Caring for morbidly obese bariatric Pt

[Cheyenne RN,BSHS]

Soon our facility will increase their scope of services to include bariatric patients. The surgeon has been very successful in his present practice in another state and has a great reputation.

I am concerned for several reasons and wonder if there any nurses that work with bariatric patient and the morbidly obese who would be will to help me out. I am fat myself but not in the domains these patients are but I at least do understand what they are going though.

We have had new bariatric toilets installed, larger beds, wheelchairs, many needful things to make the person feel normal and that we want to help them. We have asked that nurses and assistants that are going to work on the unit get properly trained on all the equipment, And we have tried to avoid hiring anyone with negative attitudes about the morbidly obese.

I can see the need for patients to have counseling and dietary education.

I HAVE some CONCERNS/QUESTIONS.

1. For those patients that seem to use anger as a defence mode how do you deal with the emotional toll it takes.

2, i have watched so many come back years down the road and the have complications and end up back in the OR. What are the most common issues they face?

3. How many gain their weight back? What do they do with all the excess skin? Not everyone can afford that type of surgery.

4. How many end up with sever life threatening complications. We seem to have quite a few come into the OR and ER.

Thanks to all who help me out.

[Nurseinprocess]

I worked on a bariatric surgery floor for a couple of years. I have never seen that particular patient population have any anger issues that differ from any other? Most are just as pleasant as any other type of patient. Not every bariatric surgery patient is huge, most were not. I have seen some that we all shook our heads at over why they were a candidate for the surgery at all. The most common complications I saw were malnutrition, N&V, and blockages that required stents. I don't think that a large percentage gain back the weight. I have seen people eat around their lap bands and have to have a sleeve or bypass done instead. From what I understand, if a patient has a large amount of excess skin it is usually covered by insurance to have it removed as part of the weight loss surgery. It is a medical problem that causes chafing and infection. One problem I saw during immediate post op recovery was those patients who needed a c-pap and wouldn't wear one. They can go into respiratory distress while sleeping (not a common thing, but when it happens it is scary). Another issues is watching out for patients with internal bleeds post op, pretty rare. Other than that, most were very good patients and not hard to care for. We would get an occasional super morbidly obese patient, but most were under 350.

[amoLucia]

Cholelithias freq occurs.

[VivaLasViejas, ASN, RN]

Why would obese patients have any more anger issues than other types of patients?

[Ruby Vee, BSN]

Why would obese patients have any more anger issues than other types of patients?

Oh, I dunno. Maybe it has something to do with the attitudes they encounter from health care professionals . . . . some of which may be appearing in this thread soon. But they certainly are apparent in other threads!

[dudette10, MSN, RN]

Most bari pts are highly motivated and very compliant with the plan of care. In my opinion, they are some of the easiest patients to care for.