'Scuse me sir, don't bite into that frito ! ! !

[CaLLaCoDe, BSN, RN]

One issue I think is awfully odd; I know it really is meant to be benificial is putting a patient on a strict diet (let's say low sodium, diabetic, renal etc). I could understand why this is done; however, if the patient complains and is sneaking food on the side what good does this dietary solution for a short while do anyway?!!! D/C'd today to sin tommorow!?

I can't tell you how often I've seen patients' families cart in heavy leaden doughnuts for breakfast when the patient is on a diabetic diet; I know that education is valid at these moments but when it happens again and again...with candy falling out of the bedside table..filled to the brim with goodies and soda bottles everywhere! What is this all about? Why should we have to be the P*O*L*I*C*E for a patient's life choice?

[lovingtheunloved, ASN, RN]

Kind of similar, why put a 94 year old Alzheimer's patient on a low fat, sodium restricted diet? They'll live just fine on cookies.

[NewEastCoastRN]

I agree that it gets to a point where you just need to let them make their own decisions. I am also a tele nurse, and I can't tell you how many times people sneak fluids when they are on strict fluid restrictions. If we have told them repeatedly the risks and dangers, and they continue to do it anyway, the best thing is just to document it. I also agree that I am not the police, but I also won't give them anything they want either. If they want to eat crap and drink like a fish, they need to find the means to do it themselves.

[sissyboo]

If I live to be *OLD*...I don't want anyone telling me that I can't have my cookies or a piece of bacon... Let'em go out happy...

[canoehead, BSN, RN]

My mother was on a cardiac unit with a woman who turned a lovely shade of blue whenever she was ambulated, swollen legs, the whole bit. Her sons came in and were worried beyond belief that she hadn't eaten enough supper. They offered to go out and get her some KFC, saying she'd feel better if she ate. Not.

The funny part was the nurse in me only really started to worry about her when she turned them down.

[CaLLaCoDe, BSN, RN]

Oh by gosh! I forgot entirely about fluid restriction with the renal/chf pt! What's a nurse to do when you see evidence (rales, swollen legs etc)...Lasix is not the cure entirely...especially on a cardiac floor where potasium is vital for cardiac output lol and bumex takes to long to push...well maybe not that long ;-)

Canoehead quote: The funny part was the nurse in me only really started to worry about her when she turned them down

Gosh, this really hit home; we want folks to eat and sometimes these diets appear so harsh to the patient's mind that they figure "better to not eat while I'm here"...and then 2 weeks go by pneumonia sets in followed by MRSA etc and bye bye...so sad

Sissyboo quote:If I live to be *OLD*...I don't want anyone telling me that I can't have my cookies or a piece of bacon... Let'em go out happy...

LOL I tell folks that I plan on smoking and drinking when I'm 90!

[LeahJet, ASN, RN]

This may be a little off topic but I remember a poor little 88 year old lady that was taking "too many pain pills" according to her daughter. The daughter lived out of state and made an appearance when mama was sent from the nursing home to the hospital.

She stayed on the doc's back about drying mama out and the whimp went along with it.

That poor woman!! It was pitiful.

I say, if you are over 85 and you want to eat cheeseburgers and shoot heroin........go for it. (a little extreme, but you get my point)

[morte, LPN, LVN]

worked at a nursing home, where a woman wanted a fried egg with breakfast, every day.....mind you not FOR breakfast, added to breakfast.....she was so obese she was nearly bed bound and diabetic.....they told her no, it didnt fit with her dietary regimen, she called the state, the state called the nh and told them they HAD to provide it for her......as long as she was minimally competent and could understand the consequences.......my thought was they should have charged her for it or told her to order out.......

[CaLLaCoDe, BSN, RN]

Somehow I wish there existed a mandatory food clinic for patients who just don't get it...perhaps very nicely prepared meals for an entire month and no cheating period...but that's just fantasy.

PS. If such a clinic did exist possibly some would enjoy the benefits of a nutritionally based diet (ie. more energy, less ballooning, better mood state).

[muffie, RN]

heart failure man on the ward

anxiously awaiting the doc to tap his huge ascitic belly

family brings in salty chicken with sauces from one of those chicken places ?!?!?!?!?!?!

okeydokey

[CritterLover, BSN, RN]

and cms wonders why the chf patients keep returning two days after we d/c them...... its isn't always the care (or lack of care) they received in the hospital, but lack of adherence to their diets (and meds) once they get home. though for some it is an availability of resources issue, for many it is simple choice.

[CaLLaCoDe, BSN, RN]

some diets or preparation offered by my facility look to grim to even pass health department standards....so, i may offer the family either go out to get their favorite soup or bring some home cooked meal to the hospital.

what is really tricky is explaining to family the case of silent aspiration with a recent diagnosed stroke patient or aphasia patient. ice chips offered too often during a shift or swabing of the mouth ending up in a deludge of fluid transfered to the victim to aspirate on.