Hey you guys, I don't have any comments to incorporate!!!
I have been thinking about this incident though, and here are my current thoughts.
I still think that I did the right thing with this patient. I know smoking is bad, blah, blah blah and some people might think that I was allowing the patient to manipulate me, but in my mind getting to the root of why he wanted to leave the hospital was vital. By giving in to his want to go outside and smoke, I put myself into a "bargaining" position which led him to feel he "owed" me an explanation.
As it turned out, he was discharged the next day anyway, low platelet count and all. I don't know if that was at his request or not, and that really doesn't matter. At the time I was caring for him he was an inpatient with a potentially fatal diagnosis and I was the nurse in charge of his care. I think that I handled the situation fairly well and I wouldn't change anything about the experience.
2 comments:
You are absolutely right. You knew the possible implications had he left AMA. As a caring nurse and understanding the disease process, you thought out of the box and tried to keep him in the hospital. I don't think he manipulated you at all. I would have done the exact same thing. A cigarette was important to him to that time. Do you ever think of what may have happened had you not taken him out? He could have left AMA and could possilby have died that night. Interesting how he was discharged the next day (?). I believe you did the "right" thing that night regardless of the fact he was discharged the next day.
Do you at times feel like your efforts are taken for granted? By this I mean, here you were the night before making sure that the patient does not leave AMA, then the very next morning, he is discharged without his medical problem resolved.
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