Nursing makes me hate fat people

Nurses Relations

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Ok, first off let me say I know this topic will probably generate a lot of strong opinions. I will also state that I am not a perfect person and don't take care of my health 100% so please don't think I am trying to be an elitist or something in posting this.

Disclaimer aside, I want to know if other nurses sympathize with me.

I am going to try and be as brief as possible in my story. First of all we have 2 resident patients on my floor that have been there over a year. They are obese and have suffered strokes. They require total care. These particular patients are about 250lbs and 1 has hemiparesis and the other has use of 1 arm (not sure what to call that).

The patient that really has me over the edge is one that is over 300lbs, vent dependent, unstageable sacral (of course, no one wants to turn this patient which is a whole other issue), lower extremities contracted with knee replacements, on dialysis, PEG feeding, restrained because she pulls any tube in sight, and contact isolation for c diff and acenotibacter. This patient has been on the floor for 3 months so far because no LTC facility will take her (understandably).

Not to mention all the cellulitis patients and other comorbities we deal with on admissions.

I am a 25 year old male and starting to feel back pains. This really has me over the edge as a combination of lazy/uneducated coworkers and heavy (literally) care.

Please share how you deal with these kinds of patients and what I can do to reverse my growing animosity towards these patients.

The title of this thread is really needlessly provacative and offensive.

Agreed. However, it does raise (somewhat) of a civil discussion about patient care with those that are considered 'overweight'.

A good friend of mine who read this thread and my response to it a few pages back messaged me with: "It is none of our business [sic] when it comes to the care of our patient. Everyone deserves to be treated with dignity and respect: fat, skinny, ugly, pretty, old and young."

I think this sums it up beautifully from my perspective. Regardless of diagnosis or prognosis, each patient deserves to be considered on the individual merits of their case -- not from our perceptions or prejudice. There is always some factor that we do not know about to contribute to their weight. If it is 'laziness' as the end result, so be it (as far as I am concerned) due to the fact I have no right to judge and have plenty of skeletons in my own closet.

Specializes in Acute Rehab, IMCU, ED, med-surg.

What about OP's facility contacting their workers comp carrier and getting some assistance with creation of a more ergonomic workplace?

Most W.C. carriers have risk managers and other workplace specialists on hand to help employers make workplaces safer = reduce claims costs = reduce premiums.

Again, tying this to the dollar (in this case for the good of all, rather than just in the name of profit) might motivate facility leadership.

I'd rather talk about solutions rather than debate moral issues about weight, etc. I just really don't care about all that.

I've been thin, am currently "obese" (but strong as a dang ox, fortunately) and have experience working with patients in the 700 lb range.

I just want for everyone to be safer - patients, staff, everyone.

Esme, I have a general understanding of your position and I feel for your situation, but you are not an example of the patient I am talking about. I stated that obesity is a "general" sign of laziness and I still stand by that statement; ie, it does not automatically apply to everyone who is obese. I am very sorry to hear your story, but your situation is simply not what I am referring to. The vast majority of overweight people in this country have much more control over their situations than you do; and unfortunately, they are clogging up the healthcare system.

My issue with this is mostly practical. I treat my patients with respect as long as they are generally respectful back, and I even give them the benefit of the doubt much, much more often than not. I provide them with the best care that I can regardless. But there is no way to police someone's feelings about people who can't take care of themselves.

The vast majority of overweight people in this country have much more control over their situations than you do; and unfortunately, they are clogging up the healthcare system.

Let's play a little semantic game here and change "overweight" in the quote above to "individuals with brown hair". I know it is not the same thing, but play along and see if there is anything you notice outright.

To quote w/ the changes in effect: "The vast majority of people with brown hair in this country have much more control over their situations than you do; and unfortunately, they are clogging up the healthcare system."

