Food police?

[mschelee, MSN, RN]

I have a question for the nurses who work ICU step down. In your facility, our patients allowed to have family members bring food into them? Let's say your patient has a renal diet, Or cardiac diet, or even a diabetic diet. Are those patients be allowed to have their family members bring fast food in to them or are they required to stick to the diet that the doctor has set for them?

[GaRN1952]

We try to counsel families on helping the patient stick to the prescribed diet. It is an education issue. If they bring fried chicken to the cardiac patient or chocolate candy to the diabetic while they are in the hospital, you know they will do the same or worse after discharge! Getting the family involved in learning the dietary restrictions may even keep your patient from future admissions. That being said, when I have a failure to thrive patient, particularly an elder patient who is not eating enough to get better, I will recommend to the family that they bring something either from home or a favorite restaurant hoping the familiar taste will get some much needed calories in.

[TiffyRN, BSN, PhD]

Your patients have autonomy, that is, the right to make their own decisions (as long as they are competent). Educate them and their families and let the MD know if they are choosing to eat things off the prescribed diet.

But they better not be expecting me as their nurse to enable their noncompliance as in running to get them items off the diet. No thanks!

[SaoirseRN]

You can educate but you cannot always stop a capable person from doing what they want. Just be sure to document the education and if the patient still has a Big Mac delivered, document that too. Make sure the physician is made aware on rounds the patient's choice, and that's all you can do. You can also refuse to provide the off-diet food yourself (ie, from whatever snacks are available on your unit), and you have the doctor's order to fall back on. Otherwise, people will make their own poor decisions.

[MunoRN, RN]

Patients have the right to refuse any therapy, including specific diets.

[chrisrn24]

Your patients have autonomy, that is, the right to make their own decisions (as long as they are competent). Educate them and their families and let the MD know if they are choosing to eat things off the prescribed diet.

But they better not be expecting me as their nurse to enable their noncompliance as in running to get them items off the diet. No thanks!

This. It's one thing if they do it but don't aide in it.

There are exceptions. I think it was Esme who told a great story about bringing a dying woman pizza and beer into the ICU. It's a good story.

[CVmursenary]

they can eat whatever they want; I will tell them the side effects of the food that they want to eat but I personally do not care if they choose to follow my advice or not.

[DoeRN]

They can do whatever they want. I provide literature about their specific diet. I tell them why certain foods aren't apart of their diet. But if they chose to eat that Whooper then so be it. I document education provided and let them eat the burger. Because I know as soon as they are discharged they will make a stop at Burger King along the way.

Sent from my iPhone using allnurses.com

[SaoirseRN]

I had a post-op lap appendectomy patient call a taxi at one in the morning (he returned from the recovery room at just past midnight) to bring him McDonald's! Surgeon had ordered diet as tolerated, and I did strongly suggest he not do it, but the man was simply hungry and willing to take the chance on the fast food. To my surprise he did not vomit!

[ICUPrincessNurse]

Same same same as all above! Usually once I tell the families WHY the special diet will help their person, they become more compliant. I have rarely had a problem with our heart patients- they get pretty extensive counseling pre-op, even more so if they'll be on coumadin. I did have one who begged and begged for water, swallowed fine, threw up 10 minutes later and then begged for more water because his stomach was empty....um, no.

However, I am quite guilty of making sure my patients have special things that they like- ESPECIALLY the younger trauma patients who have been NPO for an extended time waiting on some test or another. I saved one kid a cupcake I had made for him to have post op (IF he used his PCA) and I made sure family had a Dr. Pepper waiting for one after her esophogram ruled out any esophageal injury. Granted- these were young otherwise healthy trauma patients with no injuries that would necessitate a special dietary need.

[SaoirseRN]

However I am quite guilty of making sure my patients have special things that they like- ESPECIALLY the younger trauma patients who have been NPO for an extended time waiting on some test or another. I saved one kid a cupcake I had made for him to have post op (IF he used his PCA) and I made sure family had a Dr. Pepper waiting for one after her esophogram ruled out any esophageal injury. Granted- these were young otherwise healthy trauma patients with no injuries that would necessitate a special dietary need.[/quote']

That's nothing to be "guilty" about. That's just awesome nursing.

[blackvans1234]

I had a post-op lap appendectomy patient call a taxi at one in the morning (he returned from the recovery room at just past midnight) to bring him McDonald's! Surgeon had ordered diet as tolerated, and I did strongly suggest he not do it, but the man was simply hungry and willing to take the chance on the fast food. To my surprise he did not vomit!

I also had a young (28 Y.O.) patient, fresh out of the OR, up to the unit, and had her family bring mcdonalds.

Considering about 1/3 of patients have N/V postop, I was not supportive of her decision.

Luckily for me, she did not get sick either.