"Force Feed"

Flynurse · Apr 29, 2003

Originally posted by Desert Rat
One day he decided to show us how to feed a patient. After the patient told him several times he didn't want any more. he spit it in the doc's face. Really hard to keep from laughing. :roll Other times he caused the patient to aspirate, then blamed the nurses.

I used to work at a private facility (retirment community with one floor dedicated to sub-acute and LTC) in which we branched into many areas. From Rehab to Hospice. Anyhow, a patient came to us who had surgery and just went down hill one day. It was obvious to us she could not eat or drink. Her living will simply stated no heroic measures to try and save her life. So with her wishes and her families "blessing" we didn't feed her. We didn't put in a tube, etc.

One day her primary MD came to the facility and started ranting and raving that we were starving her to death. He started feeding her and of course she aspirated. :eek: Needless to say the police were called and arrived shortly after she had aspirated to escort the MD out of the building. All the while he was yelling, "You are trying to kill her!"

Well, wouldn't you know it for the next week or two the woman had gone down hill even further and we were all sure she wasn't going to make it. But then one day she started talking again. She was asking for food and water. Her swallowing reflexes had returned! :)

The following week I was working on Sunday during the day shift as a favor for someone. The nurse who was taking care of this woman and I were sitting at the station reading the Sunday paper (relaxed atmosphere ) when she nearly fell over in her chair. She shouted, "You guys, you'l never believe this!" Stunned we all wanted to know what and gathered near. "Remember the doctor who came and tried to feed Mrs. X and nearly killed her? He's dead! His obituary is in the paper."

Wouldn't you know it. The man dropped dead before his patient had. We don't know what of, but we suspected he aspirated on something.

Makes ya think.

Flynurse · Apr 29, 2003

Originally posted by Desert Rat
One day he decided to show us how to feed a patient. After the patient told him several times he didn't want any more. he spit it in the doc's face. Really hard to keep from laughing. :roll Other times he caused the patient to aspirate, then blamed the nurses.

I used to work at a private facility (retirment community with one floor dedicated to sub-acute and LTC) in which we branched into many areas. From Rehab to Hospice. Anyhow, a patient came to us who had surgery and just went down hill one day. It was obvious to us she could not eat or drink. Her living will simply stated no heroic measures to try and save her life. So with her wishes and her families "blessing" we didn't feed her. We didn't put in a tube, etc.

One day her primary MD came to the facility and started ranting and raving that we were starving her to death. He started feeding her and of course she aspirated. :eek: Needless to say the police were called and arrived shortly after she had aspirated to escort the MD out of the building. All the while he was yelling, "You are trying to kill her!"

Well, wouldn't you know it for the next week or two the woman had gone down hill even further and we were all sure she wasn't going to make it. But then one day she started talking again. She was asking for food and water. Her swallowing reflexes had returned! :)

The following week I was working on Sunday during the day shift as a favor for someone. The nurse who was taking care of this woman and I were sitting at the station reading the Sunday paper (relaxed atmosphere ) when she nearly fell over in her chair. She shouted, "You guys, you'l never believe this!" Stunned we all wanted to know what and gathered near. "Remember the doctor who came and tried to feed Mrs. X and nearly killed her? He's dead! His obituary is in the paper."

Wouldn't you know it. The man dropped dead before his patient had. We don't know what of, but we suspected he aspirated on something.

Makes ya think.

MandyInMS · Apr 29, 2003

Originally posted by Nurse Ratched
I think the doc may want to reconsider his choice of words:

"Encourage po intake."

I, too, remember doing the syringe thing with pureed foods "back in the day", nightmoon. If I had to do it over again, I wouldn't.

DITTO....MD's wording is wayyy off...all you can do is encourage foods/snacks/supplements...you cannot "force" an alert /oriented person to do anything against his/her will for goodness sakes.Immagine this pt is YOU...how would you react? Can't post how I'd react..would be too many profanities...lol

MandyInMS · Apr 29, 2003

Originally posted by Nurse Ratched
I think the doc may want to reconsider his choice of words:

"Encourage po intake."

I, too, remember doing the syringe thing with pureed foods "back in the day", nightmoon. If I had to do it over again, I wouldn't.

DITTO....MD's wording is wayyy off...all you can do is encourage foods/snacks/supplements...you cannot "force" an alert /oriented person to do anything against his/her will for goodness sakes.Immagine this pt is YOU...how would you react? Can't post how I'd react..would be too many profanities...lol

renerian, BSN, RN · Apr 29, 2003

Desert rat............served him right to be spit at!

renerian

renerian, BSN, RN · Apr 29, 2003

Desert rat............served him right to be spit at!

renerian

ceecel.dee, MSN, RN · Apr 29, 2003

Originally posted by ktwlpn
...."force feeding" this fella would be assault and battery,wouldn't it?"

Absolutely!

"I am sure that you are doing all that you can with supplements and goodies"

Absolutely! This is a gentleman, who says "I'm sorry you girls will have to write down that I ate so little, but I am really trying.":o

This man is sick, not obstinate! :eek:

ceecel.dee, MSN, RN · Apr 29, 2003

Originally posted by ktwlpn
...."force feeding" this fella would be assault and battery,wouldn't it?"

Absolutely!

"I am sure that you are doing all that you can with supplements and goodies"

Absolutely! This is a gentleman, who says "I'm sorry you girls will have to write down that I ate so little, but I am really trying.":o

This man is sick, not obstinate! :eek:

ceecel.dee, MSN, RN · Apr 29, 2003

Originally posted by susanmary
To start, your patient needs a nutrition consult. He may also have some depression (small wonder -- doesn't mean he's got major psych issues -- but depression might be caused by his surgery, and prostate cancer. He needs support -- not ultimatums.

I would refer this case to your manager, and the ethics committee. Encourage a patient to eat, wonderful. Assist a patient with meals & snacks, wonderful. Force feed a patient -- never. Unethical, humiliating. Does he have any family? I would also start documenting verbatim when the patient states he is not hungry, etc, & his refusal to be "force fed."

Our patients deserve to be treated with respect and dignity. This kind of case makes me very sad -- but I would follow up the chain of command if he were my patient. Good luck. He's lucky to have such a caring, compassionate patient advocate for a nurse!!!!
Sue

Sue, you are aligned exactly with my line of thinking. I agree with everything you said!

Unfortunately, no ethics committee, but we derailed this order before any "forcing" would even be contemplated!

Patient refused feeding tube after surgeon's sales pitch.

Do you know what I suspect? The surgeon is considering his "stats". A couple of routine hip pinnings died before the magic "surgical recovery period". They were OLD, and the death were not his fault, but still recorded on the "stats sheet". Some admits directly to ICU from PAR that were not anticipated....noone could blame him for any of these, (he really is an excellent surgeon), but could this have anything to do with this order?

Would love your opinions!

ceecel.dee, MSN, RN · Apr 29, 2003

Originally posted by susanmary
To start, your patient needs a nutrition consult. He may also have some depression (small wonder -- doesn't mean he's got major psych issues -- but depression might be caused by his surgery, and prostate cancer. He needs support -- not ultimatums.

I would refer this case to your manager, and the ethics committee. Encourage a patient to eat, wonderful. Assist a patient with meals & snacks, wonderful. Force feed a patient -- never. Unethical, humiliating. Does he have any family? I would also start documenting verbatim when the patient states he is not hungry, etc, & his refusal to be "force fed."

Our patients deserve to be treated with respect and dignity. This kind of case makes me very sad -- but I would follow up the chain of command if he were my patient. Good luck. He's lucky to have such a caring, compassionate patient advocate for a nurse!!!!
Sue