Help! Problems At Work Re: Diabetic Pt, Rights

[debow261]

I Work In A Ltc And Rehab Nursing Home. I Have A Pt With Diabetes That Wants To Eat Sugar, Sugar,and More Sugar. Surprisingly Her B.s. Is Finally Under Control With Po Meds. But I Have Another Pt. That Is Able To Go To The Store And Buy Her Sweets So When I Asked The Pt To Quit Buying Her Sweets (with The Diabetic Pts Money Of Course) This Pt Turned Me In To The Don . The Don Said I Was Wrong Because Alert & Oriented Pts Have Rights And She Can Eat Whatever She Wants And All I Have To Do Is Chart This? I Thought We Are To Discourage And Take Care Of Pts, Not Let Them Go Into Diabetic Coma? Anyone Know What Is The Right Answer ? I Just Find This Hard To Believe Due To Pts Rights? Help In Florida Thanks

[ktwlpn, LPN]

What I notice about this thread is that there seems to be little effort on the part of the staff and the facilities to assess and address WHY these patients are non-compliant. The attitude seems to be that telling a person what to do and why should be sufficient.

Research shows us that there are LOTS of factors that influence why some patients are compliant and others are not. Until we understand and address those factors, we can talk at them until we are blue in the face and it won't change their behavior.

Another thing ... Maybe some diabetic patients would eat less sugar if they had readily available sugar-free snacks. As a diabetic myself, I know I am much more compliant when healthy choices -- that are also appealing -- are right in front of me. What are your institutions doing to have healthy and appealing choices readily available for those patients? Even if it ends up being a "compromise choice" that is not the ideal but is better than pure sugar, it would help the patients to avoid the worst choices and begin to help them develop healthier habits.

Every non-compliant resident I have cared for in LTC was admitted with a LONG history of non-compliant behavior at home.Usually the family/s.o.'s are co-dependent and food becomes a major issue. You are suggesting that we should be able to change that-we can not....My facility does offer healthy snacks for diabetics,both straight from food service and in some of the vending machines.The non -compliant would still rather eat a bag of Hershey bars.It's a form of passive suicide imho-and once they enter our doors the behaviors accelerate and I can't blame them.I work there every day-even though I believe we give the best care in the area I still would not want to live there. We have obtained slding scales topping out at 500 to 550 for several hard core non-compliant residents.I don't believe in shaming,humiliating or verbally harassing them-I generally just re-enforce the care plan and move on..