Non-compliant Patient

I cannot stand when I have a non-compliant patient.  The one I had this week was a very obese male (around 400 lbs) that came in with chest pain & dizziness.  What's the first thing he wanted to do upon arriving on the floor....go outside & smoke.  Ummm, helloooooo....do you not realize that smoking is unhealthy ESPECIALLY when you are having chest pain?  Our unit does not allow patients to leave the floor, much less go outside & smoke.  He complied with me the first night I had him thanks to my clinical leader helping out...although he tried to sneak out but I followed him & he gave up trying.  Last night, however, was a different story.  He declared he was going outside.  I informed my clinical leader (a different one than I had the night before) & I grabbed a form for him to sign....an AMA (against medical advice) form & I was fully prepared to not allow him to come back to the floor.  I told him "our rules" about leaving the floor = that we will not take on that liability & if he leaves, the only way he'll be re-entering the hospital is thru the ER where he'd have to start the admission process all over again.  However, my clinical leader did not back me up.  She basically took a "who cares" attitude & did not even speak to him one time.  So he left the floor, I informed the doctor...but without any backup from my clinical leader, there wasn't much I could do.  He came back & was being very annoying.  The type that wouldn't stop talking about nonsense...then he proceeds to go into our refreshment room where patients aren't allowed.  I said "Sir, you aren't allowed in here."  He walks out & proceeds to call me a f'n bitch.  Nice, huh?  At that point, I refused to have anything more to do with him.  I had an orientee who I had assigned to him & she put up with his b.s. the rest of the night.  At one point the patient care tech came out of his room & told me he had been smoking in there.  I, once again, informed my clinical leader...who did absolutely nothing.  I thought to myself "screw it, if she doesn't care, then why do I care?"  And I documented all that went on that evening & added in about the clinical leader's attitude & lack of involvement regarding this patient.  This is the type of patient that I have absolutely no patience or compassion for.  If I ever run into him at the hospital again, I will refuse to take care of him.  Life is too short to have to put up with someone like that.

My other patients were the ones I had over the weekend...so it made it easy to get report.  I also was orienting a new nurse to our hospital.  She's not new out of school, she's been a nurse for 4 yrs...she's just new to our hospital.  It's nice having an orientee. 

I'm off now until Monday night.  I went to a baseball game tonight & I'm gonna go to another one Friday night.  It looks like my nephew is going to get an offer to play professional baseball...most likely with the Atlanta Braves.  We'll know by June.  Wish him luck!

I hope everyone has a safe & wonderful weekend!