Increase of super morbidly obese patients?

detroitdano · Jul 27, 2010

I've noticed this as well. I had a 400 lb. patient that screwed up my back a few months back, I admitted a 350 lb. patient just last week, and we've got another bigger lady on my unit right now, she's maybe 250-300 lb.

It really is challenging taking care of bigger patients. You surely can't turn them yourself, and you've literally got to climb on the bed to have effective chest compressions God forbid there's a code.

The huge gowns are far and few between. Quite often our big patients rock out wearing nothing but a white blanket or two lol.

Hoozdo, ADN · Jul 27, 2010

Yeah, I need at least 4 people and more like 6 to bathe these patients and changer

their sheets. Let's see, that is 8 to 12 patients that are not being obseved while

helping me.

Not to mention whoever is down in MRI, IR, or CT with their patients. Or gone on rapid

response or codes. Leaves us a bit short! :rolleyes:

meandragonbrett · Jul 28, 2010

Yes. We are seeing more and more obese patients. We had a 700 pounder recently.

NtannRN · Jul 28, 2010

OMG You're not kidding, we special order "SizeWize" beds that are supposed to automatically turn your patient. They also have a button for "big turn" to use when you're rolling them over to assess their bottom, but the part of the bed that blows up to turn them also gets in the way. Can we say 400lbders, whose legs must weigh 40lbs each, which are now full of fluid, intubated, sedated and have no necks. Then they pull the nurses aide, I wash as much as I can by myself, then call in the troops-----if we have any! LOL

sunnycalifRN · Jul 28, 2010

We only have a 15 bed ICU, but I would say that we usually have 1 or 2 in the 400 lb+ range, on average . . . thankfully, we have hovermats and ceiling lifts, which makes movement of these patients much easier and safer.

Diprivan*Diva · Jul 30, 2010

For those of you who have CNA's, consider yourself lucky. We don't have any in my unit- the nurses do it ALL. Trust me, the large patients are all over the states. Talk to your manager and see about getting equipment like hoyer lifts to help out with the lifting. I know we're all advocates on continuity of care, however you are given one BACK- share the wealth and take turns rotating these patients among the staff. I have been an ICU nurse for 4 years and can already tell a huge difference in my posture and the way I feel after a stretch of days.

Little things to think about- invest in a good mattress at home, drink lots of water (your muscles are made of 99% water and these support our backs) and if you have the time/money, treat yourself to a massage once a month. Makes a big difference and we deserve it!

Hoozdo, ADN · Jul 30, 2010

Makes one wonder just HOW MANY people in the US are 500 lb+. I would bet

that number is way higher than we suspect.

I am starting to be happy that my new patients weigh 150 Kg or less when

I getting them settled.

I am also going to ask for inservice on the ceiling track type lifts we have

that no one uses. Last I heard "they were broke." All I know is the last time

and only time I have heard of it being used, the tracks tore off the ceiling

and the patient fell (back into bed sort of.)

XingtheBBB, BSN, RN · Aug 4, 2010

Yeah, I need at least 4 people and more like 6 to bathe these patients and changer
their sheets. Let's see, that is 8 to 12 patients that are not being obseved while
helping me.
Not to mention whoever is down in MRI, IR, or CT with their patients. Or gone on rapid
response or codes. Leaves us a bit short!

Yup, we had a pt self extubate and one nearly fall OOB while one nurse was watching the unit alone because 6 nurses and and aide were struggling with a 600+ #er.

Not safe. For anyone.

BellaInBlueScrubsRN · Aug 4, 2010

We have a couple bariatric rooms with lifts in the ceiling. A good thought on paper. BUT if you already have a pt in that room and get a bari admit, you have to move people around to make that room available. Ugh!

Editorial Team / Admin · Aug 4, 2010

Do a google search for Safe Patient Handling.

Our hospital has recently jumped on the wagon to reduce staff injuries and lift/handle all patients safely, installing ceiling lifts in EVERY room, providing slings on EVERY patient bed (for those who need them), etc.

Did you know in several states use of the "hook and drag" method (we've all done it: faced the sitting or lying pt, hook our elbow under pt's arm and dragged him/her up) is illegal?

Just a short class on Body Mechanics no longer is "enough" for keeping healthcare workers AND patients safe.

We need help: lifts, friction-reducing sliders/transfer devices, positioning aids, motorized gurneys and beds (that's WAAAY in the future, but coming) . . .

. . and the appropriate inservices.

Gather the data and stats and push for change.

Check out what the VA system is doing:

http://www.visn8.va.gov/patientsafetycenter/safePTHandling/

Off soapbox now. :)

dzadzey, MSN, RN · Aug 31, 2010

It's becoming more and more common. just his weekend as many as 7 of our 24 patients were over 350lbs, with 4 of them at over 400lbs. Yet we don;t get any more staff to meet their needs. A study in the Southern Online Journal of Nursing Research has shown that the morbidly and super-morbidly obese patients can take two times, or more, the number of staff and care time than non-obese patients. And given the economy and changes to Medicare, it's hard to see where the funding to provide the necessary equipment and staff to adequately care for this population is going to come from.

But do patient care providers have to face the daily choice between avoiding injury or providing care to their patients? Because that is the choice many of us face...personal and potentially debilitating injury...Or simply giving up and not providing the level of care these patients need. It's a choice none of us should have to make.