Adults Who Can't Swallow Pills

[Medic946RN]

Where I work now we seem to have cornered the market on adults who can't swallow pills. I'm not referring to children or eldery people with dysphagia. I'm talking about gagging and crying like they were four or something. They whine and beg you. "Please don"t make me take that pill. I can't swallow it, I never have been able to."

I swear I see at least one a week. I've tried everything, even crushing pills in applesauce. They just can't swallow the med. Of course they don't want an injection or a suppository either.

Anybody else run into this in the ED?

[stressednurse]

I like to watch the little performances each patient displays. for some reason this amuses me, maybe because I came from such a disfunctional family. I guess I can relate to some of their ways of thinking too.

Humor and compassion do help a lot with the 'can't swallow the pill' problem. Usually there is something more going on that you cannot truly evaluate in a few hours in an ER. This has got to be really frustrating.

[MAGIK GIRL]

Originally posted by hogan4736

magik, you are a true realist...

i cringe when i hear the whining, begging and pleading from patients about the bloodwork, the po meds, foley, etc. (though an NG HAS to suck, it still doesn't give someone license to be rude)...

it's like WE came to THEIR home and forced these things onto them...

my favorite were the 3 brothers (all still living at home, ALL in their 30s) and their mom (the patient) coming in asking me for every little thing every 3 minutes, whining and crying over their mom (she had pneumonia, small fever, good SAO2)...OH MY GOD...talk about being a fly on the wall in THEIR home (she must still wipe their behinds:stone )

And the mom just LOVED every BIT of attention she was getting

Carrying on and attention seeking like some of the stories posted here is simply LAME...It shows a general lack of respect for oneself, detracts from any shred of dignity you may THINK you have, and is just plain embarassing...Get over it...

sean

:) why thank you hogan 4736!

yes i am a realist. i read a book called the four agreements and since then it has been smooth sailing!

as for the rest of your post.... :roll !!!!!

it slays me that those people get insulted when you ask them to do something. and as for dignity... my favorite are these folks :

"hi. i am your nurse. i need to ask you a few questions. ok, i will let the doctor know that you are here. i would like for you to change into this pt gown. the split goes in the back, ok?"

the nurse goes to leave the room and shut the curtain but before you can take a breath, the patient is butt naked fumbleing with the gown and asking if the split goes in the front or the back. how can you keep a straight face?

:roll

[maxee123]

First thing i would like to say u is that your photo is very nice.

and second thing.

The only way I learned to do it, is to do the dysphagia swallow. You know, tilt your head forward and swallow, like patients that have had CVAs do. It opens up the esophagus and closes the windpipe (which is why they have stroke patients do so, so that they do not aspirate).

But if you watch, most people do it the opposite way, by tipping their heads way back and trying to swallow. Which, if you think about it, anatomically, is probably the worst thing that you can do.

So u just try to do above,If you cann't do above thing then you can crush the pill and try to mix it with food and you can eat your med with food.

ok keep in touch

according to me this is just fear. if you can swallo food mean you can also sallow pills.

-max ([email protected])

[Marie_LPN, RN, LPN, RN]

I have tried EVERYTHING, even hypnotherapy, and still nothing.

[RN-PA, RN]

I've had trouble swallowing pills over the years. I was in 6th grade when I finally learned how to swallow them by rolling up pieces of white bread to the approximate shape and size. My Mom said the liquid antibiotics were too expensive and I was having to take 6 baby aspirin at a time for fever (orange-flavored candy continues to be a turn-off to this day...:stone ).

I still have trouble swallowing round tablets with edges on them, and do best taking them one at a time with juice or milk-- something thicker than water, and have recommended that to patients who are having trouble swallowing with water-- if they're allowed OJ or milk, that is. I also tell myself that the pill is smaller than the chewed food I swallow with ease, and make sure that my mouth is well-lubricated with fluid before placing the pill in the middle of my tongue. (I get this look: from my husband when I take my vitamins one at a time as he tosses a handful of vitamins in all at once. I almost gag watching him.)

