Fluid Balance charts

Back to my dad.

His swallow has been assessed (After ten days in hospital, where he had been drinking normal fluids) and they have decided that he should drink "thickened fluids" as he does not have a cough reflex. This means that if fluid starts going down "The wrong way" i.e. into the trachea, he will not cough and so he could aspirate (The fluid go into the lungs, with chance of causing pneumonia) :

"The cough reflex is a protective physiological mechanism that defends against aspiration of harmful substances into the respiratory tree." The stroke association

On hearing this, I gave him a drink of tea, with a teaspoon of "Thick and easy" in it and he looked at me as if another head had sprouted out of my neck. Thickened fluids are pretty grim things. They are so grim that he has stopped drinking them and so the nurses have had to get a venflon re-sited and put him on IV fluids. When a patient is on these, they need to have a fluid balance chart to record what is being put in and what is coming out. If nursing care is at a good standard and the charts are filled in correctly, they are a great help.

The problem is that the charts are not being filled in. For the past four nights, my mother and I have given him drinks and filled the charts in accordingly. My mother (Ex nurse of 27 years) and myself are the only ones filling them in. The nurses are not recording things going in or things coming out.

This is so hard to deal with: My father is likely to be on this ward for a long time and antagonising the ward staff is not a good way to go, but filling in fluid balance charts is just such a basic, basic task of nursing care. As they are empty of information, it is assumed that he is not drinking. My mother and I know that he is drinking, but as long as the charts are empty, he will remain on IV fluids.