Tuesday, August 12, 2008

they should make a contract for that

Someone should have told the Pillsbury Doughboy that belly pokes come with the territory. I am seriously debating the 'autonomy' ethic of nursing theory because let's face it...sometimes you just want to bang your head on the wall when you go 'round and 'round with patients on a certain issues...particularly, one known as medication compliance!

Shouldn't we have patients sign a binding contract--that once they agree to start chemotherapy, they also agree to...

TAKE SUPPORTIVE CARE MEDICATION! (such as anti-nausea pills, pain pills, bowel medications, the list goes on and on)

Surprisingly, there are a whole lotta folks out there who don't bat an eye at taking chemotherapy infusions who also apparently don't believe in taking ANY OTHER MEDICATIONS.

Argh. Can't you just feel the irony?

To a certain extent, I can emphasize and help support someone trying to address their pain or nausea at a homeopathic level; but to another extent...if you're absolutely miserable and all your attempts are failing, you need to re-evaluate those beliefs. For your sake and mine, people... please!

Nurse Rae's warning...Chemotherapy is a serious medication. It can (and most likely will) cause some unintended, unpleasant side effects, such as nausea, constipation, diarrhea...but! There is hope! Please try supportive care medication. Please call me when you're feeling crappy. And keep you hands and feet inside the vehicle at all times, please...Thank you!


Alex Sicre said...

Medication non-adherence is a serious problem, effecting 1 in 2 patients. It seems like your patients simply refuse to take their supportive medications or just do not believe in them? Is it an educational problem? They do not see the value in the meds to help them with the side effects? An economic issue? Maybe they think the chemo already has put too much "poison" in their body already?

Luckily I have never had to go through chemo myself of with a family member, but there are so many factors that apply to non-adherence, you never know what can be driving them. I understand your frustration, and you are not alone.

Surprisingly the non-adherence rates for chronic pain medication hovers around 60%. I would think that if a patient is in pain from the chemo, they would be receptive to other medications, but as you have seen first hand, that doesn't always seem to be the case.

Best of luck in the future!

running wildly said...

I think a lot of the reason why people won't take other meds is because they fear any negative interactions.....or they have some ill-informed belief that they may become "addicted" to other meds etc. But yes, I agree. Non-adherence is very frustrating. It's not as if we can pry open their mouths and shove it in. Nope, we have to respect their own choices.

Lawfrog said...

I'm all about better living through chemistry! I'll take anything and everything if it will help me get through a particular medical situation. I don't understand why someone wouldn't want to get whatever relief was available.

raecatherine said...

Thanks for all your thoughtful comments. I just had a week where it seemed I was running into an unusually high number of folks were just saying no....for all sorts of reasons. Some financial, some personal belief, some a combination.

There's no easy answers, unfortunately!