Why not question pts about their eating habits?

  1. Why is it that, on our assessment intake, we always question pts about cigarettes and drinking, but there's not section about their eating habits? I ask this because I just watched the movie Supersize Me, which you probably already know is about the dangers of fast food.

    We all know that obesity is a huge public menace. Why don't we start emphasizing it more in our pt education? For instance, why not ask pts how often they eat fast food? According to the movie, our consumption of fastfood is directly related to our weight. The guy in the movie also had dramatic changes to his bloodwork lab values.

    I think it's high time for us to start including that in our pt teaching. I also think hospital cafeterias should quit offering junk food themselves. This epidemic is the cause of so many chronic illnesses, it's no joke.
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  2. 34 Comments

  3. by   Mommy TeleRN
    Our admission history has a place for "diet" but no real definition of what we are supposed to ask. I usually ask them if they are on any special diet or restrictions (we get lots of diabetes and sodium restricted patients) but I suppose you could ask what a typical day is and put that in there too.

    Poor diet/lack of exercise is definitely a health risk! We do also have a new place for BMI on our history. We have a chart by the front desk but so far I never input that because well - I have the computer in their room doing the history and the chart is at the front desk.

    It almost seems like weight is still a taboo subject - you feel like you'll offend? And doesn't it seem like dietary consults are for UNDERnourished people - like if they've lost a huge amt of weight recently, have pegs or TPN, stuff like that. Who does a dietary consult for TOO MUCH food?

    Food for thought (no pun intended)
  4. by   CHATSDALE
    over consumption of food will obesity where ever the excess comes from
    i am not saying that fast food is healthy but you have to use common sense
    and yo have to get that body out and move it, i have had pts who were in vegetative state and given tube feeding per dietitian recommendations and they gained weight
  5. by   GardenDove
    I wonder if discussing weight is still a taboo still in this country. Maybe because it's so visable? I think, though, in light of national trends, that we need an anti-junkfood campaign similar to the anti-smoking one that started in the 70's. I think we're already seeing it happen, such as banning trans-fats. We need to get on the bandwagon with this, and start emphasizing it more.
  6. by   HeartsOpenWide
    I am in a BSN program that is holistic and we use Gordon's and when we did assessments we asked our clients 24-hour diet
  7. by   RN BSN 2009
    yes... overconsumption seems to be a problem needing to be addressed...
  8. by   GardenDove
    Quote from HeartsOpenWide
    I am in a BSN program that is holistic and we use Gordon's and when we did assessments we asked our clients 24-hour diet
    This must be the new trend. Glad to hear it!
  9. by   AtlantaRN
    probably because we don't want people to feel bad....it's like kids in school that get ribbons on field day because we don't want them to feel bad because they didn't win...just a thought.

    I posted on another forum about a person who was seated in one of those electric chairs, 350-400lb range height 5'1"; her mother tipped over a walker while seated and I rushed over to pick the walker up so the mother wouldn't fall; I did so because I KNEW the woman in the electric chair couldn't have picked up ANYTHING on the floor because she is physically unable to do so....anywhoo on this other, nonmedical forum....I was CHASTISED because I posted her size.............................................. ...................................They accused me of having a problem with overweight persons (truth be told i'm 5'2" and am pushing the 200lb range...yes I eat badly, but I don't deny it.)
    ANYWHOO, my point is, we have gotten to where we are politically correct to a fault. No one is responsible for thier own consumption anymore.................

    Just my opinion; but I do believe a review of intake could steer patients to a healthier lifestyle, should they choose to do so. we can at least give them the tools.

    linda
  10. by   angel337
    i do ask patients about their regular eating habit, especially when it might be related to their complaints such as chronic abdominal pain, reflux etc... i do this because alot of patients don't realize that what they eat affects how they feel. i agree that people are touchy about food and weight, but its not what you ask, but how you ask it.
  11. by   GardenDove
    But, we're not too sensitive to smokers and drinkers. We banish smokers to an alley somewhere. We have a big anti-smoking part of our intake assessment sheet where we're supposed to lecture smokers. We have CAGE screening where we ask if they drink >7 drinks a week, if they feel guilty, etc. They are blunt questions.
  12. by   gentle
    Our facility assessment sheet allows for a minimal dietary assessment which one may extend or minimize as they see fit. If I have a patient, say a diabetic, who may or may not need assistance, I perform what education that I can and place a dietary referral.

    If I have a pregnant patient, I refer them to dietary. If I have a COPD patient, I encourage well cooked but not "boiled to death vegetables" so that they can get in their vitamins and nutrients. I also warn them to be aware if salads may or may not aggravate their dyspnea.

    In short, I do believe it depends on each individuals comfort level to approach this topic. I also believe that each nurse will need to assess the receptiveness of the patient in broaching (sp?) the topic.

    Now then all this said, I personally struggle with my diet. I also admit this to my patients and whomever asks me. I let them know that over time we can all slowly and with diligence improve our health. Again, honestly, I really struggle.

    Thank you to the OP for posting the topic.
  13. by   TheCommuter
    Last year my endocrinologist questioned me about my eating habits when doing her initial assessment of me.

    In addition, a nurse practitioner questioned me about my eating habits during a visit to a general practitioner's medical office.

    Moreover, my gynecologist noted that I gained 30 pounds in one year and asked me about my eating habits.
  14. by   Jabramac
    IMHO the whole health care system does a very poor job of addressing over weight issues. I can say, being over weight my self, I get weighed at the clinic each time I am there and once the physician talked to me about watching my portions.

    Where I work we send people home with brochures and instructions on smoking cessation, ETOH abuse, domestic violence, but nothing about obesity. We have an assessment area for "nutritional status" but the only time I ever see anyone fill it out is when people appear under weight.

    I think it still must be taboo. We want people to be happy and comfortable, and eating is comfortable (at least for me). What I think is there needs to be a better network of services for weight loss that can be triggered and accessed through physcians. Instead of telling people in the office about weight loss, or sending home with a brochure, why not a referal to a nutrisionist, deitician, weight loss clinic, or weight loss program. What about having follow up appointments just for weight issues? "We noticed you are XX lbs over weight today. Here is a referal to a nutritionist and I would like to see you back here in about a month or two to review."

    Here is an interesting question- who has weight loss programs or services at their hospital, and what is it? We host weight watchers, and periodically have some type of physical fitness campagne were we are encouraged to walk, run etc, but very little incentive.

    On a happy note, I am proud to say I did join weight watchers and have lost 40lbs so far.

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