As a child, my family visited my mother’s mother on a frequent basis.  During one weekend visit, my grandmother placed cloth napkins at the table setting.  Having grown up with paper napkins and then upon seeing the cloth ones, my younger brother Andy and I asked, “What are these?”

            “They are napkins,” my grandmother replied.

            This dialogue repeated itself for a few more meals.  Finally, after the question arose again, my grandmother threw down the napkin and yelled, “That’s it!  We’ll stick with paper ones!”

            Contrarily, here in the ICU, we constantly face the continuous changeover from “paper napkins” to “cloth” ones, and we cannot go back (i.e. Quest, Symphony, etc.).  However, whether the changes seem appropriate or not, let us always keep in mind the long-term goal of constantly improving the care we provide to our patients and their loved ones.