I don't think that I ever realized just how many things nurses keep track of in regards to their patients. I have charted before for nutrition evaluations, but all I have to talk about is someone's diet. If it doesn't have to do with their eating or bowel habits, it likely won't be in my note (unless there is some psychosocial issue affecting eating or nutrition).
Nurses, on the other hand, are responsible for keeping track of the person as a whole. After I had been in the hospital for about 5 days, one of my nurses said, "Let me know when you are ready to take your shower so I can change your sheets." I figured that this was just because my sheets hadn't been changed in about 3 days (I hadn't requested to have them changed because I don't change them every 3 days at home so I figured that I wouldn't request others to change them that often), and it would be a convenient time for her to change the sheets while I was out of bed. But when I got out of the shower, not only were my sheets changed, but my nurse came back into the room and charted that I had taken my shower. I had been taking daily showers since my second full day in the hospital, but I hadn't even thought about telling them when I was taking my showers. Often my hair would be dry before my nurses would see me again, so I have a feeling that it looks, according to my medical record, like I didn't take a shower for 5 days. Since then, I have still been taking daily showers and my nurses have seen me with wet hair 2 times and asked if I had showered. My nurse asked me again today to inform her when I take my shower so she could change my sheets. So in the last 11 days it looks like I have only taken 4 showers, according to my chart.
I didn't realize that they were monitoring my food intake until today. I know that for some patients we (the dietitians and me) would ask that the nurses estimate how much of the meal that the patient ate to make sure that they were eating enough. However, it never occurred that they might be keeping track of my intakes. It makes sense that they would track it because I am a pregnant woman and they want to make sure that I am eating enough. But if they have been tracking my intakes since I entered the hospital, I can tell you that their records are completely wrong. For one thing, I often don't feel hungry when they bring me my tray. As a third trimester pregnant women, it is recommended that I eat 6 small meals a day instead of 3 large meals. This hospital's meal service is not amenable to that. They send 3 meals: Breakfast at 8:00, Lunch at noon, and Dinner at 5:00. I am usually not hungry at these times. They wake me up at 6:00 am every day to do fetal monitoring, so I am usually hungry by 7:00 am. I have a snack drawer right next to my bed, so I either give in and eat a snack at 7:00 making me not very hungry by 8:00, or I hold off until 8:00 and eat my entire tray of food. An entire tray of food is really too much food, so when noon rolls around I am usually not very hungry. However, I tend to like the food served at lunch more than the food served at dinner, so I try to eat the food because I know that I might be getting a bad meal later. I usually save a couple of items off of my lunch tray to give to Keith when he comes to visit me at 1:00. But then dinner is a 5:00 - way too early. I am accustomed to eating dinner at about 7 or 8 at night, and I am not hungry at 5:00 because I ate at noon when I wasn't hungry in case dinner was bad. So I usually give my entire dinner tray to Keith.
Even when Keith and I don't eat my entire tray, I take certain items off of my tray to store in my mini fridge. I figure that Keith or I might be hungry later, and there is no sense in throwing away food we might eat. The kitchen here is probably wondering why some dish or piece of silverware goes missing from my tray every meal. And at other meals they end up with 2 extra plates on my tray because Keith or I eat something from my refrigerator. Long story short, usually 100% of my tray is cleared of food. Some of it ends up in my belly, some if it in Keith's, some of it in my night stand, and some of it in my refrigerator. Furthermore, I have acquired food from the outside through guests, my baby shower, and Keith (he brings me small items from the cafeteria periodically - the food in the cafeteria is much better than the food on the trays - and he also brings me free food left over from resident lunches). I often eat this food instead of the food from the trays. There is no way that the intake estimates are accurate in any way.
I didn't realize until today that they are tracking my eating habits. And frankly, the more and more that I find out that they chart about me, the more and more paranoid that I get. At home I might miss taking a shower one day. But here, there is no way because I know that big brother is watching. At home, I have a rule that I will eat what I want when I want it (within reason - I won't go and eat a dozen chocolate chip cookies) because I have struggled with losing and failing to regain weight this entire pregnancy. I figure that I will change this strategy if I start to gain weight too quickly, but given that I still have entire days of nausea, I doubt this is the case (today was one of those days, causing me to not eat anything from my lunch or dinner trays and to send Keith down to the cafeteria for ice cream at around 3:00). Here I feel like they are judging my every meal: "Is she eating enough? Is she eating too much?"
Finally, I found out that each and every hour, they are charting on my position in bed: am I sitting up, laying on my left side, my right side or my back? How high is the head of my bed? This is important because the best blood flow occurs when on your left side and the worst is on your back. I refuse to lay flat on my back, but I will lay on my back if I have the head of my bed elevated. However, I don't want my medical record to read that I am cutting off the oxygen to my baby by laying on my back.
I sure hope that they don't let me know anything else that they are keeping track of. I am already modifying my showering, eating and sleeping habits because I want my chart to show that I am a good soon-to-be mommy. I realize that no one is combing through my chart to check my showering or sleeping trends, but knowing that they are writing it down makes me paranoid that they are tracking and making judgments regarding if I am a fit future mom.
