Do we really need a MD's order for this?

[Plagueis]

I understand that resident's need a physician's order to apply ice, heat, or even for Vaseline, for instance. However, recently I've seen orders to D/C particular food items from a resident's diet.

For example, one order was to D/C waffles with breakfast (the resident doesn't like waffles), and the nurse had to get permission from the MD to do so. Another was to D/C jelly with the resident's afternoon snack, as the resident only wanted peanut butter sandwiches. I always thought that a diet slip would be the only thing to fill out for changes such as these, as these aren't orders to change the diet (i.e. from puree to mech. soft), or to add fluids to a fluid-restricted diet.

To require a MD's permission for this seems odd to me (my previous facility didn't require that), but I was wondering: is this a common practice in other LTC facilities?

[cb_rn]

I am allergic to eggs. Despite this, when I was hospitalized for cardiac issues, on the cardiac floor, I GOT EGGS EVERY MORNING. And not the fake ones, either.

Yes, there are breakdowns in communication everywhere. No, orders aren't needed, but may be a last resort.

And I've seen transplant patients get raw salads even though we clearly teach them in pre-op that no uncooked vegetables or fruits should be eaten. You can imagine the patient's confusion when the very hospital that does their transplant serves them the thing we tell them not to eat. Frustrating. I have enough to do without running to inspect whats on the tray before the patient can take a bite... What can I say exactly? "Excuse me, Mr. X, please don't have any lunch until I have a chance to come in and make sure dietary hasn't sent anything that can make you gravely ill."

[marthyellen]

Are your orders computerize? Sometimes food preference are written as order so the computer system can be acurate.

[Plagueis]

Are your orders computerize? Sometimes food preference are written as order so the computer system can be acurate.

First, thanks to everyone who responded. And, no, our orders aren't computerized. Diet orders here, or so I thought, just list the kind of diet (ie. regular, puree) the resident is on. It just killed me when I saw the POS with these food preferences orders.

I have to add that despite the MD order and diet request slip, the one resident still gets peanut butter sandwiches with jelly.