Setting a bad example? - page 2

I am curious about what people think about working nurses who are extremely out of shape, obese, smokers, etc. I work in a CVICU where a good portion of the nurses are overweight and out of shape,... Read More

  1. by   mattcastens
    Originally posted by mcl4
    I've yet to see a nurse at two in the morning when patients are not fully awake start teaching lifestyle changes which include how they need to exercise, quite smoking or cut back on their fat intake. Patient assessments are done, needs are met, and we encourage rest which is very important part of recovery.
    You must be very fortunate to work in the only place where every patient sleeps through the entire night.

    In places I've worked in, anyway, there's a whole periods called morning and evening when everyone is awake. Prime teaching time.
  2. by   mcl4
    Originally posted by mattcastens


    You must be very fortunate to work in the only place where every patient sleeps through the entire night.

    In places I've worked in, anyway, there's a whole periods called morning and evening when everyone is awake. Prime teaching time.


    Matt, morning and evening is not what I consider night shift or two in the morning. The point is that on nights, we encourage patients to sleep. There is a whole area of health problems in regards to sleep depriveration that also isn't good for your health. I'm not going to start telling people why they should not smoke or why a low fat diet is good for you in the middle of the night and to be honest, most people are aware of what habits are good or not good for one's health, but people chose not to follow them.

    By the time report is given by the evening shift, it is well past eleven and in the morning we are admitting patients for surgery for that day so time is limited.

    Doesn't North have a cardiac rehab. department that covers all the necessary change to ensure that their cardiac patients know how to change their lifestyles which will improve their health? Do you feel more qualified then these individuals in prescribing exercise activities or changes necessary in their diet? Do you have the ability to prescribe medication that might help a patient quite smoking?
  3. by   LilgirlRN
    Are you going to carry this standard to anyone who works with the patient? There a few docs that smoke where I work. Funny that most of the respiratory therapists that work at my hospital smoke. Is the patient really sitting there thinking how dare the nurse tell me to watch my weight when he/she is fatter than I am? I think patients know that the nurse knows what he/she is talking about. Losing weight is a difficult thing, even for a nurse, knowing all that we know about health, some of us are overweight. I think that perhaps this is a case of do what I say, not as I do. Fat does not always equal bad health, while it may increase the chance for heart disease, genetics plays an even more important role as far as hyperlipidemia is concerned. I am overweight but my cholesterol is 140, my blood sugar is always less than 100. The cardiologist that I would prefer to take care of me should I ever need one is also overweight. If I were to chose a doc based on the way he/she looks, I might not choose the best or brightest. Same goes for any other health care professional.
    Last edit by LilgirlRN on Dec 29, '01
  4. by   RNforLongTime
    I agree with what Julie lpn said.

    I, too am overweight and also smoke. I have never had anyone tell me that I was preaching to the choir when I educated anyone on proper nutrition and the benefits of not smoking. Personally, I do not think that it is my patients business whether or not I smoke. Sure some may be able to smell it, but I know I can't smell it on my coworkers that smoke as we have to go outside to smoke.

    Last place I worked at several of the registered Dieticians were morbidly obese. The cardiologist at the place I work now smokes.
    Patients want a caring nurse, I don't think that many are concerned with what the nurse looks like as long as that person is caring and professional.

    I have struggled with my weight my entire 29 years of life. Sure I know that I need to eat better and excercise...blah, blah blah...Losing weight is not an easy thing and it seems to get harder as I get older. Will I ever be the picture of perfect health? No, probably not. Does this make me a bad nurse? I hardly think so.
  5. by   VAC
    mc14
    I don't work open heart, but my father in law just had a 6 vessel bypass, and as soon as he was awake, his nurses were doing diet teaching. Paitents where I work rarely sleep through the night, no matter how much we 'encourage' it. In ICU we are in their rooms at least every hour, usually more. Hospitals are not the best places to sleep. I find my patients who can't sleep often want to talk about what theyre going through, and I was taught in nursing school to use as many patient interactions as possible as opportunities for teaching, so if my patient wants to talk at 2 am about health maintence or anything bothering them, I give them as much time as I can and address their concerns.

    An overweight or smoking nurse isn't less competent or capable of doing the job, but they are not going to be as effective teaching about healthy lifestyles.
  6. by   mcl4
    I think to be an effective teacher you need to truly believe what it is you are teaching. If you are lecturing your patient on eating right, exercising, stopping smoking, are you doing it by rote, or do you really believe it? If you do, why don't you practice it yourself? It will only do you good. [/B][/QUOTE]


    With lifestyle changes, a person must first be open to change. You have assume a patient wants to quite smoking or eat healthier. A person who truly is going to change, will seek out the information and look for long term help. Hopefully, a patient who ask for help from a nurse to change their smoking habit or diet, their nurse will direct them to hospital personel that can truly help them especially after being discharged.
  7. by   mcl4
    [QUOTE]Originally posted by VAC
    [B]mc14
    I don't work open heart, but my father in law just had a 6 vessel bypass, and as soon as he was awake, his nurses were doing diet teaching. Paitents where I work rarely sleep through the night, no matter how much we 'encourage' it. In ICU we are in their rooms at least every hour, usually more. Hospitals are not the best places to sleep. I find my patients who can't sleep often want to talk about what theyre going through, and I was taught in nursing school to use as many patient interactions as possible as opportunities for teaching, so if my patient wants to talk at 2 am about health maintence or anything bothering them, I give them as much time as I can and address their concerns.



