As a nurse for over 30 years, I get it.  I have done it.  In frustration over seeing people suffer at their own hand, I have called them “Non-Compliant”.  Especially those darn diabetics whose lives would be so much better if they would only eat right, exercise, check their blood sugar and live healthier!!  A long time ago there was security in that label, as I was not one of “them”.  I was a healthcare professional who knew if they only comply with their treatment plan, they would feel better.  Sound familiar?

The trouble is twofold: labels and assuming intent.  So, let’s start with labels.  They are nice descriptive words that tell us what to expect inside –   Flour in a canister. Files in a folder. Commode in a bathroom.   Soup in a can.  Very helpful when looking for a particular item or understanding which thing to open. But when we apply to people, we often do it based on our vantage point and we miss the truth. The truth is I don’t believe there are any non-compliant people with any illness.  There ARE a lot of scared, angry, frustrated, undereducated, overwhelmed people who have stories that influence their choices every day.  Choices like what to spend money on, who to prioritize, how to manage emotions, and how to survive.   Maybe what they are doing is the best they can with the resources and coping skills they have.

Judging the “non-compliant”

The other issue with “non-compliance” is that it implies some intent to do harm or disobey ON PURPOSE.  That they are intentionally trying to fail.  This is the part that really needs to change.  We wouldn’t label a kindergartener “non-compliant” with writing the alphabet, nor would you label a co-worker “non-compliant” if they had not mastered a new skill.  But in healthcare, that label floats around in hospitals, doctors’ offices, and clinics every day.  It creates a shielding gap between those who treat and we who are treated.  You are not us.   It creates a feeling of judgment that you believe we should comply to that which we cannot.    The real irony is that “compliance” requires perfection and perfection doesn’t exist.

So, in truth, we are all “non-compliant” with something, diabetes or not.  Who of you really eats perfectly, exercises daily, never misses a medication, never runs a stoplight or speeds, is never late for work, always pays on time, and always makes perfect decisions?  No one.  It is unattainable.

So, join me and abolishing this label.  Take a moment to understand what is really on the inside if you want to change behavior.  Award and complement progress, not perfection.   Seek to build up, not tear down.  Find out what your patient’s goals are, instead of applying yours to them.

And leave the labels for the pantry.

Peace,

Patricia %