The medication is a blood thinner, the patient is a competent adult not in delirium, A&OX4. There are 2 ways to see this:
Manager's and a group of doctor's POV: you are a nurse and it's your job and duty to do that. Plus, we know better than him what's good for him. These people have built their identity around working in healthcare and to them this means I have to stay in the room and make sure the patient takes the medication.
My POV: nursing is not a calling but a job. What my manager and these doctors think is stupid:
the patient is a competent adult not in delirium, A&OX4. He's old enough to know what happens if he doesn't take the medication because we have told him a number of times already. I'm not his father and I'm not ready to treat a competent adult like a child.
I have other patients and I'm not going to waste my time watching a patient silently until he decides to take the medication. I'm charting that I left the medication next to him and told him he needs it and why and that I have other patients to take care of.
It is stupid to watch a person while doing nothing when I should be working with my other patients. It's also invasive as f*ck.
I see it like this: my manager and this group of doctors are not ready to respect a person's autonomy whereas I'm not ready to ignore this same autonomy, even if it means a negative outcome. Respecting a consenting adult's autonomy means respecting his bad choices as well. I feel this group of doctors and my manager are not ready to respect any patient's autonomy.
At this moment, this is a hill I'm willing to die on. AITA?
ETA: I wrote about a group of doctors, because there are other doctors that don't give me hard time if a patient refuses his medication, they simply chart it and move on. I like working with doctors like this because I feel they don’t judge and respect the patient's autonomy as well.
So what happens if they don't want to take it, or want to take it "later"? Are you expected to force-feed them? Call security? Hold yourself hostage until they change their mind?
I'm with you on instinct, but I have no idea what the regulations are like in healthcare.
my manager and this group of doctors are not ready to respect a person’s autonomy
This is why I hate hospitals. I'm there because I need medical help, not because I am incapable of running my own life.
If you need medical help... why aren't you accepting that help? Medication is often a part of that help. If you have problems with the medication, you should talk with your doctor, not act like a petulant child.
If a patient doesn't want to take it, they just say they don't want to take it, no one is force feeding people or calling security. Patients refuse medication all the time for many different reasons. In this example, the nurse should just document the patient refused and why, notify the doctor what happened, and continue on with their work. Not stand there in an hour long staring contest until the patient takes it.
It's very important the medical staff know what things you have and haven't actually taken while in the hospital (and before you got there too). If it's a medication you really need, your doctor will probably come and explain why refusing is a bad idea. If people don't like the plan, don't want any treatment, or don't want to stay in the hospital, they can just walk out and leave. It's a hospital not a prison. Your doctor may just ask you to sign something just to document they explained to you why leaving is a bad idea.
Rather than documenting that the patient refused to take it at 7, taking the pill away, and then (time allowing) giving the patient another chance to take it later, OP wants to leave the medication with the patient and document that it was handed to the patient at 7. Unfortunately, doing that creates uncertainty, which isn’t acceptable in a medical context.