In a message dated 3/1/2006 10:16:53 AM Eastern Standard Time,
[log in to unmask] writes:
Betsy writes: "Around here, if a patient is non-compliant, a physician has
the right to terminate care."
Dear Friends:
In my nursing education "non-compliance" was a nursing diagnosis and all
the interventions I was trained to do involved some form of manipulation and
use of authority. A non-compliant patient was one who didn't do what they
were told to do. The problem was that the patient wasn't doing something, never
that the healthcare professional was asking for things that weren't
understood, or weren't acceptable culturally, or weren't acceptable personally. I was
trained to find ways to get the patient to accept the medical care, and never
once was I taught to any counseling techniques or any techniques to
investigate the reason an autonomous person would reject any suggestion.
I remember as a beginning student nurse working with a demented tiny old
lady. This lady refused her bath. As I was young and strong and bigger, I
basically picked her up and put her in the tub and washed her. I earned a "A"
for that clinical day, and got lots of strokes from my instructor for taking
charge, and accomplishing the necessary task.
The little old lady struggled, and tried to bite me. She must have felt
that I was going to kill her. I was never given any guidance about how to
work with the patient to meet mutually acceptable goals, never any reminders
about maintaining respect and dignity of personhood, and never any encouragement
about cooperation.
I will never forget that day...............as a young nurse, I was so
proud to have earned a commendation from my teacher. And I am horrifed and
ashamed today, and also aware of the power struggle between patients and the
healthcare system.
The head neonatologist in a NICU said at a meeting, in front of staff
nurses and me, that human milk is insufficient nutrition for the first few days
of life. That belief is underneath her clinical practice to supplement with
human milk substitutes for premature or sick babies.
One on hand I am glad that she was honest; on the other hand I am
horrifed. Because this physician has all the power in the NICU, I am fighting an
uphill battle. And I am supposed to support this practice, so that parents in
the NICU won't be upset with physician recommendations.
Such a complex situation, and NOT about health. This time it is about
power and control.
How many hospitals have a 'patient bill of rights' posted on the wall?
And how many hospitals will actually support those rights?
warmly,
Nikki Lee RN, MS, Mother of 2, IBCLC, CCE
Maternal-Child Adjunct Faculty Union Institute and University
Film Reviews Editor, Journal of Human Lactation
www.breastfeedingalwaysbest.com
***********************************************
To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html
|