Published Jan 28, 2007
CaLLaCoDe, BSN, RN
1,174 Posts
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
940 Posts
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
90 Posts
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
162 Posts
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
6,901 Posts
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.
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
486 Posts
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
7,015 Posts
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.......
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
1,411 Posts
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
929 Posts
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.