I’m not implying every nurse or doctor does this, but couldn’t come up with a better title.
A cognizant patient is above all a free person. A free person is free to accept and to deny care, whatever may come. It’s his life, let him live his life as he sees fit. Explain, educate, inform and then ask: do you understand that if we don’t do this you may die / lose a limb / lose your liver / fall down and have a stroke and end up bed bound if we’re lucky enough to save your life?
I don’t understand the logic playing mental gymnastics to make a patient stay at a unit because the nurse or doctor in charge are convinced it’s in the patient’s best interest to do so, even when after education he wants to leave. I’m the odd one at my unit, as most of my coworkers do vehemently disagree with me, as they expect me to provide care AND to care. They feel they lost if a patient leaves against medical advice.
To me it looks like they don’t understand individual freedom and forget that a patient is still a free person. I wouldn’t want to be my coworkers’ patient.
You cannot stop grown ups from making stupid choices. The cognizant patient gets to decide his answer. Not a nurse or doctor convinced they get to decide for the patient.
Another problem I see: say you force a cognizant patient to stay at your unit because you are convinced you are doing the right thing. Why do you think he’s going to be a pleasant patient to work with? People lash out when they feel trapped and they insult and punch personnel. What’s the point?
Punched coworkers will call in sick and start looking for jobs elsewhere, some insulted ones too.
Wouldn’t it be better to inform, document, let him leave, move on?
I think you generally shouldn’t make it super easy for people to harm themselves. They should be able to do so. But I believe it should require a mininum amount of effort.
Also you might be invested a bit. If you did 6h of surgery on them. Or wiped off their butt for a week, I suppose it might hurt to see that’s been in vain, or at least made worse. I’m not a doctor or nurse and only worked briefly in healthcare. But I suppose it’s the same as with other professions. I’m also offended if I put in quite some effort to get something right, strive for a perfect result. And then someone slaps on a badly-made and buggy UI… That’s just taking pride in your work.
Plus with hospitals, there is liability, the hippocratic oath. And you probably learned that job because you’re intrinsically motivated to help people. Not because you’re interested in philosophy and freedom. And then trying to help will be more natural to you.
Plus, hospital staff is desensitized to a degree. They deal with a lot of people who are not sound. Mentally ill, are making a lot of bad decisions and that ended them up there, took drugs and are doing weird things, or the drugs they’re getting as medication affects them. Nurses might just be desensitized by their everyday job once they face the one person that’s talking about the same weird things, just for a sound reason. Because what you tend to see all day, every day is people trying to rip out the tubes directly attached to their arteries, wanting to smoke in urgent care, while being attached to the oxygen tank directly next to them. Every other week someone will try to just walk out with big open wounds… And you can’t really have them blow up the hospital, or die at the bus stop infront of the hospital, regularly. It’s just difficult to balance all of that.