How Do You Approach Helping Non-Compliant Patients?
Nurse Magazine
How Do You Approach Helping Non-Compliant Patients?
In the face of patient non-compliance, a Psychiatric Nurse Practitioner begins by reframing the issue with empathy and understanding. Our exploration includes insights from various nursing professionals, along with additional answers that enrich our perspective on this challenge. From the initial approach of replacing 'non-compliance' with understanding to the supportive strategy of encouraging peer support group participation, here's how experts navigate the complexities of patient care.
- Replace 'Non-Compliance' with Understanding
- Ensure Continuity of Care
- Create Context-Specific Action Plans
- Use Motivational Interviewing Techniques
- Collaborate with Interdisciplinary Teams
- Provide Educational Health Resources
- Adjust Treatment Plans Flexibly
- Encourage Peer Support Group Participation
Replace 'Non-Compliance' with Understanding
First of all, it is important for all nurses to remove the word 'non-compliance' from our vocabulary. It is our duty to help our patients understand their treatment protocols and rationales. If a patient is not abiding by the treatment protocol, then it is our duty to find out why and meet them where they are. Oftentimes, it is due to feeling overwhelmed, in which case it would be best to break the treatment plan into obtainable goals, making sure the patient is part of creating the goals and actionable steps. Patient involvement in goal setting is key to getting patient buy-in of the treatment plan and process.
Ensure Continuity of Care
Working in a higher-level facility, I encounter many rare disorders and hard-to-treat situations. Compliance weighs even heavier when treatment is limited and contingent on quality of life. Follow-up phone calls, handoffs, and continuity of care, well-coordinated, are essential to patients with compliance issues. Hospital readmission is also followed very closely, and if compliance is suspect for readmission, a detailed inquiry and assessment are performed to highlight and ensure all areas are addressed. The best approach to ensuring compliance post-hospital discharge is to address all issues upon admission, throughout the stay within a multidisciplinary format, and at discharge. A follow-up call and handoff to community outreach and resources are all the best safeguards to mitigate compliance barriers.
Create Context-Specific Action Plans
It's so important to get the full context of a patient's circumstances before admonishing them for non-compliance. I'm not afraid to give a reality check, but first, I need to understand why they've been unable to meet their burden. In most cases, a lecture alone won't help. What will is an action plan that provides step-by-step instructions for health maintenance within the real-world nuances of lived experiences.
For example, work schedules might be interfering with self-care, and in those cases, it's helpful to role-play a conversation with their manager or boss. Helping them to advocate for the time they need is key to long-term compliance.
If it's purely physical fatigue, I like to bring in friends and family members whenever possible. Speaking to them as a group can help convey a higher level of need and increases the likelihood that the patient gets the assistance required.
If the problem is mental health, I start by recommending adjunct treatments.
As you can see, to tailor my advice accurately, I need to first ask some questions. That means a sit-down conversation starting with empathy and understanding.
Use Motivational Interviewing Techniques
Registered nurses often adopt motivational interviewing techniques to address non-compliance in patients. This approach involves engaging the patient in a collaborative conversation aimed at strengthening their motivation for change. Nurses are trained to listen actively to the patient's concerns and to help them elucidate their personal reasons for adhering to their treatment plan.
The goal is not to persuade the patient forcefully but to guide them to find their intrinsic motivation for positive health behaviors. By encouraging patients to articulate their goals and values, nurses facilitate a patient-centered dialogue. Reflect on your own health goals and discuss these with a healthcare professional to find your path forward.
Collaborate with Interdisciplinary Teams
When patients show non-compliance, nurses frequently work with an interdisciplinary team to create a supportive care environment. This collaboration may include doctors, pharmacists, social workers, and dieticians who collectively provide comprehensive care tailored to the patient's specific needs. Interdisciplinary team meetings allow healthcare providers to share insights and develop a unified approach to patient care.
The collective expertise ensures that all aspects of the patient's health and circumstances are considered, increasing the likelihood of compliance. Reach out to your healthcare provider to learn more about how an interdisciplinary team can help manage your health care.
Provide Educational Health Resources
Nurses often offer educational health resources to patients who struggle with compliance. By providing easy-to-understand materials or directing patients to reliable sources of information, they empower patients to make informed decisions about their health. Understanding the rationale behind a treatment plan can significantly improve a patient's commitment to following it.
Nurses ensure that the information is tailored to the individual's learning style and comprehension level. Take the first step in understanding your treatment by seeking out educational resources provided by healthcare professionals.
Adjust Treatment Plans Flexibly
One strategy that nurses use for handling non-compliant patients is to adjust treatment plans flexibly. When a patient's resistance is due to treatment difficulty, nurses assess the situation to identify and address barriers. They work closely with the prescribing physicians to modify the treatment in ways that align better with the patient's lifestyle or preferences while still aiming to achieve the desired health outcomes.
Such adjustments often result in higher rates of adherence and less friction in the patient-care provider relationship. Speak with your nurse or doctor if you're having trouble with your treatment plan; there may be flexible options available that better suit your needs.
Encourage Peer Support Group Participation
Encouraging participation in peer support groups is another tactic nurses suggest to patients facing difficulties with compliance. Being part of a group of individuals who are dealing with similar health issues can provide a network of empathy, shared experiences, and practical tips. This sense of community often proves invaluable in motivating patients to stay on course with their treatment plans.
Peer support can remind patients that they are not alone in their struggles and instill a greater sense of accountability and encouragement. Consider joining a peer support group to gain insights and support from others who understand what you're going through.