First of all it is important for all nurses to remove the word non-compliance in 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 at. 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 get patient buy-in of the treatment plan and process.
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 to quality of life. Follow up phone calls, handoff and continuity of care well coordinated is 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 is 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 within a multidisciplinary format and at discharge. A follow-up call and handoff to community outreach and resources are all the best gusafeguards to mitigate compliance barriers.
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 nuance of lived experiences. For example, work schedules might be interfering with self-care, and in those cases, it's helpful to playact 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.
When patients who aren't sticking to their treatment plans, we focus on figuring out why and working together to find solutions that fit their lifestyle better. It's important to have open conversations, really listen to their concerns, and adjust their treatment plan to help them stick with it.