    Diet changes can be quite extensive with how to prepare a meal, how to shop and how to read food labels. A dietitian has the time as well as education to provide a more extensive
    education to a patient rather then a lecture from a nurse telling them they should lose weight.

    The hospitals in this area who do open hearts have an extensive cardiac rehab program which includes a dietician going over any changes necessary in their diet. Exercise is directed by a CICU nurse/cardiac nurse and their heart activity is monitored. The rehab programs last for several weeks and it give the patients the tools necessary to live a healthier life.

    While we do follow patients closely postoperative, we enter rooms quietly and try to promote rest. Teaching is done with what pertains to each individual patient, for example
    using good body mechanic with an ortho post op procedure if we assist them to the bathroom. I encourage TCH/Volydne, but I don't lecture them on the evils of smoking in the middle of the night. It is important that we know a person's smoking history so we can be more aggressive at keeping their lungs clear. I believe you are kidding yourself if you think a nurse telling a patient that smoking is bad, they will stop. Everyone under the sun knows that smoking is bad which makes it difficult to understand why a young person would start, but they do. If you have a patient who ask for help to stop smoking, I hope most nurses would direct them to their physicians who will be able to help them more.
    Basically all we can do is tell a patient that smoking isn't healthy, but again they already know this.





    An overweight or smoking nurse isn't less competent or capable of doing the job, but they are not going to be as effective teaching about healthy lifestyles.

    They have as good as change as any other person to changes a person's lifestyle with a short lecture or quick talk on diet, exercise or smoking. Again, the patient first must want to change.
    A patient who asks for help, you are doing them a disservice if you don't refer to other health professionals that are specialized and will follow up on their progress after being discharge.
  8. by   mcl4
    Patients want a caring nurse, I don't think that many are concerned with what the nurse looks like as long as that person is caring and professional.


    Your absolutely right, patients want a caring competent nurse, but I guess some nurses need to define the profession with how much education they should have to what their image should be.
  9. by   mcl4
    I think to be an effective teacher you need to truly believe what it is you are teaching. If you are lecturing your patient on eating right, exercising, stopping smoking, are you doing it by rote, or do you really believe it? If you do, why don't you practice it yourself? It will only do you good. [/B][/QUOTE]

    What is your concept of what it takes to lose weight and keep it off or quite smoking. Remember, ninety-five percent of people who lose weight. gain the original weight back and more. Smokers may take several attempts to quite and most likely need the help of prescription meds, or a program specifically set up to help people cease smoking due to the addictive
    qualities of cigarettes. Do you think if all nurses didn't smoke and all had healthy weights, no one would smoke or eat unhealthy?
    We are with a patient a split fraction of their life and there are many many other influences that are ongoing.
  10. by   canoehead
    Perhaps hearing about needing to change a person's lifestyle from someone who has also had the same struggle would carry some extra weight. As opposed to hearing from a muscley tofu eater (no offense )

    I am sure that obese smokers have other redeeming qualities. For example, I would not want to hear about tolerance for different lifestyles, or respecting patients' choices from someone who cannot tolerate or respect their coworkers faults.

    Everyone has value, and I don't think a mass discrediting of those who are less than perfect physical specimens will improve anyone else's physical health.
  11. by   semstr
    I find it pretty hard to swallow, when I read the things Matt wrote.
    I am also sick of the you-have-to-be-as-thin-as-possible rules being forced down our throats by the media, designers, Hollywood etc. etc.

    It is getting so bad, that a collegue of mine, she has got 30 kilo too much, didn't get a job, because she wasn't representable enough!! What would people say? She wasn't told this in her face of course, but we found out through our union-nurse, who advised her to protest this decission.
    My collegue didn't, cause she was really fed up with hospital politics and so were we!

    On the other hand am I discriminated too, I am skinny, always was and probably always will be.
    As soon as I start saying something about healthy food, people don't take me serious and laugh at me, tell me yeah, it's easy for you to say etc.
    Hey, why don't you start eating something healthy youself!

    On my annual health-check, the (new) doctor even wanted me to go to a eating-disorder-specialist.

    So, all in all, it doesn't really matter, whether you are fat or skinny of smoke or not smoke, as a nurse it is always difficult to give the right example with your own body.

    I think, I agree with a lot of other posters here, that attitude makes the big difference though, or it should anyway!!

    Take care, Renee
  12. by   thisnurse
    oh geez, do we have to add "setting an example" to our job descriptions now too?
    oh no.
  13. by   Q.
    Originally posted by mcl4
    [
    I've yet to see a nurse at two in the morning when patients are not fully awake start teaching lifestyle changes which include how they need to exercise, quite smoking or cut back on their fat intake. Patient assessments are done, needs are met, and we encourage rest which is very important part of recovery.
    I disagree with this. I worked third shift labor and delivery/post partum and nursery. Teaching was done at every opportunity - whether it was about breastfeeding, exercise, nutrition, etc. As a nurse teaching is one of the most important aspects; it differentiates you from a UAP for example. You need to accomplish teaching at every available moment. I am shocked that you don't practice this as well.

close