Patient Bill of Rights
I encountered a rather tough situation in clinical this week. This situation also gave me some first-hand understanding of the Patient’s Bill of Rights.
Friday morning when I arrived at my clinical site, the first procedure I participated in was a barium enema. As a side note to this procedure, we were using Hypaque instead of Barium Sulfate. The patient had a colostomy as a result of a gunshot wound from several years ago, so barium might have introduced a risk of extravasation. This procedure was being performed as a prelude to the patient having surgery to repair the lower GI tract and help him get rid of the colostomy so he might be able to function normally again. The patient was a 26-year old male.
We prepared the room and brought in the patient. We explained the procedure. This was the beginning of the problems we had. Apparently no one prior to us had given him any idea of what this procedure involved and why he was having it. He was totally in the dark. He got quite nervous when we were describing the procedure. We tried to reassure him and help him understand that breathing techniques would make the procedure easier. He never seemed to understand and never relaxed much before the exam started.
When we tipped the patient, that’s when the complaining really started. Everything was properly lubed, but the patient couldn’t seem to endure the discomfort. The radiologist came in and we started filling the patient with Hypaque and his complaints continued. The complaints got to the point where the radiologist stopped and asked the patient if he wanted us to stop the procedure. When the patient was presented with this opportunity, he immediately said YES. The radiologist told him that not completing this procedure would keep him from being able to have his surgery. The patient still wanted the procedure stopped, so we stopped.
The patient has the right to refuse or stop any procedure.
I was disappointed that the procedure wasn’t completed. He’ll have a decision to make now. He either lives with the colostomy or he repeats the procedure again. For me, it’s a no-brainer. A colostomy is not something you would want to live with by choice when there is a better alternative. I also thought we were very effective at explaining the procedure along with the benefits of having it. I think this patient’s doctor will probably have a good talk with him and he’ll be back for the barium (or Hypaque) enema in the future…
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