So dietitians can now write orders: Denial of rights.

Nurses Relations

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Well first I had no clue that dietitians can now writes orders and take verbal orders from physicians (depending on state) but it was put forward by CMS and practiced. I don't get many memos. Yet,now out of my daily curiosity, or more like checking the weekly **** ups I found the dietitian wrote an order by any standard is a denial of rights of the patient. When I asked my house supervisor how? I got an "its a known issue", yet its a known issue for 10 days and no one has done anything.

The rational is what killed me was "due to infection control". So, what am I missing? Am I in the wrong thinking this is Waaaaaaaa(a^1000)aay outside a dietitians scope of practice? Or am I an uppity nurse that needs to shut up?

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
there was a post a few back. Gotta follow with me or you'll get left behind. It's no the ordering of the diet that is an issue. It's the enforcement. I give enough forced medications by court order to know what enforcement is. If someone doesn't want insulin well although I might educate them to the reason and do everything I can they still have the right to refuse the diet as treatment.
Could you reference that post....I am still not following.

Yes they can refuse the diet but the dietician is not under any obligation to change the order. They can choose whether to refuse and go hungry....or eat it and do what they want when they go home.

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Specializes in Complex pedi to LTC/SA & now a manager.

Is the dietician ordering a diet such as 2100 kcal ADA patient refusing the diet and dietician insisting patient be forced to consume ADA meal "as per the "law"" or starve? Does the patient want a regular diet?

The physician can override a dietician order.

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Could you reference that post....I am still not following.

Yes they can refuse the diet but the dietician is not under any obligation to change the order. They can choose whether to refuse and go hungry....or eat it and do what they want when they go home.

Agreed. I think sometimes people confuse the right to refuse with a right to be "housed" at the hospital or facility indefinitely. If you don't want to follow the treatment plan, that's cool, but you need to do that at home instead of wasting everyone's time and money.

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Specializes in Hospital Education Coordinator.

FYI: Our dieticians are both licensed and registered, just like nurses. They can write orders pertaining to nutrition. They frequently collaborate with the nurses and MD's in the care of the patient, as when the MD prescribed diet is not deemed appropriate, infection control issues regarding interal/parenteral feeding, blood sugar elevation due to formula consumed---the trick is to communicate

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Could you reference that post....I am still not following.

Yes they can refuse the diet but the dietician is not under any obligation to change the order. They can choose whether to refuse and go hungry....or eat it and do what they want when they go home.

Yes, I'm having trouble finding that post as well. And this thread isn't that long. I don't remember discussing a "vitamin".

This is a very confusing thread.

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Here are all your comments . . .. where is the vitamin before the post where another poster asked about the vitamin you mention??? How can we "keep up" with something we can't find?

Well first I had no clue that dietitians can now writes orders and take verbal orders from physicians (depending on state) but it was put forward by CMS and practiced. I don't get many memos. Yet,now out of my daily curiosity, or more like checking the weekly )@$*U@) ups I found the dietitian wrote an order by any standard is a denial of rights of the patient. When I asked my house supervisor how? I got an "its a known issue", yet its a known issue for 10 days and no one has done anything.

The rational is what killed me was "due to infection control". So, what am I missing? Am I in the wrong thinking this is Waaaaaaaa(a^1000)aay outside a dietitians scope of practice? Or am I an uppity nurse that needs to shut up?

Locked unit mental health. Pt voluntary for addiction. Unit restriction r/t non infectionous skin condition.

I am trying to say without saying to much.

Figured my last post would have been clear as mud, but from what I see as replies diets should be only thing they should be writing.

Sounds like a mon day issue for the don and as of right now I won't be following the order. Since as far as I know within my state restrictions of rights with the hospital still falls on providers and nurses

the vitamin came up today on another patient. So far in my research there is nothing allowing this or policy at the facility. I've caught her stepping over the line previous in forcing patients to accept their diet. Pt has the right to refuse treatment no matter what it is. She told me a diabetic cant refuse a diabetic meal ordered for them that the ADA diet is "LAW". I looked at her and handed a copy of the patient rights given to every patient.

I was checking state law in regards to this and saw little to nothing. Matter fact its specific that dietitians can not dx anything according to state law, which was a rational for the reason of this original post.

Sorry I might work in mental health, but I give a damn about my patients.

there was a post a few back. Gotta follow with me or you'll get left behind. It's no the ordering of the diet that is an issue. It's the enforcement. I give enough forced medications by court order to know what enforcement is. If someone doesn't want insulin well although I might educate them to the reason and do everything I can they still have the right to refuse the diet as treatment.
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Specializes in LTC Rehab Med/Surg.

This thread makes me smile. Twenty seven responses to sketchy information.

We don't even know what the question or the concern is.

I've seen perfectly worded and thought out threads die after 6 posts. This one is clear as mud, and it's developed a life of it's own.

Look at me. I'm the 30th post and I don't have a clue about what exactly the OP is asking.

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I have absolutely no idea what this thread is about.

Did someone leave the door to the day room, where the computer is, unlocked again?

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Specializes in Hospital Education Coordinator.

aren't people funny? Group dynamics lab is now closed.

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This thread makes me smile. Twenty seven responses to sketchy information.

We don't even know what the question or the concern is.

I've seen perfectly worded and thought out threads die after 6 posts. This one is clear as mud, and it's developed a life of it's own.

Look at me. I'm the 30th post and I don't have a clue about what exactly the OP is asking.

Too true . . . . but I think we just want to be helpful and we simply cannot be helpful with sketchy information.

:)

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Specializes in Emergency, Telemetry, Transplant.
I'm not quite following the vitamin part

I'm sure many patients would prefer lobster to shepherd's pie, but the patient doesn't have a "right" to lobster, only to food, which shepherd's pie counts as (although I might argue differently).

I too am quite confused about the vitamin part--it seems to really have nothing to do with the OP or infection control issues.

However, I have a big problem with the shepherd's pie comment. If it is done correctly, it is awesome. :up:

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Specializes in Emergency, Telemetry, Transplant.
Figured my last post would have been clear as mud

Oh it was...

(sorry for the snark :sorry:)

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