eating on dialysis

[nrsjo]

Ok.........I am new to dialysis. After 10 years in ICU I am totally digging this change, and the new challenge.

I just have one peeve. I do think policies are in place for a reason, and I think like most facilities, ours does not let patients eat while on the machines for a reason.

However, IF they come in with food or drink, we don't wrestle it away from them. But, employees are not allowed to purchase food from vending machines for patients. My problem is that I do see this being done. I have discussed this with the manager, simply because I see it as a liability issue. For one, we can be fired for doing it. And two, if something dire happens to that patient, and they choose to sue, we broke our own rules.

Me being the new nurse on the block, how I do I make techs understand that this is not appropriate?

[kids]

The dialysis center in my fairly large town is open and operating 16 hours per day. They are unable to schedule treatment to accomidate meal and insulin schedules for everyone, every time. Diabetics are REQUIRED to bring a sack meal with them. Others are encouraged to bring a light snack as treatment (and the wait for transportation) can have them there of 6+ hours.

[TELEpathicRN]

if the pt brings in food, drops BP and aspirates and ends up in the ICU, or worse, it is their fault, if the staff purchases the food for th pt, it is the STAFF and the COMPANY's fault now!!!

Heard an awful true story from a co-worker that works acutes now, but worked chronics for about 10 yrs... She said there was a pt that would always eat on the machine, and then, of course... get sick and usually vomit all over the place. But one particular time, the pt brought a nice thick peanut butter and jelly sandwich to dialysis, lost their BP and aspirated the piece of sandwich they were eating, they were unable to clear her airway, paramedics were unable to clear it and intubate or crich....the patient died, all for a PB&J!!!

[New CCU RN]

That is very sad... still don't know why she couldn't have been criched... very sad.

But still, what are you going to do? Tell these people they are NPO after midnight three days a week?

[jnette, ASN, EMT-I]

We do NOT allow eating on the machine either.. too dangerous and the pt. usually loses his/her BP even more.. then gets sick.

It is company and doc policy and we stick to it. We do ask that our patients be sure to eat something before they come for tx., or on the way there. Those that have to wait on transportation after will bring a snack with them, which they eat after they come off the machine.

If it is policy at your place, then I would be consistent !

Our DON passes around a flyer every so many mos. letting patients know what the policy is and why... thsi way they know we're not just being "mean" and that it is in their own best interest. I would speak with your mgr. and discuss the inconsistencies, and perhaps she can speak to the techs or other staff about being consistent. New kid on the block or no...it's the pts.' lives / wellbeing at stake, right?

[susanmary]

Always send patient food trays to the dialysis unit so that they can eat there. We make sure that bs/insulins are covered and the patient eats.

[jnette, ASN, EMT-I]

Quote

Originally posted by New CCU RN

But still, what are you going to do? Tell these people they are NPO after midnight three days a week?

Not at all... our pts. eat before they come to tx. Either a decent breakfast, or if they run in the afternoon, they eat lunch before they come. That gives their tummies time to digest a little before they actually start on the machine. We check b/s as well, at the beginning of tx.

Our pts. have never complained or disagreed with our protocol on this. We allow hard candy or lemon drops, mostly for drymouth/thirst. But other than that, they don't eat.

[TELEpathicRN]

I was going to reply, but I think jnette did a great job.

It's not like we are asking these people to starve! They surely wouldn't be NPO after midnight!!! That's a little dramatic.

It is policy, and finally a policy that makes sense!!

[Hellllllo Nurse, BSN, RN]

No eating in the HD unit is policy where I work, too, but it is not enforced.

Wish it was. I don't know why some pts want to eat when they are just going to vomit it up.

HD units are really contaminated environments, lots of blood.

I don't understand why pts want to eat there!

[sixes]

When I did my course at Sick Kids Hospital ( Home Baxter Peritoneal diayalisis(sp). My nephew was recieving Hemo diaylsis and he was allowed to eat anything he wanted before treatment but never anything while on the machines. He often got lots of cramping in his legs. Too much being drawn off at once?? they use to ohave to stop the machine and put his bed with the head down and his bp would bootm out. He never vomited but he would become quite pale. Sometimes they gave him a special drink with lytes or something in it can't remember but never solid food.

Once he was on diaylisis at home it was odne while he slept. So eating was never an issue. Although I don't think that applies to peritoneal diaylsis. I'll have to refresh as he had a transplant with his Mom as the donor 6 or 7 years ago

[jnette, ASN, EMT-I]

Quote

Originally posted by Hellllllo Nurse

HD units are really contaminated environments, lots of blood.

I don't understand why pts want to eat there!

Another highly important reason it's not permitted at our facility !

We do explain that to our patients as well, and htey understand that. The staff is not even allowed to chew gum, or put on lipgloss for this very reason. Stop and think a minute of how very contaminated a unit like this is ! Scary! Would YOU want to eat there? :stone

[babs_rn]

We DO allow our patients to eat on the machine; not only that, but we sometimes provide low-phosphorus, low-potassium treats for them as well. I have a real problem with telling a diabetic patient that he/she must sit in a chair for 4-5 hours while we are providing a treatment that does cause some reduction in blood sugar and not eat a thing.