Clever genius or Evil genius?

I have learned that sometimes in nursing, you have to trick
your patients to help them. I know this sounds awful, but it is for their own
good. Here is something I saw a few weeks ago, and I must admit, although it
was slightly evil, it was extremely clever. My patient’s roommate had severe Alzheimer’s.
She was weak from not eating, but didn’t like any of the hospital food. The
nurse sat down by the woman’s bed, took the lid off the food tray, and showed
the food to the woman. "Hmm… what’s that?" the woman asked. The
nurse told her it was macaroni and cheese, and then offered her a bite. The
woman put the food in her mouth, started chewing, and said, "Eww.. this is
awful," but ate that bite. She refused to take another bite. As I
mentioned before, she was weak and needed food, so it was important to get her
to eat, but she was being stubborn and refused. So the nurse put the lid back
on the food and left the room. She returned a few minutes later and sat back
down next to the woman to do something else, when the woman pointed at the tray
of food and said, "What’s that?" The nurse lifted the lid and said,
"Macaroni and cheese." The woman motioned for the nurse to give her a
bite. The nurse obliged, and right on cue, the woman said, "Eww… this is
awful!" So the nurse put the lid back on the tray, finished doing what she
entered the room to do, and left. A few minutes later, the nurse sent an aide
into the room to feed the lady a bite, leave until the woman had forgotten that
the food was gross, and then return to feed her another bite. In my opinion,
that is great nursing!! What do you guys think? Would you do the same, or fight
the woman and possibly let her go hungry?


21 thoughts on “Clever genius or Evil genius?

  1. I think it\’s PURE GENIUS! As long as the patient didn\’t get sick to her
    stomach eating the gross mac n cheese! I had a patient once with
    dementia.  She swore that her napkin was a pastry, and proceeded
    to pop it into her mouth and chewed on it.  I was terrified that she would
    swallow it and CHOKE! So I told her that the pastry was bad for her
    teeth, and that she shouldn\’t eat it.  Luckily she agreed and spat it out!

  2. How funny!  What a good idea!  I love the NJ Nursing Student\’s story on the napkin/pastry–how clever!  I would say and do the same thing in a second if it meant getting some food down–I\’m sure it\’s very needed.  😀

  3. Have to say that was a great way to get her to eat. I love working with
    the Alzheimers patients and you have to come up with all sorts of
    inventive ways to get them to do something that they generally don\’t
    want to do but need to. Imagination and a good sense of humor are 2 key
    essentials to nursing.

  4. Great nursing.  Very inventive.  Sometimes the patient needs a little help.  Love the blog by the way.  A little something to prep me as I ponder the path towards med school.

  5. Not really tricking her since she had a different sense of reality than you. Sometimes we must put ourselves in our patient\’s world in order to help them. The end result is one of care and concern. You are learning, grasshopper.
                                                        Nurse Bill

  6. Hey, that is quite the trick. Had a drunk driver that I had to do something very similar to. He would\’nt blow on the intoxilizer. I left him alone for a while and when I got back I told him that it was a Tuberculosis test that we had to give him and that the higher the numbers the more imune to T.B. he was . He blew a .140 I told him that was High enough to stay the night with us.

  7. Hi Katie!
    My vote is pure genius!  What a wonderful nurse to be so patient and made sure that her patient ate.  FYI- this works with finicky children too!  Just add the dramatics of tasting and making silly faces (to avoid showing your own disgust) to get them to eat!  It works!  I\’ve tried! LOL

  8. hmmm….my ethics class actually discussed that last year. it was an interesting debate. the way i see it is, because the woman has dementia, it is ok i think to help her eat that way, because i always think….if she didn\’t have dimentia, would she be eating? probably, yes. however, if the elderly person is in a lot of pain and is getting ready to pass (as was one of my patients about a month ago), i tend to focus my nursing care more on supportive aspects (pain control, end of life concerns, etc.) than nutritional ones. when in doubt though, you can always consult dietary. it is your right as a nurse and caregiver. even as a student you can do that. utilize resources that are there. i find that sometimes it is easy to forget the other services that are in hospital to aid in helping patients…we try and take on the world sometimes.

  9. wow ~ I thought this kind of thing that can only happen in the movies, but it seems I was wrong. you guys  are really doing a great work. Have a nice day!! ^_^ 

  10. Wow…that\’s slightly underhanded, but definitely for the patient\’s own good.  I have to give props to the nurse  though for taking so much time and effort to get the patient to eat!

  11. I think that is funny. I mean it\’s sad the food is gross, but what a clever way to get her to get some much needed nutrients!

  12. I live by the rules of my profession….Do no harm. I don\’t see how doing this would cause the lady any harm – you are helping her out the best way you know how. You aren\’t even lying!
    Now, if she asked, did you feed this to me a minute ago and then you said, "no" there might be a SLIGHT issue but even that – she\’s eating and not being supplied with a feeding tube.
    Right on – you nurses rock!

  13. Well, you\’re keeping her alive, right?  If she came into the emergency room with a bullet through her side, you\’d do everything you could to save her, regardless of her mental condition or what she wanted.  Not eating is not as urgent, but it is kind of a really slow-acting bullet if she continued to be malnourished.
    Sam is moving to Dallas, but he already found an apartment.  That was fast!  I\’m leaving on Thursday–I\’ll call you, and I\’ll leave a message if you don\’t pick up.  If I don\’t talk to you, have a safe trip!  Wish me a safe trip too!
    Love you. 

  14. I hope i never have this disease, I can see why its done and i can see it is in the \’best interests\’ but I think its also slightly unethical, but then im from a social work background and not nursing.  It would sit with me better if the food had been changed to something she might enjoy, i also realise this may not have been possible, but wouldnt it be more satisfying to know that even tho the patient couldnt remember at least she gained some pleasure.
    Its a difficult debate that doesnt sit easy with me because I feel that this kind of trickery is often used not for the best interests of patients.

  15. Personally, I think it\’s BRILLIANT!  (To quote the guys in the Guiness ads!)  You got the food into her without a lot of drama. 

  16. I had a patient not too long ago that refused to take his oral morphine, because it LOOKED like he wasnt getting a lot, even though it was like 4mg or something. He insisted he needed IV, but the MD\’s said no. (wont go into that) but to make a long story short and to relieve his pain…… when in doubt, just add water… heeehee. That little 5cc cup of Morphine that he insisted wouldnt do anything for pain turned into 25cc (with water) and his pain was gone.

  17. Absolutely clever!  How can that be evil?? You are trying to keep her alive and nourished.  You might even try telling her it\’s something she likes to eat and see if she notices it really isn\’t.  If she thinks it\’s a food she really enjoys, she may eat the entire portion! 

  18. That Alzheimer\’s patient would probably think ANYTHING was gross – I doubt there was something else she would have eaten with pleasure.  She probably whould have liked being fed orally better than by tube.  I would have issues with some kinds of trickery, but not this – anyone who can help an Alzheimer\’s patient has my blessing.  It is the cruelest disease and working with these folks (who in their pre-Alz days would be mortified to behave as they now do) is one of the most thankless tasks on Earth.  The near and dear commonly buckle under the pressure.  This person has been placed in your care, she must eat and any means to that end is fine, barring torture and harm.  It is ridiculous to apply rational standards to irrational people when the intent and result is beneficial.  It seems to me that when a person places himself or another in the care of a hospital, the hospital must do what works, not what the patient likes, to provide that care.  Otherwise, I would be getting chocolate pills and IV whiskey sours. 

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