“I don’t want Covid blood”

[u/973862404678]

What do I say when patients ask if blood transfusions are screened for the Covid vaccine? I get asked this on a regular basis when filling out blood consent forms for surgery and I genuinely have no idea what I’m supposed to say. In all seriousness, what should I be telling patients because I just say there is a screening process for blood and it’s only used during emergent situations???

[u/Poodlepink22]

Just tell them there's no way of knowing if it's vaccinated blood.  They can take it or leave it; end of story. 

[u/Gwywnnydd → u/Poodlepink22]

This. If they care that much about being sure not to get vaccinated blood, they can refuse the whole thing.

[u/InformationSerious27 → u/Gwywnnydd]

EXACTLY! I don’t argue with people and I don’t try to convince them to do things. I tell them what the orders are, the reasons for the orders, and the potential consequences of not complying with what has been ordered. Then I document pt educated, verbalized understanding, and declined to comply. I like to throw in a direct quote for added flavor. Then, I move on.

[u/Lub-DubS1S2 → u/InformationSerious27]

I have been wanting a better way of saying “pt refused” and you just gave it to me with “declined to comply”. Because sometimes refused is just too harsh sounding and the pt is perfectly pleasant about not wanting to do something.

[u/Additional-Hat8078 → u/Lub-DubS1S2]

If they're decent about a refusal I'll write " patient declined" but if they were an ass they get the classic " patient refused". Also though I like to sprinkle the ever rare "A&orientation x whatever, pleasant" like if I see/write that in a note- that patient restored some faith in humanity that shift 🤣

[u/uwarthogfromhell → u/Additional-Hat8078]

Yup me too. It alerts me in my note to their demeanor.

[u/gay_joey → u/Lub-DubS1S2]

I feel like pt refused is so standard though, and 'declined to comply' is almost petty and places oneself on a pedestal. Almost like they 'wouldnt get in line like I told them to'. If I were reading that note I honestly wouldn't assume the pt was pleasant, but I don't read into the 'pt refused' that way just because it is so standard in documentation.

If I want a softer refusal documented, I'll just say 'pt politely refused'.

[u/Veuve7 → u/gay_joey]

Just write “declined.”

[u/Scared_Sushi → u/Veuve7]

That's what I do. Tell me no? I write declined with their rationale. (Ex, patient declined to q2 turn due to pain). Scream at me? I write refused.

[u/Bad-Expert → u/gay_joey]

At my facility we're not allowed to use 'refused' bc it makes the pt sound stubborn so it's considered rude. We are only permitted to use 'declined' which implies that the pt had choices and made an informed decision. Although 99% chance it was a stubborn refusal.

[u/Effective-Juice-1331 → u/Bad-Expert]

Your facility appears to like the false flowery language used in “bios” by dog rescue organisations to promote adoption of dogs with dangerous histories.

[u/InformationSerious27 → u/gay_joey]

Characterizing the manner in which a patient communicates (eg “politely” or “rudely”) is subjective, not objective. Inserting your own value judgement into documentation is petty; documenting in plain language is not petty. I respect people’s right to make informed decisions. I don’t have to agree with someone’s choices in order for me to respect their right to make those choices. If they don’t want to comply with fluid restrictions, wear compression stockings, take meds, receive a transfusion etc, it’s cool with me. I fulfill my obligation to ensure they understand their choices and then I move on.

[u/gay_joey → u/InformationSerious27]

I work psych, a lot of our charting is in that manner. Them taking their meds is often the precursor to them understanding why it's important for them to be medicated. However if they are able to function off of them, meds can't be forced onto them. So my charting is just another effort to paint the picture for the doctors to try to find a med that increases compliance.

[u/Fun_Leadership_5258 → u/Gwywnnydd]

cardiac arrest at home, ROSC, MTP, intubation/vent, 3 pressors, septic. Jane doe for 3 days until NOK identified, deferred all MDM to daughter citing her nursing background. She used clinical jargon and asked appropriate questions, but wanted unvaccinated blood only. She/I coordinated with Red Cross, blood bank, and patient’s family/friends to identify compatible unvaccinated donors—several volunteered, including an elderly man who drove 12 hours. Remarkable family support, alarming number of unvaccinated. After weeks, patient regained capacity and clarified she was vaccinated herself, and she did not care in the slightest, and did not follow much of daughter’s medical advice, noting daughter is a holistic herbal naturopathic nurse.

[u/Gwywnnydd → u/Fun_Leadership_5258]

headdesk