It's for your own good
A new elderly patient came in today. She's presented with generalised malaise and poor appetite. She was noted to be uncommunicative 3 months ago and also exhibited weakness on her right side during that time. She's a diabetic with bilateral lower limb amputations. Functionally, she's ADL dependent. The provisional diagnosis was of sepsis resulting in the malaise and poor appetite. There is also suspicion of a stroke due to her right sided weakness and loss of verbal communication. We ordered investigations, namely blood cultures, blood count and electrolytes.Throughout the clerking, you can see she was not comfortable being in the hospital. She shook her head incessantly as if that was her way of telling us she didn't want to be in the hospital.
We took blood from her, with restraint of course. As i held her down, she struggled. And boy did she struggle. She's amazing strong on her good side for an elderly lady, she must have tried to shake me off at least 20 times, tried to bite me about 6 times and shook her head a million times.
I felt horrible holding her down but if i didn't she would definitely have prevented the blood from being taken. I kept telling her that this was for her own good, and that we needed to do this so that we can treat her. I suspect she didn't buy it.
"If patient refuse treatment, can we still continue?" I asked that to my friends. Kwanghow said this depends on whether they are mentally capable of making a sound decision. "How do we know they are capable?" "The abbreviated mental test?"
As much as i didn't enjoy the incident, i think i will face this again in the future.
Wei Qiang converses @ 18:43
1 Comments:
Patient has the right to refuse treatment...but since u mentioned that she's "uncommunicative" then i think u could cont. taking her blood...but define the term "uncommunicative"...couldn't she write or expressed her words in other ways or was she a dementia patient???? was she with a sound mind? If so, I think u should have persauded her instead of using force on her...persaude her not only by saying "it's for your own good" but explain what and why u need the blood for? or maybe ask her why she refused to let u take blood...???
the above are jus some suggestion so pls don take it to heart if i had offended u in any way....
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