Thoughts on vegetarian/ vegan diet

brownbook · Feb 19, 2019

45 minutes ago, hherrn said:
Why?
It is an integral part of many nursing jobs.

I have toooo much respect for Registered Dietitians to presume I could give appropriate dietary advice.

A BS at an accredited university, or entry level Masters Degree.. Completed an ACEND accredited supervised practice program, typically a 6 - 12 month program, passed a national examination by the Commission on Dietetic Registration.

I don't presume the average bedside nurse with 4 - 8 patients has the knowledge or time to advise patients.

I guess if you had one on one time as a public health nurse or some other areas of nursing it would be appropriate.

I have overheard some wacky ideas from co-workers about diet advise to each other. To say nothing of the original poster wanting to give advise to patients about a vegan diet, or a co-worker of mine telling patients coffee was bad for them.

Davey Do · Feb 19, 2019

2 hours ago, Sour Lemon said:
They're not all that way ...but the ones you hear from frequently may be.

Your perceptions are so folk philosophical, Sour Lemon.

There are vegans who are "obsessed and evangelical" to quote Emergent. But as the old saying goes...

"The squeaky vegan gets the vegetable oil!"

Emergent, RN · Feb 20, 2019

1 hour ago, Davey Do said:
Your perceptions are so folk philosophical, Sour Lemon.
There are vegans who are "obsessed and evangelical" to quote Emergent. But as the old saying goes...
"The squeaky vegan gets the vegetable oil!"

Speaking of vegetable oil, my vegan cousin, who is on the plant-based diet, is totally opposed to it. She even has her 2 Bijon Frises on a vegan diet. They are always having to go to the vet's. When she's not talking about how great the diet is, she's talking about her health problems (all of which were worse before, naturally) ?

OldDude · Feb 20, 2019

29 minutes ago, Emergent said:
Speaking of vegetable oil, my vegan cousin, who is on the plant-based diet, is totally opposed to it. She even has her 2 Bijon Frises on a vegan diet. They are always having to go to the vet's. When she's not talking about how great the diet is, she's talking about her health problems (all of which were worse before, naturally) ?

I used to work with a RN who is a vegan. When he was about 40 he tripped while going UP his stairs at home and snapped his right greater trochanter completely in half. I often told him is was because of his "healthy" diet...he never believed me. I still think the diet was the cause.

JKL33 · Feb 20, 2019

2 hours ago, brownbook said:
I have toooo much respect for Registered Dietitians to presume I could give appropriate dietary advice.
A BS at an accredited university, or entry level Masters Degree.. Completed an ACEND accredited supervised practice program, typically a 6 - 12 month program, passed a national examination by the Commission on Dietetic Registration.
I don't presume the average bedside nurse with 4 - 8 patients has the knowledge or time to advise patients.
I guess if you had one on one time as a public health nurse or some other areas of nursing it would be appropriate.
I have overheard some wacky ideas from co-workers about diet advise to each other. To say nothing of the original poster wanting to give advise to patients about a vegan diet, or a co-worker of mine telling patients coffee was bad for them.

brownbook, with respect -

I have to disagree. As far as general information/education/health promotion, that is one of our major roles.

Pharmacists are in the medication realm - shall we not do medication instruction/education, then?

Physical Therapists are specialists - should we not educate about activity limitation or promotion as appropriate for our patients' conditions?

Respiratory therapists have their realms - can we instruct about inhaler use, smoking cessation, use of I/S, or any other number of things that could cross into their territory?

Etc., etc.

If a nurse doesn't have time for any education/health promotion, there's a problem. The amount of things we are expected to do that don't directly involve interacting with patients is a problem.

If what you mean is that you don't think it's appropriate to spontaneously promote a particular diet based on personal beliefs or preferences, I would agree with you. But other than that I think you have overgeneralized a little bit. ?

KatieMI, BSN, MSN, RN · Feb 20, 2019

1). If you took Nutrition course as an RN, you should be able to offer some sensible advice. You cannot refer out 100% of everything. BTW, consulting services of RDs tend to be not covered by insurance and seriously good RDs are few and far between.

2). Vegans' (as well whoever else's) evangelical, philosophical, political and other such issues is out of our scope of practice as long as they do not do something clearly reckless with their dependants.

