how to bribe your patient into compliance?

answer: with coffee and tea. No joke!

Geriatric psychiatry is a lot of things... however holding my interest is not one of them. I tried to give it a fair shake. And for about a week I was intrigued and pleasantly surprised by just how much I liked it. But it must have been the newness, or the fun patients I had that week because my enthusiasm quickly wore off.

 Last week was rough. I didn't really want to go to work and once I was there I just couldn't wait to leave. My patients were belligerent, agitated, hostile and demented. I feel bad for them. But not bad enough to make myself bribe them to take their medications like my Attending does. I mean I guess if getting a cup of tea or buying a cup of coffee is all it takes for a patient to become compliant why not do it? But in my short experience it only works for a limited amount of time. And even if patient complies for the moment/day/week then what? Even if the patient is discharged it is not like we won't see the same patient back next week or month for the same thing.

Medication non-compliance is real. Psychiatry is a revolving door. I wish this were not the case or there was something else I could hang my hat on. But so far that is all I've got.

I only have two weeks left. And it is bearable but not exactly fun. Now the admission notes and discharge summaries just feel like scut work. Write this. Dictate that. Go talk to a patient that is laying in bed naked and refusing to take any medications or put on any clothes or eat any food. Wait for said patient to decompensate to point of needing IM meds or become so dehydrated or hypoglycemic that she qualifies for medical transfer. Type up discharge summary for transfer. Repeat.

Did I mention, I only have two weeks left? But on the upside I do have a whole entire weekend (off) to study in NYC so I'll survive. One latte at a time. Maybe I need to be bribed just like my patients. Oh my...

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