Feeding patients

Lacie, BSN, RN · Jun 14, 2009

We occasionally did fruit smoothies with the protein powder added, angel food cake on pts birthdays also. Drinks we use non-sweet tea and apple juice. Also a little note with each plate "Take your binder" lol. Holidays we pretty much went all out and let them cheat example 4th July they will have all the goodies except tomatoes and star fruit. they will get ham and turkey, green beans, baked beans, corn salad, fruit salad, and anything else pts and staff bring in. We did same thing for xmas and easter. Holidays we let them cheat. I may not like the employer but I will give them credit when it comes to holidays feeding thier patients. When I worked at Davita they gave them 1 chicken wing and 1/2 bagel with 1/2 cup of water for thier xmas meal (cough cough).

Tish88 · Jun 14, 2009

The idea of feeding these patients just makes me cringe.

Thank goodness I have a no eating policy and don't have to worry about feeding these patients too.

It is not like the nurses and techs don't have enough work to do already besides having to feed patients too!

GeauxNursing · Jun 14, 2009

If we are feeding people, it is our dietitian doing a demonstration with something from her Dialysis-friendly recipes, (found on Davita website I think). She makes sweet stuff using artificial sweetener, and one time she made this really good tuna salad. For the holidays the company puts out a measly amount of money for a "spread", which is usually just fruit and sandwiches. And pink lemonade.

Food in the clinic really causes problems for us. Some patients are very messy and inconsiderate, throwing trash on the floor, or dropping crumbs and stuff deep down into the cracks of the chairs. Others can't feed themselves, so we have to find time to sit there and feed them. Roaches are a big problem, too. Once we get them, it is very hard to get rid of them. I wouldn't be surprised if they were actually coming into the clinic in some pt's bags...

I don't know the validity of it, but doesn't our dialysate keep BS at a constant level during treatment due to containing glucose? I always hear patients saying "I need to eat on the machine, my BS is dropping!" "What are you going to do when I pass out?!" I'm going to tell you it isn't your sugar, it's probably your BP dropping because you just ate a sausage mcmuffin and 2 hashbrowns!

Tish88 · Jun 14, 2009

As mentioned above, we don't feed or allow our patients to eat on treatment or even in the dialysis unit.

We do check their sugars at the start of treatment and if they are low or dropping during treatment we give them a sugar tablet.

Some of these patients come in for treatment and take all their insulin and then tell the staff they only "ate a small meal" prior to coming.

Our dialysate does contain glucose, so we are not dropping them out of range.

I agree with the bp dropping due to food in the stomach and the blood is being diverted to digest the food and not going to the vital organs - such as their BRAINS!!!! and hearts, etc. :)

GeauxNursing · Jun 15, 2009

and the blood is being diverted to digest the food and not going to the vital organs - such as their BRAINS!!!! and hearts, etc. :)

:yeah: LOL really!

Lacie, BSN, RN · Jun 15, 2009

And some of the stuff they bring. I have patients that bring suitcases and I truly believe they must fear someone will rob thier home while they are gone. I understand a book, an ipod a blanket and a pillow but lord the whole house and the contents of thier refridgerator? They will ask you to unpack everything then your tripping over half the garbage they bring then expect you to pack it all up for them. And yes I have had some god awful bugs drop out of those bags LOL. God help you if you put or fold something differently then they do lol. Oops I forgot to put the tab on the tape to the right instead of the left and no I dont know what you did with you headsets the last time you were here since you were also a no show your last 2 treatments!!!! Sorry I wasnt thinking as was too busy with the mop cleaning up the large McD's coke you just knocked on the floor during turnover:nono:

GeauxNursing · Jun 15, 2009

lol. I'm sitting here in the clinic and I just heard a loud "CLANK". It was a spoon dropping. Someone had the nerve to ask me for sweet n low and creamer this morning!? Oh yea, this was good too. "Can you put this pie in ya'lls fridge? I don't want it to spoil before I can eat it." I said Nope.

Dialysis RN1 · Jun 15, 2009

There was a great article that was published in the Nephrology Nursing Journal September-October 2005-Vol.32, No.4. Titled: “Should Patients Eat During Hemodialysis Treatments?” by Katina Kinnel. You can do a Google search on the title and find the article. We too have a no eating policy and I have used this article to back my position on multiple occasions.

diabo, RN · Jun 15, 2009

Just have the vomit brigade ready if they eat, worse yet, the aspiration brigade. Hard candy with a stick (lollipops) is the limit in our center. No gum. Oh, I forgot to mention the increase in cramping. :nono:

Tish88 · Jun 16, 2009

Gee, if I ever have to go on dialysis, I want to go where your clinics are located! You feed your patients, clean up after them, and pack their bags for them!

My thought is - these people are adults and can take care of themselves..... my patients come in for treatment, they get their own chairs ready with a sheet, blanket and pillow.

We are there to provide them with a dialysis treatment - not maid service, food service or parenting services.

I know this may sound harsh, but we need to keep these patients as independent as possible or their life expectancy will just grow shorter.

I have a patient that turned 90 years old and he still works during the morning and then comes in for his treatment in the afternoon. He will not let anyone help him get his area ready for him, he tells everyone there is "nothing" wrong with him and he can take care of himself. I know he will be around until he is 100. :)

Chisca, RN · Jun 26, 2009

As long as they are not hypotensive I leave the tube feedings on.

:sofahider