Nurses, on the other hand, are responsible for keeping track of the person as a whole. After I had been in the hospital for about 5 days, one of my nurses said, "Let me know when you are ready to take your shower so I can change your sheets." I figured that this was just because my sheets hadn't been changed in about 3 days (I hadn't requested to have them changed because I don't change them every 3 days at home so I figured that I wouldn't request others to change them that often), and it would be a convenient time for her to change the sheets while I was out of bed. But when I got out of the shower, not only were my sheets changed, but my nurse came back into the room and charted that I had taken my shower. I had been taking daily showers since my second full day in the hospital, but I hadn't even thought about telling them when I was taking my showers. Often my hair would be dry before my nurses would see me again, so I have a feeling that it looks, according to my medical record, like I didn't take a shower for 5 days. Since then, I have still been taking daily showers and my nurses have seen me with wet hair 2 times and asked if I had showered. My nurse asked me again today to inform her when I take my shower so she could change my sheets. So in the last 11 days it looks like I have only taken 4 showers, according to my chart.
I didn't realize that they were monitoring my food intake until today. I know that for some patients we (the dietitians and me) would ask that the nurses estimate how much of the meal that the patient ate to make sure that they were eating enough. However, it never occurred that they might be keeping track of my intakes. It makes sense that they would track it because I am a pregnant woman and they want to make sure that I am eating enough. But if they have been tracking my intakes since I entered the hospital, I can tell you that their records are completely wrong. For one thing, I often don't feel hungry when they bring me my tray. As a third trimester pregnant women, it is recommended that I eat 6 small meals a day instead of 3 large meals. This hospital's meal service is not amenable to that. They send 3 meals: Breakfast at 8:00, Lunch at noon, and Dinner at 5:00. I am usually not hungry at these times. They wake me up at 6:00 am every day to do fetal monitoring, so I am usually hungry by 7:00 am. I have a snack drawer right next to my bed, so I either give in and eat a snack at 7:00 making me not very hungry by 8:00, or I hold off until 8:00 and eat my entire tray of food. An entire tray of food is really too much food, so when noon rolls around I am usually not very hungry. However, I tend to like the food served at lunch more than the food served at dinner, so I try to eat the food because I know that I might be getting a bad meal later. I usually save a couple of items off of my lunch tray to give to Keith when he comes to visit me at 1:00. But then dinner is a 5:00 - way too early. I am accustomed to eating dinner at about 7 or 8 at night, and I am not hungry at 5:00 because I ate at noon when I wasn't hungry in case dinner was bad. So I usually give my entire dinner tray to Keith.
Even when Keith and I don't eat my entire tray, I take certain items off of my tray to store in my mini fridge. I figure that Keith or I might be hungry later, and there is no sense in throwing away food we might eat. The kitchen here is probably wondering why some dish or piece of silverware goes missing from my tray every meal. And at other meals they end up with 2 extra plates on my tray because Keith or I eat something from my refrigerator. Long story short, usually 100% of my tray is cleared of food. Some of it ends up in my belly, some if it in Keith's, some of it in my night stand, and some of it in my refrigerator. Furthermore, I have acquired food from the outside through guests, my baby shower, and Keith (he brings me small items from the cafeteria periodically - the food in the cafeteria is much better than the food on the trays - and he also brings me free food left over from resident lunches). I often eat this food instead of the food from the trays. There is no way that the intake estimates are accurate in any way.
I didn't realize until today that they are tracking my eating habits. And frankly, the more and more that I find out that they chart about me, the more and more paranoid that I get. At home I might miss taking a shower one day. But here, there is no way because I know that big brother is watching. At home, I have a rule that I will eat what I want when I want it (within reason - I won't go and eat a dozen chocolate chip cookies) because I have struggled with losing and failing to regain weight this entire pregnancy. I figure that I will change this strategy if I start to gain weight too quickly, but given that I still have entire days of nausea, I doubt this is the case (today was one of those days, causing me to not eat anything from my lunch or dinner trays and to send Keith down to the cafeteria for ice cream at around 3:00). Here I feel like they are judging my every meal: "Is she eating enough? Is she eating too much?"
Finally, I found out that each and every hour, they are charting on my position in bed: am I sitting up, laying on my left side, my right side or my back? How high is the head of my bed? This is important because the best blood flow occurs when on your left side and the worst is on your back. I refuse to lay flat on my back, but I will lay on my back if I have the head of my bed elevated. However, I don't want my medical record to read that I am cutting off the oxygen to my baby by laying on my back.
I sure hope that they don't let me know anything else that they are keeping track of. I am already modifying my showering, eating and sleeping habits because I want my chart to show that I am a good soon-to-be mommy. I realize that no one is combing through my chart to check my showering or sleeping trends, but knowing that they are writing it down makes me paranoid that they are tracking and making judgments regarding if I am a fit future mom.
Is the charting just to show that they are attentive and care about you as a patient and that you are doing ok?
ReplyDeleteYes. They really don't care what I am doing. The charting is just how the hospital keeps track of the nurses to make sure that they are being attentive to me. But I still get a little bit annoyed about the lack of privacy sometimes.
ReplyDelete