Although Lia is a child, she’s also my patient. As a product of “the old school”, I have to make a conscious effort not to forget that little fact.

I was raised under the doctrine of Respect Your Elders, regardless of who they are; good manners aren’t optional; and children should do as they’re told. In my youth I occasionally found this doctrine to be an unreasonable imposition and I declared I would never become my parents. Now, I find that I have a low tolerance for misbehavior in anybody’s child, and I believe children should be taught obedience at an early age. I also expect children to follow instructions without any back talk. I am my parents.

But I am also a Nurse, and Lia is my patient. As such, she has Patient Rights. She has a right to her own opinions about her care, even with her limitations, and she has the right to say “no”. Unfortunately, “no” is often her default response.

Before I administer care, I will ask for her permission, and I try to present options that allow her to make choices. When she’s in a good mood, “Yes” is easy. If she says “No” to something we need to do, such as going to the bathroom, meds, or vital signs, I will wait a few minutes and ask again. There are days when she makes me feel like a salesperson, going through twenty NOs to get one YES.

On the other hand, there are times when “No” means “No” and I have to honor that. She is my patient, and she has rights.