Two nurses who served as witnesses in a medical malpractice case were asked if they knew what cachexia is. Both said “No.”
How could these nurses not know what this common medical term means?
One was a head nurse, and the other was a regular nurse, at a nursing facility that a deceased resident’s spouse blamed for her death.
In two separate depositions (which I proofread, as a long-time proofreader of litigation transcripts), the plaintiff’s attorney asked each nurse if they knew what cachexia is. Neither knew.
The really crazy thing is that at a nursing home, there will be residents with cachexia. Will they be popping out of the woodwork? No.
But if you’ve been working there for several years, you’ll definitely see it in a lot more than just one resident.
I’d also think it’d get good coverage in nursing school.
This condition is that of unintentional and significant weight loss and muscle wasting directly caused by a chronic or acute disease.
Commonly, those include advanced cancer, congestive heart failure and chronic kidney disease. It’s not caused by advanced age.
The mechanism involves inflammation throughout the body that causes aggressive breakdown of fat and muscle, leading to the weight loss. Appetite may also be suppressed.
Increasing caloric intake won’t fix this problem because it’s driven by the underlying severe disease.
It doesn’t make sense that these two nurses wouldn’t know that this process has a single name.
I realize that any given nurse can’t possibly know everything in the annals of medicine. No medical doctor knows, either.
But cachexia is a common outcome of very common disease processes in their advanced stages.
So it seems like something a nurse would know, especially a charge nurse and one who’s been in the profession for many years, as were the cases with these two nurses.
In fact, cancer cachexia is estimated to directly account for 20 to 30% of cancer deaths, according to the National Cancer Institute.
Cachexia can become so severe that patients die from complications related to profound muscle wasting, including weakness of the respiratory and cardiac muscles, rather than from the direct effects of tumor growth itself.
This makes cachexia a major contributor to cancer mortality. So it’s not a matter of “eat more, put on weight so you don’t die from emaciation.”
Again, the condition is caused by the disease, not from a restriction of calories in and of itself.
However, appetite suppression that leads to reduced food intake can cause a weight loss that, visibly, mimics cachexia.
With all that said, I had to wonder how the condition of cachexia could’ve escaped two nurses. It’s common. It’s seen all the time in patients with advanced stages of common illnesses.
What else didn’t these nurses know? Would you want them taking care of your sick family member or yourself?
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