Increase of super morbidly obese patients?

Specialties MICU

Published

Is anyone else noticing the increase of these type of patients? It seems that half of my

40 bed ICU has patients of this type. The basic problem is they can not breathe

with all that weight compressing the lungs.

I am just wondering if I am seeing an usual streak of this or is this becoming a

more common diagnosis? I have been having the bad luck lately of being paired

up with two of these types of patients. 500 lb + with very difficult intubations.

Perhaps it's the summer heat. I am becoming way to familiar with bariatric beds,

difficult intubations, and searching the hospital for gowns that fit!

LOL @ the "hook and drag method"

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Specializes in MICU, SICU, CVICU, CCU, and Neuro ICU.

I've found it rare that a patient was a "healthy" weight for their height unless they are over 70 years old. Even then most of our older patients are overweight. I use to think that a 300 lb batient was big, but sadly, I've been getting use to 300 lb patients.

It almost makes me want to work as a NICU nurse so I don't have to deal with 400 and 500 lb patients.

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I work postpartum where we are seeing more and more moms in the 300-400 lb range. They're almost all c-sections. Some try to breastfeed, but their breasts are so large that the babies have difficulty latching, and the moms can hardly maneuver into the correct position.

I feel for them. But I do wonder how they managed to get pregnant in the first place. Not in the judgmental sense, but I just wonder about the logistics of getting the equipment lined up. I guess where there's a will, there's a way.

My other concern is that many of them have gestational diabetes. This puts their infants at risk for blood glucose problems.

It's definitely a growing challenge (no pun intended).

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Funny, an ER RN and myself were just talking about it this morning

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We have had to accommodate several rooms in our hospital, by extending door frames for bariatric beds to move through. Those rooms also have lifts. To move a bariatric bed, it requires at least 2 people as a regular bed is just a 1 person job. We have bariatric wheelchairs also. I have noticed an increase, as have my co-workers. There was an instance where the pt was just a few lbs shy of being too heavy for our CT machine.

So, yes we have also noticed this increase!

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Specializes in intensive care, med-surg, tele, stepdown.

To the person complaining of pts in the 300lb range-those are the norm now. We've had a couple vents recently >400lbs and have a 'frequent flier' who is almost 900. We are lucky enough to have overhead lifts and get a rented bed for them but it is still very time consuming and difficult. Even with the lift, when you change the sheets or do dressing changes it takes several people. Nothing like 4 nurses putting a foley in when the unit is staffed with 5! These patients are draining on resources!

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Specializes in ICU.
To the person complaining of pts in the 300lb range-those are the norm now. We've had a couple vents recently >400lbs and have a 'frequent flier' who is almost 900. We are lucky enough to have overhead lifts and get a rented bed for them but it is still very time consuming and difficult. Even with the lift, when you change the sheets or do dressing changes it takes several people. Nothing like 4 nurses putting a foley in when the unit is staffed with 5! These patients are draining on resources!

I wonder how sterile the process must actually be if it takes this many people to put a foley in. I've had to assist with holding a patient's legs out of the way many times, and it is very straining on the backs of the nurses assisting. We recently had to do a bladder scan on a patient and it took 4 of us to hold the patient's porifice while one nurse tried to do the scan. It was very difficult with 4 of us leaning over the bed to hold a porifice! Another RN from another floor tore a ligament in her arm while she was holding a patient's porifice so she could wash in the folds!

Now, I myself have gained 55 pounds since becoming a nurse, but if I ever get THAT big, I can't expect an RN to injure herself while caring for me!

On another note, I had a patient's boyfriend get upset with me because I didn't have time during my shift to SHAVE his GIRLFRIEND! I had to feed her because she couldn't reach her mouth because her belly was in the way!!!!! I've made sure my hubbie knows that if I'm ever hospitalized for more than a couple of days, he better hire a waxing technician and a colorist to visit me every few weeks!!!!

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Specializes in ER/SICU/Med-Surg/Ortho/Trauma/Flight.

Ive hurt my back doing this same stuff also, Im not kidding I think it takes every RN, LPN, and cna in our unit to turn one of these pts.

LOL-Hook and drag method.

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Specializes in Adult ICU/PICU/NICU.

I'm a retired critical care nurse and I worked adult ICU (late MICU) from the early 1960s-2005. I don't remember many obese/morbidly obese patients back in the 60s and 70s. It seems like they started poping up in the 80s and I can't help but wonder if it has anything to do with the consumption of processed foods vs eating home cooked meals. By the early 1990s I was pushing 60 and it seemed that every patient I took care of was a morbidly obese type II DM who were chronically in and out of the MICU. My own aging body was started to show the effects of 40 years in nursing, although I always tried to be careful during lifts. I had back pain, knee pain, shoulder pain....so I retired from full time MICU nursing and became cross trained at the Childrens' hospital working contingent in the PICU and later the NICU while working only one day a week in the MICU. By 2005 my doctor told me to cease taking care of any adults due to my knee getting worse and I spent my final four years exclusively as a contingent PICU/NICU nurse. Its a simple matter of physics...the lighter patients are easier on the body....and if I had to do it all over again I would have been a PICU nurse from the start.

I had knee replacement surgery in August of 2009 and fully retired from critical care nursing as I knew I couldn't physically do the job as well as I used to. Now I work as a substitute assistant school nurse, and we are now seeing a fair amount of high school and jr high school students who are obese and some who are developing type II DM. They no longer teach home economics in schools and they only get one semester of health. I wish I could take some of these kids on a tour of the MICU where I used to work and show them what can happen if you don't learn to eat right and keep physically active.

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