I have an interview to work on a bariatric surgical floor (not the OR itself) on Thursday. I'd never considered bariatric - I'm trying to get back home to my home city, so I've been applying everywhere there. My dream job is ICU or stepdown or ER, maybe OR or PACU; unfortunately, it looks like most of those jobs require experience, so I'm thinking of getting a med-surg job (as my first job, I've worked 2 years on nights on a post-orthopedic surgical/med-surg floor), working it for maybe a year, and then trying to do an internal transfer to more critical care.
Can anyone tell me about bariatric nursing? I've read a little about it here, and a few themes came up: 1) lots of physical work (I'm used to turning Pts and helping them ambulate after hip/knee surgery, but they're usually
What kind of age group is it?? I'm thinking probably middle-aged? I do prefer younger or middle-aged.
More men or women? (Middle-aged/early elderly whiny anxious neurotic women who won't lift a hand for themselves -- not saying that statement represents bari Pts, because I don't know, I'm just saying that I don't like the little sub-demographic of "Entitled Helpless usually-female aged 40-70 Pt" -- are my bane.)
How do the Patients feel, emotionally? Are they glad that they're doing this, and excited about a new step in their lives?
Is it emotionally satisfying? Do you see the fruits of your labor? (One of the things I like about ortho nursing is seeing the Pt work and get stronger.)
Do the Pts tend to come back for surgical revisions or new surgeries, or is it a one-time deal?
I'm kind of wondering if I should take the job (if they offer it) or keep searching for something "better." It is a good hospital (I went to school there) with one of the best reputations in the city, and maybe I should just take it, get some knowledge/skills out of it and appreciate it for what it is, and then try to internally transfer within a year.
Hope I didn't offend anyone; thanks for any replies in advance.
Your experience will depend on the hospital and the surgeons - I've worked Bari at two hospitals.
Hospital A had a very selective screening process - low risk only, thorough psych eval. Patients were motivated, prepared, many knew each other from the support groups, it was a positive, even joyous floor to work. 85% of patients had strong family / friend supporters who were a joy to have around and truly supportive. Only complaint is that the nature of the work was somewhat monotonous.
Hospital B was less selective and seemed to be in it for the money. Higher risk patients, psych issues, lots of complications. Not so positive. "Difficult" patients, "demanding" (and I can't really say it's the fault of the patient!). Patients were not prepared or screened as well for the surgery.
So make sure to research their bariatric program and screening - that would be the key. Best of luck!
So long as they have lift equipment and maxi slides, it's a good job lol. And, so long as you don't have a herniated disc or something going into the job, it may just be a good fit.
I have worked on a bariatric floor. The surgeon was EXCELLENT with his patients AND his nurses. We got a lot of extra training to be able to provide adequate care for these patients. I don't think it is fair to "stereotype" these patients. I have been a travel nurse and have worked in many different specialties. I see the "whiny, demanding, complaining, woah-is-me" patients with "mental/emotional issues" everywhere!!! I never had one bad experience in the 2 years I worked on the floor. Most of the time these patients were so grateful for the care they received. How would you feel if you were some 500 lbs and had to have someone assist you in wiping your butt? You might be a little whiny yourself!
It can be a disaster zone. The unit I worked on got the post op bariatric surgeries and the return trainwreck bari patients.
For every positive patient we got, we got four that could best be described as challenging.
Supposedly, our patients underwent psych assessment, etc. but often it was a case of pushing their GP to demand surgery and they'd come in unprepared or return with leaks, etc because they thought it would be a quick fix.
Oh, and having bariatric surgery in Mexico on vacation is never a good idea. Cost my health service over a $million to fix that one.
Just approach it like any other surgical unit and use the specialized equipment and it's not horrible work.
Oh, and if the patient is sane, usually the family is the issue. We had one mother who basically fed her 20yo child upto 300 kilos and was caught sneaking in cheeseburgers post op.