Yes; brown hair is a course of genetics and inheritance. Some would argue (with supportive data) so are those with weight issues. Do those of an 'approved' hair color other than brown constitute something that is more pleasing to the throws of the healthcare system? Do they flow past the algorithms of "acceptable care" more easily of those of other hair colors?

"Clogging", "Practical", "Control". All of these words have possible meanings of exclusion and condition pertaining to a certain demographic or ideal.

My heart just flips reading these definitions for the people that are excluded out of what is considered 'acceptable'. I'm glad you treat your patients with respect (with the condition that they treat you with respect back), but when you tack on a qualification statement at the end of your premise like: '... people that can't take care of themselves'. Ugh.

What would happen if you suddenly found yourself in your own defined category of '... people that can't take care of themselves'? What would your reaction be and how would you like to be treated?

Ugh. :sniff:

Esme, I have a general understanding of your position and I feel for your situation, but you are not an example of the patient I am talking about. I stated that obesity is a "general" sign of laziness and I still stand by that statement; ie, it does not automatically apply to everyone who is obese. I am very sorry to hear your story, but your situation is simply not what I am referring to. The vast majority of overweight people in this country have much more control over their situations than you do; and unfortunately, they are clogging up the healthcare system.

My issue with this is mostly practical. I treat my patients with respect as long as they are generally respectful back, and I even give them the benefit of the doubt much, much more often than not. I provide them with the best care that I can regardless. But there is no way to police someone's feelings about people who can't take care of themselves.

You're right, it's pointless to try and police other people's feelings. Everyone is entitled to their personal opinions, including nurses.

With that said, I think it's scary that someone who would make such stridently harsh judgement calls chooses to practice in a profession that is dedicated to patient advocacy and the easing of suffering.

That's my personal opinion.

Perhaps there needs to be a great deal more work done on how a nurse treats ANY patient. Contempt, thinly disguised or not, isn't a place any of us should be, nor any patient subjected to.

I was always skinny as a rail. Couldn't eat enough to maintain weight. That all changed drastically when I hit my 40's. I spent a great deal of my life hearing "are you anorexic? Do you not eat? You are soooo skinny, are you sick?" All the way up to "should we test you for HIV?"

The title of this thread is inflammatory and perpetuates many, many myths. We, as nurses, need an attitude adjustment to not be judgemental on anyone's conditions. Educating patients and judging them are 2 entirely different things. Like anything else, it is never a thought process of "I think that I will get this awful disease, cause I really want to be wheelchair bound!!" or "I am gonna make those nurses miserable because THEN I will get good care!!"

Honestly, if you need things to make your job easier, advocate for them. But to advocate, it is to make the PATIENT'S care better. There is equiptment, there are lift teams, PT and OT that can be specific to how to move someone who is difficult to move. So, OP, stop being hateful and eye rolling, get a grip, and attempt to change culture.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Esme, I have a general understanding of your position and I feel for your situation, but you are not an example of the patient I am talking about. I stated that obesity is a "general" sign of laziness and I still stand by that statement; ie, it does not automatically apply to everyone who is obese. I am very sorry to hear your story, but your situation is simply not what I am referring to. The vast majority of overweight people in this country have much more control over their situations than you do; and unfortunately, they are clogging up the healthcare system.

My issue with this is mostly practical. I treat my patients with respect as long as they are generally respectful back, and I even give them the benefit of the doubt much, much more often than not. I provide them with the best care that I can regardless. But there is no way to police someone's feelings about people who can't take care of themselves.

I hear you and I am glad that you treat your patients accordingly even though you believe that they are lazy and lack self respect. I realize that my situation is unique and I tell myself in my head it doesn't matter...but it does matter. It hurts...a lot. Do I need to wear a T-shirt with a picture of my former self and an explanation of my disease process in order to be treated with respect? No...I shouldn't.

Obese or not.....they are patients. Patients are the reason why we do our jobs. It is not for us to judge WHO is "clogging up the healthcare system" the fact remains patients are our job (no patients no job) regardless of their diagnosis, race, religion, sex, addiction, or cause of their current healthcare needs. Whether it is suicide, drug addiction, mental illness...they are patients and deserve our respectful care and empathy.

