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:
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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.
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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.
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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.
Why? Any number of reasons. Ultimately, it is the patient's choice when to actually take them, or if to take them. There is a degree of realistic limit to that, particularly with dose and time sensitive medication, but you absolutely have that choice within those limits.
Should you be fucking around and not taking them on schedule? Hell no! Let the pros do their job unless there's a good reason otherwise, and communicate any reason asap so it can get sorted. But it is the patient's right to manage their care as long as they're competent.
Now, as to why? Dry mouth, sore throat, nausea, concerns about timing of side effects (like drowsiness) interfering with something, there's all kinds of good reasons to delay taking a medication. There's also plenty of bad reasons lol.
And it's important to remember as a patient that if you're going to fuck around with things that most patients aren't qualified to fuck around with (like dosage scheduling), that most facilities can turn that into a reason to turf your ass lol. It's rare, but hospitals can kick our asses to the curb via transfer or other means if we're unwilling to cooperate with our own care at all.