One of the more stressful aspects of being a nurse practitioner that I certainly didn’t feel prepared for during my MSN program was managing patient medication requests. Especially when patients demand specific medications or try to dictate the course of treatment.
This often shows up in the form of patients requesting benzos or stimulants because they feel they’ve “tried everything else and nothing has worked.” Such encounters, especially during an initial evaluation, can be tough because you want to build a therapeutic rapport, and starting from opposition makes that difficult.
How to Manage Medication Requests Effectively
Patient collaboration is key, but it’s challenging when a patient strongly insists on one particular medication, especially if that medication carries a high potential for abuse or dependency. Our role as prescribers is to help patients without creating long-term issues.
As a more experienced NP, my approach is to truly listen to understand why my patient wants a certain medication or treatment. Outright dismissal usually leads to more resistance.
Outlining treatment options transparently is important, too. If a requested medication doesn’t make clinical sense, be prepared for the patient to be upset sometimes. Becoming comfortable with not being liked (or possibly yelled at) after explaining your rationale is a skill that can be developed.
Ultimately, our primary role as NPs is to provide safe, evidence-based care—not to be our patient’s best friend forever.
Practical Tips for Managing Patient Medication Requests
- Acknowledge Their Concerns: Validate your patient’s feelings by saying something like, “I understand you’re frustrated and have tried many options. Your comfort is important, and I want to find the best solution together.”
- Educate on Risks and Benefits: Explain the potential risks, e.g., “This medication has a high potential for dependency. Let’s explore safer alternatives that can also help.”
- Offer Alternatives: Present other treatment options and invite collaboration: “Would you be open to trying [alternative treatment] for a few weeks, then we can reassess?”
- Set Clear Boundaries: Clarify your professional limits: “My goal is to ensure your safety. I cannot prescribe medications that may harm you long-term. Let’s find a safe, effective plan.”
Using these strategies often leads to better conversations than simply saying “no” or giving in to demands.
If you’re a psych NP student, new grad, or experienced NP feeling stressed or under-resourced, check out my free Master Mental Health training . It focuses on diagnosing and treating patients more effectively.
Further Reading
For more tips on handling challenging patient interactions, check out this post: What to Do When Patients Refuse Your Care