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[Dysphagia] disagree with doctor?
This happens quite a bit everywhere, especially when MD's don't note the
difference between aspiration pneumonia and aspiration pneumonitis. I
make sure I explain to the family that aspiration "pneumonia" can be
caused by many things including refluxed material, vomit, secretions,
etc. I then explain the MBS and show it to them if possible. Then
explain that you don't feel that they are at any risk of their
meals/drinks causing an aspiration pneumonia (keeping in mind a person
can be aspirating, even though they don't do it on the MBS). However,
since many things can cause it, it doesn't rule out that it can happen
in the future from any of those factors.
You can include this info in the patient chart so that the MD can read
it and gain the knowledge without feeling as if you are being
disrespectful. We also inservice frequently (monthly in the ICU as that
is how often the MD's rotate there). Your other option is to find or
create some great take-home literature. Don't forget that families and
patients forget most of what they are told in the hospital:-)
Heidi
-----Original Message-----
From: Jonathan Bennett [mailto:ajbennett05@yahoo.com]
Sent: Friday, August 18, 2006 4:12 PM
To: dysphagia@b9.com
Subject: [Dysphagia] disagree with doctor?
I'm curious about how many of you handle this type of situation. Of
course, many of the patients that we see have pneumonia...but after I
see a patient, sometimes I do not believe that it is being caused by
aspiration, yet, the doctors are labeling it aspiration pneumonia. I am
then put in the position where I have them on a regular diet and the
family is asking how we are sure they won't end up with aspiration
pneumonia again. If they end up back in the hospital, the doctors and
family will be angry and once again, labeling it aspiration pneumonia,
when in fact it may be viral, community acquired, etc. How do you
handle both the patient and the doctor in these types of situations
without losing respect of the doctors?
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