Sometimes Nurses Say No

[trailerparkmedic]

I admit, I wasn't one of the nursing students who walked into nursing school all starry eyed about how I was going to save the world. Like Dr. Cox, I generally think people are bastard coated bastards with bastard filling (you can thank the credit card call center that put me in retention for that). I was naive enough, however, to think that patients would actually listen to me as a nurse.

So I go into a patient's room and see that his family has brought in a big bucket of fried chicken. It's like 7 am--where do you get chicken that early?? It's important to know that eating before surgery=badness. This patient's surgery was scheduled for the afternoon but they shouldn't have eaten anything all day, per hospital policy.

Me: Patient, have you eaten any of that chicken?
Patient: Yes.
Me: Were you told that you couldn't eat anything? You were scheduled for surgery this afternoon.
Patient: When I called to order breakfast they wouldn't bring me anything so I got my family to bring me some food.
Me: Ok, I need to let your doctor know about this and they'll be the one to make the call, but we are probably going to need to reschedule your surgery. I would also strongly encourage you to stop eating that chicken because it is incredibly high in salt and that is going to really complicate your chronic diseases with nasty side effects that caused the need for this surgery. (A condensed HIPPA friendly version of what I really said)
Patient: All you nurses ever say is "No!" No food! No surgery! No decent food! I thought you were supposed to help me, not keep knocking me back down!
Me: Let me call your surgeon. If we reschedule your surgery I'll talk to dietary about getting some food sent up now.
Patient: You call whoever you want, but I'm having my damn surgery today, and I'm eating my damn chicken. This ain't no way to treat a paying customer!

Needless to say, the patient did not have surgery that day.


And this is why I have a MiM thread about why patients are not customers.

[Seshat]

Didn't his doctor explain to him that he couldn't eat anything the day before surgery?

[trailerparkmedic]

Didn't his doctor explain to him that he couldn't eat anything the day before surgery?

Yes. The night shift nurse also explained it. And dietary explained why he couldn't order breakfast. This patient was just obstinate and difficult to work with because he wanted everything done his way on his time frame.

[Iris Kojiro]

I'm toying with the idea of getting into nursing, and I've already got a healthy coat of cynicism from 7+ years as a pharmacy technician, most of that as an unofficial lead tech.

Yeah, I get my share of patients who do (insert bad thing here) despite being on medications that specifically call for NOT doing (bad thing).

[Seshat]

Yes. The night shift nurse also explained it. And dietary explained why he couldn't order breakfast. This patient was just obstinate and difficult to work with because he wanted everything done his way on his time frame.

......


Le sigh.

No wonder I'm listed as 'highly compliant'. Even when I don't always do all my prescribed exercise.

[LillFilly]

I'm curious to know of his reaction when he was told he'd just caused his surgery to be postponed. I'm sure he foisted the fault off on you guys; probably complained about the increased bill from the extra time he needed to stay too.

Kinda makes me think of the guy who was in the hospital and wanted a smoke, so he went into the bathroom and tried to disable the smoke alarm which set the system off anyway and caused an evacuation.

These people; the world just has to revolve around THEM!

[Rapscallion]

Fried chicken is something he defines as good food? Damn. It's fine on occasion, but if that's his idea of solid nutrition then there's a good reason he's in hospital.

Rapscallion

[TheSHAD0W]

Sometimes you have to be a bit graphic about the consequences of actions to get ideas through a patient's skull. "One side effect of the drugs we use to put you to sleep is nausea. If you have food in your stomach, you'll puke it up, then because you're unconscious and flat on your back you'll breathe it in and DIE. That's how Jimi Hendrix died, y'know?"

[thansal]

Fried chicken is something he defines as good food? Damn. It's fine on occasion, but if that's his idea of solid nutrition then there's a good reason he's in hospital.

Rapscallion

I do believe good meant tasty (to him) in this case :P

[blas]

I've always wondered about people bringing in food to hospitals for people.

Although one of my former coworkers, who had already had one baby before and was due to have her second, knew that once she got there, she couldn't eat once they got the process going, so while she was in the early stages of labor, she had her boyfriend take her through the McDonalds drive thru and she scarfed that food down as fast as possible before they got to the hospital, because all they'll give you is ice to chew on once you're admitted.

I can honestly say, if hell freezes over and I'm expecting a child......I will be riproaring through either McDonalds or Taco Hell with my water gushing all over the floorboards and possibly the head crowning.

[telecom_goddess]

I can honestly say, if hell freezes over and I'm expecting a child......I will be riproaring through either McDonalds or Taco Hell with my water gushing all over the floorboards and possibly the head crowning.

I can just see that too

I never understood why they won't let you eat when you're in labor in a hospital....it's been proven that if you have a home birth you can eat or do whatever you want and things generally turn out fine.

[NorthernZel]

I can just see that too

I never understood why they won't let you eat when you're in labor in a hospital....it's been proven that if you have a home birth you can eat or do whatever you want and things generally turn out fine.

I guess Panacea can/will elaborate on that, but I suspect that the hospital wants to make sure that it is safe to perform an emergency C-section (i.e. a surgery) if they need to. Also, I don't know what impact an epidural has on one's digestional system...

[Kiwi]

My Mother took her DIL some food after she had been in labour 37 hours and was sobbing she was so hungry. The hospital staff had a fit but thb in her position I would have had something to eat as well. I would have to be dead not to eat for 37 hours!

[Sapphire Silk]

I never understood why they won't let you eat when you're in labor in a hospital....it's been proven that if you have a home birth you can eat or do whatever you want and things generally turn out fine.

I guess Panacea can/will elaborate on that, but I suspect that the hospital wants to make sure that it is safe to perform an emergency C-section (i.e. a surgery) if they need to. Also, I don't know what impact an epidural has on one's digestional system...

And here I am, happy to oblige!
Zel is right . . . if we have to perform an emergency section, the stomach should be empty.

Women who get epidurals can't get them before 5cm dilation of the cervix, or after 8 cm as a general rule. The epidural slows down the labor if given too early, and may not be able to be inserted quickly enough if too late.

If she doesn't have an epidural, that means general anesthesia. If you are out from a general, you can't protect your airway, which is why you are intubated . . . but even then you can still aspirate vomitus, and that can be lethal.

Epidurals don't generally affect the GI system per se. They can affect the fetus; the baby is often very sleepy after birth and may not want to feed.

The OP posted about a common problem with pre-op patients. This one is the poster child for non-compliance.

[Seshat]

I've always wondered about people bringing in food to hospitals for people.

My parents taught me (by demonstration) that it's okay as long as you ask first. If the patient's medical staff say 'no', bring them flowers or balloons or pictures of family instead.