Episode 46:

Vitamin D and How to Deal With Family in the Hospital

Vitamin D helps the body use calcium and phosphorus to make strong bones and teeth. Vitamin D deficiency can lead to diseases like rickets and osteomalacia. Is your patient’s family helpful or do they just raise everyone’s blood pressure? Learn how to deal with your patient’s family.



Vitamin D 

Vitamin D is the name given to a group of fat-soluble prohormones (substances that usually have little hormonal activity by themselves but that the body can turn into hormones). Vitamin D helps the body use calcium and phosphorus to make strong bones and teeth. Skin exposed to sunshine can make vitamin D, and vitamin D can also be obtained from certain foods. Vitamin D deficiency can cause a weakening of the bones that are called rickets in children and osteomalacia in adults.

Vitamin D has multiple roles in the body. It assists in:

  • Promoting healthy bones and teeth
    • Bonnes and microbes
      • Your body must have vitamin D to absorb calcium and promote bone growth.
      • Originally, doctors thought vitamin D was important only for bone health. This was because vitamin D deficiency caused bone diseases such as rickets in children and osteoporosis in adults. But in the 1980s, scientists discovered that immune cells had receptors for vitamin D.
      • vitamin D plays an important role in maintaining health in the gastrointestinal tract. Higher levels of vitamin D reduce susceptibility to inflammatory bowel disease and Crohn’s disease, gut and lung infections
      • Vitamin D increases the number and diversity of microbes living in the gut.
    • A 2019 review suggests that pregnant women who are deficient in vitamin D may have a greater risk of developing preeclampsia and giving birth preterm¹.
    • Supporting immune, brain, and nervous system health
      • Vitamin D receptor is expressed on immune cells (B cells, T cells, and antigen-presenting cells) and these immunologic cells are all are capable of synthesizing the active vitamin D metabolite. Vitamin D has the capability of acting in an autocrine manner in a local immunologic milieu. Vitamin D can modulate innate and adaptive immune responses.
      • Deficiency in vitamin D is associated with increased autoimmunity as well as increased susceptibility to infection².
      • Epidemiologic studies have shown that higher intake or blood levels of vitamin D are associated with a reduced risk of cancer³.
    • regulating insulin levels and supporting diabetes management
      Increases insulin sensitivity⁴
    • Supporting lung function
      Vitamin D deficiency causes deficits in lung function that are primarily explained by differences in lung volume.
      The prevalence of vitamin D deficiency is increasing and has been linked to obstructive lung diseases including asthma and chronic obstructive pulmonary disease⁵.

When family helps

  • Be empathetic
    • Empathy is the capacity or ability to imagine oneself in the situation of another, experiencing the emotions, ideas, or opinions of that person.
    • Understand what the family is going through.
    • The family is also their main support system.
  • Incorporate them in activities and education
    • Explain to the family what you are doing. The majority of the time the family is going to be doing dressing changes or giving the meds, they need to know whats going on too.
    • Listen to their concerns

What to do when you disagree with the family

  • Understand the issue, maybe their questions arent being answered or their feelings met, or there’s been a years-long dispute between 2 people.
    • One way to take control of the situation is by knowing what the family members want.
  • If you and the family don’t get alone focus on the patient. You’re there for the patient so listen to what they have to say.
  • When you enter the room speak to the patient and keep your words short with the family.
  • Don’t overreact, if you are feeling upset or angry leave the room or take a break.
  • Talk to another nurse or management.
  • If you suspect any abuse you have to let someone know. The patient could feel powerless with the person in the room so approach that when the abuser isn’t in the room.
  • Stay safe. There are options in the hospital that allow you to get someone for help in case of an emergency. Code grey is often called when someone is unruly.
  • Set boundaries. Tell them there is a limit on visitation or a limit on how many individuals in the room.

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