’s a few more tips.
Tip#2: Put yourself in your patient’s shoes
Why is your patient non compliant? What makes him non compliant? Is your NPO patient ridiculously hungry or thirsty? Why does your elderly patient keep trying to get out of bed?
Sometimes, nurses don’t EVER find out or know but when you do, it helps nurses deal a bit better with the frustration and annoyance.
Tip#3: Educate thoroughly
This cannot be stressed enough. You may or may not change a patient’s mind or behavior, but it is IMPERATIVE that you ensure that a patient has been educated thoroughly. By doing this, you’ve dispensed half your job already.
Some nurses and doctors ask a patient to repeat back what and why he or she is supposed to do something to ensure accurate and correct understanding.
Once you’re sure that the patient sufficiently understands causes, reasons, diagnosis, treatment, and the risks involved, and still chooses NOT to follow medical orders, it is ultimately out of your hands. And it’s important for nurses to understand this.
If we may quote a nurse in a forum, “Ignorance of outcomes is not the same as stupidity. At least ignorance is curable.”
Also Read: 10 Best Ways for Nurses to Educate Patients
Tip #4: Document. Document. Document.
While charting and documenting is a nurse’s life, it is all the more crucial when dealing with a non compliant patient. You will have to be very thorough in documenting because it will back you up when needed.
Tip #5: Prepare for discharge
When a patient persists in not following medical advice to the further detriment of their health, some doctors and/or hospitals decide to discharge a patient. This is quite rare but sometimes needed in order to give a stubborn patient a reality check that he or she cannot continue their present behavior and endanger themselves.
Tip #6: Don’t beat yourself up
Some nurses have had the great achievement of making a non compliant patient actually compliant. These nurses would say, “You catch more flies with honey than vinegar”.
It doesn’t work every time though and when it comes to non compliant patients who take the cake, you’ll just have to learn NOT to blame yourself, think that you didn’t do a good enough job, or think that it was your fault. Definitely not.
Take a deep breath and say your favorite mantra.
Have YOU ever had a non compliant patient? Do you know more tips on how to deal with non compliant patients? If you do, we’d love to hear from you!