I've had patients who go into an act every time I have to bring in their 6-8 PO meds, whining and moaning, and repeating, "I'll NEVER be able to take all of these", and I just act as matter-of-fact and positive as I can, offer to crush them or whatever it takes. Beyond those efforts, I just circle my initials on the med kardex which denotes "refused" and let the doctor know if there're too many issues. I just don't have that much time to wait around.

[teeituptom, BSN, RN]

Personally I feel all meds should also come in suppositories that way the pt can have a choice :rotfl: :chuckle

[Squeeta2]

Wow..I never knew I had so much company!! I cannot swallow a pill without totally psyching myself up for it first. I can't take more than one at a time and god forbid anyone is watching or I gag like a cat with a hairball!

I don't have a physical reason for this...I know its a mental issue, after all I do eat on a regular basis. I liken it to an anxiety attack...no rhyme or reason..it's just me. My kids will roll their eyes turn their back to me & keep on talking.."Is it gone yet?" if I don't answer they just keep talking. Sometimes I hafta walk out of the room & be alone to do it. :imbar

I know & often say that when I get old I am going to be my own worst enemy (as a nurse) As for those who can swallow multiples at a time, sometimes even dry..I am amazed & awed EVERY time!!

[phd]

our system in chicago had the same problem with a number of pts so we found EZ meds kit which takes care of a lot of our issues with the time it takes to deliver crushed meds. Advocate now incorporates it daily. It is the easiest way our committee found to answer the problem.

[Ellen_0ncall]

I know this is very annoying and time consuming as a nurse. This is one of the reason, I don't think I could work in a nursing home.

I have recently started having a problem with swallowing pills myself and I AM NOT OLD. I think some people after having GER, develop a limited kind of paralyisis OR maybe spasms when it comes to swallowing small dry things. Sometimes, even with a lot of water, I have problems. Yet I can eat popcorn. I have noticed drinking something warm helps a lot~but, with patients there is always the risk of somthing being too, warm.

I think that some adults have small ischemic attacks that can cause some mild esophageal spasms or paralysis, and be totally unaware that this has happened. I use to think that all of these cases were Psyche cases to some degree...now that it is happening to me, I am beginning to realize that there is something physical happening to cause the problem.

Hats off to all nurses who have patience with this issue!

[boggle, ASN, RN]

our system in chicago had the same problem with a number of pts so we found EZ meds kit which takes care of a lot of our issues with the time it takes to deliver crushed meds. Advocate now incorporates it daily. It is the easiest way our committee found to answer the problem.

?? Can you explain a little more please??

[andyman1216]

I Liked The, All Meds Should Come In Po Or Supp, Give The Pt The Choice. How Can A Person Be In An Er For An "emergency Visit", With The Common Complaint Of Pain, Then Dictate How He Or She Gets Her Meds? I'm Too Busy To Cater To Miniscule Needs Of Needy Pt's. I'd Love To Make You Comfortable. I'll Get You As Many Warm Blankets As You Want, Er's Can Be Freezing When Your Not Running. But Start Freakin Out Because You Cant Swallow A Pill, Or Because You See A Needle, And You Dont Need The Med Anyway. We Have All Seen It... When You Are Really Hurting, You Dont Give A Rats *** How You Get That Med As Long As It Takes The Pain Away!

Perfect Example, Kidney Stones. Had A Young Woman Come In The Other Night, Complaining Of "abd Cramping Worse Than Labor". That Tells You That The One Thing God Gave You Girls To Punish You- Labor Pains, Has Nothing On A Kidney Stone. Ive Heard That More Than A Few Times.

Nut Up And Take Your Medicine...

[missmercy]

Thanks for all the great ideas! My 13 y.o can't take pills -- hates liquid stuff and is embarassed when the coach or trainer wants to give him motrin etc for a strain or whatever. Not that I want him to develop and enjoyment for popping pills -- rumor has it that can get you into trouble in a big way!! -- but it would be nice for the guy to be able to take a Tylenol once in a while!!!