First Day at Clinicals: Not good at feeding =(

[Noob_to_Nursing]

Today was my first day actually applying my skills at a long term care facility and my first student assignment was to feed someone. I felt SO nervous because I didn't know whether to talk to the person or let them just watch TV. Anyway, anyone have any tips to help feed someone? I tried just asking whether the person wanted a bite of something but it looked like they didn't want the food. =( I need help! =(

[newgirlcalifornia]

Hi there-

I have found it helpful to ask some of the CNA's for help in understanding the eating habits of the residents. Like my gal this week doesn't like to eat breakfast - sleeps right through it. So if I spend 10 minutes offering it to her, and she won't wake up, or declines to eat, I don't stress because that is normal for her. I just make sure to try harder at lunch. So I would ask the CNA assigned to your resident what is normal for them if you are not sure. Personally I don't try and converse too much while the tv is on, because it's too much to concentrate on for my gal. Just try and make it as enjoyable a meal as possible!

[fuzzywuzzy, CNA]

Sometimes when the resident talks a lot during the meal they end up choking, so I try to keep the conversation minimal. Anyway if you're at a loss for words you can just talk about the food. And if I ask what they want to eat and they don't answer I just say "here's a bite of chicken" or whatever and give it to them. I think when you first start feeding, you expect the people to be more active and engaged about everything, but they're usually not... at all. If you left it up to them they would never eat.

[Poi Dog]

It is perfectly natural to feel awkward when feeding someone. I just smiled a lot at the person I was assisting and talked about the weather. I was terrified the person would start choking. It ended up being fine and now I am an expert at feedings

[jeaniekadinee]

I'm not a CNA but I helped my mom by taking care of my dad while she was at work. When I fed him, I did talk a little bit like saying stuff such as, "That orange sorbet is pretty good huh." Stuff like that. I don't know if this helps at all but good luck :)

[Hygiene Queen]

Keep the conversation at a minimum.

1) The pt needs to concentrate on chewing and swallowing. You need to be observing the pt as well. There is a choking/aspiration risk here. The pt most likely already has some sort of deficit in the first place if they require assistance.

2) Keep talk focused on the food. "Does it taste good?", "Please swallow again", "Let's have a drink now", etc.

3) If the pt insists on talking (a lot) try to refocus the pt on the meal. Also, if the pt tries to talk with a full mouth, it is okay to express concern that they will choke. Tell them to concentrate on chewing and swallowing-- not talking.

4) Silence is okay! We do not need to talk 24/7!

Feeding was scary for me too when I first started. I would only give my pt one bite of carrot at a time. I was terrified I would choke my pt! The more seasoned aide, who was watching me, burst out with a wry laugh and shook her head, "You ain't gonna ever get done feeding her that way!"

lol

However, I know that with some pts, that wee bitty bites are the only way to safely go and, yes, the feeding will take a long time. Other pts do much better and can handle just as much on a spoon as you or I can.

It's a trial-and-error learning process... but when I don't know how a pt eats, to this day, I assume they may have swallowing issues and start with small bites of soft food and go slow. As I get a feel for the pt, I may progress onward as the pt tolerates.

Keep talk at a minimum and start "small, soft and slow".

Cheers.

[Bruce_Wayne, ASN, RN]

Whenever I feed somebody I think of as if I'm a tool that allows them to eat. Tools don't talk, so I don't say a lot during feeding.

If the person can communicate I'll ask them what order they like to eat their food in or if they like to switch around randomly on the plate. Or sometimes I set up a system where they say what they want me to feed them and I'll feed them that until the say something else. Like if they say "egg" I'll feed them eggs until they ask for "milk" or whatever.

When you feed somebody both you and the patient are emotionally vulnerable, I think. There is the potential for all sorts of emotions and feelings to come up. You might feel overly protective of your patient, your patient can feel frustrated and babied, etc. And I don't think it's therapeutic to get all emotionally during meal times because you really need to be focusing on airway patency and aspiration precautions.

So that's why I'm kind of quiet and down to business at feeding time.