The reason I shared my story, which I seldom do, is the general assumption the the obese are somehow treated differently...discriminated against...openly..... and somehow it's ok.

Well, it isn't.....just as a head injured or paralyzed patient who was intoxicated at the time of an accident is "responsible for their injury" by making a decision to drink and drive....should they be treated any differently? no....they shouldn't.

I harbor no delusions that I can control or police people's feelings...... but I can share my experience to help educate others so that they can do better when they know better.

I am a victim of circumstance....do I act as a victim? No I don't. Having personally experienced this discrimination and open disgust of obese patients.....I feel I need to try to help nurses be better advocates for the benefit of our patients....and be less "intellectually lazy" as nurses.

Total care pts in general are a lot of work - no matter their weight. Even 85 lbs of dead weight is more than I could ever lift at the gym! Gotta love the useless phrase "proper body mechanics" which has no bearing on a situation when a load is just too heavy for you - proper ergonomics don't make you Superman. I was thinking about it and I think a big part of the frustration comes from lack of staff and proper equipment to safely take care of heavier/obese patients. 2 120 lb women can never safely move a 300 or 400 lbs patient with no additional help. It's frustrating when there is no additional staff to assist because your unit is understaffed. It's frustrating when there are no assistive devices on your floor for a bariatric patient to begin with. Basically the nurses and aides are just left to "deal" with it.... aka kill their bodies trying to care for someone who is just too heavy. So yes, I guess the resentment gets misplaced onto the patient when really it is a much bigger problem involving the employer, unit, and facility itself. Obese pts aren't going anywhere, and many of them do a good job of perpetuating the "jolly fat person" sterotype (lol i'm making a joke here, I'm trying to say that I've had many obese pts that were very nice people and I honestly enjoyed. So even though I'm frustrated, how could I hate them as people? I can't). What needs to be addressed is the lack of help and support staff members have in caring for these patients and trying to fix THAT problem.

My issue with this is mostly practical. I treat my patients with respect as long as they are generally respectful back, and I even give them the benefit of the doubt much, much more often than not. I provide them with the best care that I can regardless. But there is no way to police someone's feelings about people who can't take care of themselves.

How do you treat your patients that you do not consider to be generally respectful back? Your words say that if your patients are not generally respectful towards you then you do not treat them with respect, although you "give them the benefit of the doubt much more often than not." What does providing them with the "best care that I can regardless" mean if you don't treat your patients with respect regardless of whether you think they deserve it?

Something else to complain about: every BP cuff being too small! The fact is most obese people are so because they eat too much. We can argue about medical conditions, slow metabolisms and whatever anyone likes, its not like these conditions didn't exist 100 years ago when there was far less obesity. They certainly should not be discriminated against or given less care. Its normal for most people to be a bit overweight, we are not talking deranged Hollywood 'ideals', most people carry a bit more, that's not the issue...the issue is the increasing number of 170kg+ patients not taking the responsibility of themselves and expecting someone else to move them around. The physical effects on nurses have been discussed to death so I won't continue with that, however what about issues like other patients getting less quality care because obese patients are simply much more time consuming?

To deal with your animosity you need to be less judgemental. The day will come that you will be in a bed dependent on the care of someone else (unless you are one of the lucky ones). Would you want them to look at you through the eyes that you use to see your patients?

Specializes in Med/surg, Quality & Risk.

The patient that really has me over the edge is one that is over 300lbs, vent dependent, unstageable sacral (of course, no one wants to turn this patient which is a whole other issue), lower extremities contracted with knee replacements, on dialysis, PEG feeding, restrained because she pulls any tube in sight, and contact isolation for c diff and acenotibacter. This patient has been on the floor for 3 months so far because no LTC facility will take her (understandably).

Three months? I am wondering if you have a case manager at all.

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