Published Nov 26, 2008
CapeCodMermaid, RN
6,092 Posts
Do all of you do weekly weights on all your residents? We were until I came along and changed the policy to fit the state regs: weigh on admission then for 4 weeks and if stable, weigh once a month. Well...the dietician is up in arms saying that's not enough...the medical director suggests once a week for 6 months!!! and weekly with anyone on a diuretic. Let's be real, people. I'm on a diuretic and my weight is stable. I can see weekly weights with a NEW order for a diuretic but some of these people have been on the same dose for years. Why aggravate people with needless work?? What do you all think? I'm thinking the dietcian thinks we'll get rid of her if we only do monthly weights. We will always have some people who need to be weighed weekly but everyone?
Lovely_RN, MSN
1,122 Posts
Weekly weights on everyone? Yikes! That would drive the CNAs at my job to drink....they hardly have enough time to do the monthly ones as it is. We only do weekly weights if it's necessary for that particular resident and daily weights are rarely done at my facility.
CT Pixie, BSN, RN
3,723 Posts
When I started at the facility I am currently at, there were loads of residents with weekly weights. Then someone changed it to monthly for everyone unless there is a reason for a weekly. Much easier on all involved now, especially the residents.
My facility is stuck in another time zone...we aren't supposed to suggest anything to the doctors! It's unbelievable. I don't really care about having enough time, but why make more work for your CNAs and yourself?
evilolive07, BSN
32 Posts
I never have to do weekly weights, that is generally a day/evening shift responsibility (I do 11-7) but as far as I've noticed, we do weekly weights on EVERYONE on my unit. I'm not really sure what the motivation is behind this, but I think it's because it's a good measuring tool for any kind of general decline that may be happening for our residents. They often lose weight when they're ill, or go in and out of the hospital...and let's not forget those Lasix pts. We also have people on restrictive diets, diabetics, pre-diabetics, and tube feedings.
That's all I can think of for a rationale right now. Plus we have a mock survey next week, joy.
KarangRN
15 Posts
At our facility we have an IDT Nutrition at Risk committee with our Reg. Dietician as chair and we decide on who to upgrade or downgrade to weekly vs. montly weights. Anyone on the team, soc. svcs. included can ask for weekly weights but if its brought up in committee we discuss before putting them on nsg. measure weekly weights. Not sure what it is in other states but in Hawaii tube feeders are weighed weekly as well as anyone that is being observed for significant weight change. Also SNFs get weight weekly until either downgraded or the NAR committee determines they are stable enough to go to montly weights...we just gotta document in the chart, mds and care plan our rationale.
When someone goes on a diuretic for the first time they go daily, then weekly weights. We monitor them for a few weeks then decide in the NAR committee if they can come off weekly weights and go to monthly.
Our floor nurses are also good about seeing weight fluctuations or new onset/exacerbation of CHF and will automatically change a person who is on monthly weights to weekly or even daily weights.
And of course the PCPs can order daily/weekly weights but if they stablize after an intervention we generally ask them to DC daily/weekly weights.
achot chavi
980 Posts
CCM I agree with you on this, I would do daily weight if the situation justified it but...lets not abuse the CNA's for no reason. IF the weight is stable for 4 weeks- go to monthly. You can always go back to weekly if there is a change.
You need to speak to your dietitian, and doctor to make a decision. I would be firm on this.
debRN0417
511 Posts
yeah...lets just weight everybody everyday and be done with it......
Seriously CapeCodMermaid, I agree with you. There has to be a limit. Once stable on a diuretic, why continue? Would they do it at home...No....it is crazy to do all that weighing. What purpose does it serve?
PsychNurseWannaBe, BSN, RN
747 Posts
We do weekly weights (sometimes the list for the day has 10 - 12 residents) Weekly weights are AM shift responsibility, along with daily weights. Daily and Weekly BPs are PM shift. It can get very hectic for the Aides to get the weights, plus the vitals for people on report. We do not have anyone on monthly weights regardless if they have been there for years. Weekly or daily...that's it. Ugh... and the kicker is they don't do them on the weekends. Why not spread it out? Kinda confusing.
Do you have enough scales? are they user friendly? If this is a problem you can ask for another scale bought to accommodate this new demand. I would also track the weights for a month to prove that it is wasteful use of resources.
Although again I repeat that if the patient needed it I would do daily weights
It goes without saying that you must weigh at the same time of the day with similar weight clothes or the comparisons worthless.
It's just the "we've always done it that way so why change" attitude. Makes me crazy. Things should be based on CLINICAL need not facility history.
IowaKaren
180 Posts
I here ya. New admit x 3 days in a row, then twice weekly, some daily, whatever. It's enough to drive you bonkers with human/scale error almost continuously and reweighing daily. We are like a small hospital with all the labs, Dr. visits, sending them out for evaluation, medication changes daily, etc. Drives the Doc's crazy but heaven forbid if they don't live to be 100, who cares about quality of life though. As long as Momma or Daddy are the family icon of longevity, that's all they care about. I think so many residents would do much better if they had a drug holiday to see exactly what they need but the families would be up in arms over that one. As you can see, we do have a lot of family involvement (which is good) but it can be so extreme at times and sure can keep the anxiety level high for the Resident. And of course, the family knows best. :icon_roll Now add the dietician and that is another subject all together.