3). Categories of patients who must not go vegan by themselves (educate, discourage, get provider on board STAT):

- coumadin users (too much vit K)

- cancers of breast, ovary, uterus, prostate AND patients' BRSA-positive relatives, male and female (soy based foods have too much phytoestrogens, can potentially cause tumor growth and/or progression)

- CHF and uncontrolled HTN (a lot of sodium in soy-based stuff and meat substitutions)

- uncontrolled DM (carbs, especially in juices)

- renal disease stage III and down, especially HD (sodium, potassium, phosphorus, aminoacids imbalance)

- extracorporeal insemination/females (phytoestrogens can interfere with treatment)

4). Educate about: reading labels (protein content, vitamins enrichment); NO preference for "natural/organic" (these foods are frequently not enriched with microelements and vitamins, especially iodine), reaching beyond staples (seaweed is one excellent source of B12 and iodine, naturally pickled veggies like kimchi and homemade crout are rich in all B vitamins, and so is fresh craft beer), the fact that full and working vegan diet takes A WHOLE LOT of education, almost daily elements counting and money OR time spent in kitchen (people seem to be not aware of this simple fact).

5). Going vegan is OK. Making your baby vegan AND ignoring medical advice is not and will be reported to authorities.

WestCoastSunRN, MSN, CNS · Feb 20, 2019

We shouldn't teach anything not evidence based. But there are plenty of guidelines (disease specific and for well) by CDC, AHA, etc. that nurses can rely on, as well as RD advisement for specific patients/conditions.

I also agree with a poster about counseling people who are already vegans... veganism isn't a prescription by any evidence based standards I know of, but as nurses we need to know about it and how to help people make sure they are getting the nutrients they need. There are reliable resources for these purposes and it is a nurse's job to educate.

PeakRN · Feb 20, 2019

There are ways for many adults and older kids to receive all of their nutrition through a vegan diet, but it something that is pretty difficult and requires a high degree of competence. Humans evolved to eat a mixed diet of plants and animal proteins so that is what we do the best with by default, but generally doesn't preclude plant only based diets.

The amount of effort and depth of knowledge required to guide someone who wants to pursue a vegan diet is far greater than the typical dietary recommendations given by nurses. Personally I cannot even remotely consider myself competent to advise a patient on this, nor most likely the vast majority of nurses.

I don't think that it is unreasonable to recommend consultation with a RD. While this may be pricey the long term benefits of a healthy diet are an investment worth making.

allnurses Guide · Feb 20, 2019

When people ask me about a particular diet I will give education on how to vet a website so they know what they are reading is evidence based and not a lot of Hokum. I generally stay away from the topic unless it's about what works for me. I won't do any diet that exclusively restricts any food item. Being a foodatarian allows me to practice moderation in all things which makes me happy.

But I am also a member of the other PETA

https://beardeertshirt.wordpress.com/2011/09/18/peta-t-shirts-people-eating-tasty-animals/

RobbiRN, RN · Feb 20, 2019

Being vegetarian doesn't make a person healthy, but it can contribute to a healthy lifestyle. I was raised vegetarian and never found a good reason to change. 25 years into ER nursing, I can still do four 12's in a row and 2 hours of non-stop dance fitness with kids half my age. I have no ongoing medical problems and take no meds. My co-workers regularly come into the break room and tell me my food smells great--then moan when I tell them it's a garden burger. I just laugh and say, "Hey, you want to race across the parking lot?"

glencovediva · Feb 20, 2019

I have been a vegetarian for about 20 yrs. I would NEVER go back to eating animals!! I would advise patients to cut down on the processed , high fat and sugar foods and drinks. A consult with an RD would also be best because they are experts in the nutrition field.

K+MgSO4, BSN · Feb 20, 2019

Beware of young people suddenly moving to a vegan lifestyle. It can be a flag for an eating disorder as it normalises restrictive eating behaviours.

However I have conversely had a patient admitted with LOW ? Eating disorder. Basic bloods showed a sky high CRP, further investigation showed horrifically stirctureing Crhons disease. Poor kid had been trying to deal with the pain and complications by diet modifications. Poor thing didn't know that his high fibre diet was making things worse.

This case is the hoofbeats / zebra situation but if a patient declares a major lifestyle change dig deeper. Is it side effects of their current diet, eating disorder, financial (believing that they can grow enough veggies to keep going...another interesting case of someone in a 3rd floor apartment).