Cosign the replies that depends on the surgeon(s) and how strict the screening process has been. On my floor, we were the designated bari unit in the hospital but had two very different groups of surgeons, producing two very different groups of patients.
First group: strict screening, every i dotted and t crossed before surgery. Patients were well-prepared for the surgery and generally good about diet restrictions, early ambulation, pain control, so on. Often were lap surgeries which went home within 2 days. Minimal intervention needed and often easy, fun patients receptive to teaching.
Second group: seemed to take anyone who could pay. Many had histories of bipolar, depression, anxiety, chronic pain, HTN etc and a litany of meds to control same with varying compliance; these patients were some of the most difficult I've had. Capable, but unwilling. Particular, yet irrational. Hard to please, quick to complain and so, so many complications due to non-compliance with diet afterward. Worst of all: the surgeons were high strung, blamed you for patients refusing to ambulate or adhere to diet limitations, and generally made a bad situation worse whenever you involved them in the plan of care or needed orders. Ugh.
I'll hope that you get scenario 1 and enjoy the job! I find surgery very cool and lots of these patients (first group) were willing to share about their lifestyle, how they chose to have the surgery and what the prep was like. Taught me a lot and helped me trouble shoot the issues of the second group!
Second Amairilla. One of the most touching stories I heard post-op was a lady who went horseback riding with her kids, and she was too heavy to ride. Decided to have the surgery - very motivated. Also, people who realize that their lives will be shortened by morbid obesity and want to be there for their kids and grandkids - very motivated. But, as has been stated, it really depends on the surgeons. Good ones are choosy, have amazing success rates and low complications, and are great with the patients and nursing staff. Nursing staff will work hard for them because there's a personal relationship and expectations - and it can be a wonderful
We get a fair amount of bariatric patients on my floor. Generally I find them to be reasonably pleasant - a little wary maybe, I see a lot more super positive family members then patients themselves. What I will say though is that I see a LOT of readmissions - dehydration, malnutrition, obstructions, leaks, etc. The first two are most common, the last is less common although of course this population tends to be rife with co-morbidities that impede healing (DM, HTN, Obesity itself, Vascular issues...). They do go home quickly but I've seen a lot return just as quickly - education is super important.
At first when I saw your post title I was thinking a bariatric general med/surg floor and my reaction was 'heck no'. But bariatric surgery itself isn't as bad because as has been said above, these aren't total care patients and the length of stay is expected to be short.
I have two new grad offers from "bariatric floors"; I was initially going to decline since I'm looking for a more varied M/S experience, however managers of both say they really only have 5% bariatric patients at a time (since surgeries are only 3 times a week) and that the rest are GI/GU pre/post op and med overflow in ~40-bed units.
Is this common for bari units? This seems so strange to me since the posts here seem to indicate that bari care is usually its own thing. However, if this is normal - why on earth are they called bariatric floors? I'm sure the managers aren't trying to be misleading (don't get me wrong, i'm very happy to have a m/s varied floor), it just seems strange to designate a floor for a procedure that seems to be relatively rare. It ultimately doesn't matter, I was just thinking maybe there's a simple explanation i'm overlooking!
07302003, ASN, RN
142 Posts
Your experience will depend on the hospital and the surgeons - I've worked Bari at two hospitals.
Hospital A had a very selective screening process - low risk only, thorough psych eval. Patients were motivated, prepared, many knew each other from the support groups, it was a positive, even joyous floor to work. 85% of patients had strong family / friend supporters who were a joy to have around and truly supportive. Only complaint is that the nature of the work was somewhat monotonous.
Hospital B was less selective and seemed to be in it for the money. Higher risk patients, psych issues, lots of complications. Not so positive. "Difficult" patients, "demanding" (and I can't really say it's the fault of the patient!). Patients were not prepared or screened as well for the surgery.
So make sure to research their bariatric program and screening - that would be the key. Best of luck!