There is an article in this months American Journal for Nursing about nurses showing more encouragement & compassion for obese/smoking patients instead of making the patients feel judged or guilty. I am a pre-nursing student and attempting to formulate a response to this article.
My first instinct when I read this was that it was really sweet, it certainly gave me the warm-and-fuzzies, but it is simply not practical. The United States' obesity epidemic is becoming worse and worse. Researchers now even believe that the avg life expectancy is on the decline for this very reason. I just don't understand why medical professionals are expected to sugar coat their medical advice. Sure, I wouldn't expect a nurse to say, "Holy cow, you're so FAT! Lose some weight!" but I don't see why it would be offensive for a nurse to say, "You need to lose 100 lbs or your diabetes will cost you your legs." In the article it suggested a nurse say something like, "Let's focus on the aspect of your weight issue that's within your control." Does this statement really reflect the severity of the situation? I believe that guilt can be a very powerful motivator in these cases. I don't see guilt being a bad thing when it comes to issues as important as health.
If you would like to just provide a general opinion, that would be great. If you don't mind your opinion potentially being used in my paper, please let me know and I'll send you a message to get more info. Thank you!
"So at which part of your visit did the doctor tell you that you were stupid and lazy ? I never said that obesity isn't blamed when it isn't the cause, I said that I have never heard a HCP call someone stupid, fat and lazy. And I don't believe that they have said that to you either. Just my opinion."
I think it is more likely that patients are told things like these, just not in so many words. I'm sure that this, along with the patients' perception that the HCP personally believes the he/she is "stupid, fat, and lazy" is equally as hurtful, resulting in an experience one would likely relate to flat out being told he/she is "stupid, fat, and lazy". There are ways to say things without actually saying them.
Oh yeah, and we have a doc that once told a patient "I'm sorry, there is nothing more we can do for you: you are just too fat". No joke.
Exactly. That is what I have experienced far too often. They are hurt and upset over a perception that may be simply that. A perception.
also notable, is that society does not treat skinniness with the contempt that it treats obesity.
rather, 85 lbs is the ideal to many....the thinner, the better.
thus, why so many teen girls struggle with anorexia/bulimia.
it's ironic that while 'we' dislike obesity, 'we' also are part of a culture that encourages fast, fatty, convenient foods.
it's not only the (obese) person that is responsible.
our govt is also remarkably culpable as well.
leslie
I have to disagree. I am a "skinny" with not a lot of curves. I can't tell you how many times I've heard "real women have curves" and just have to grind my teeth not to reply. Don't get me started on the govt vs. personal responsibility.
What a bad, unhealthy tool this is. Unfortunately, many employment companies, Drs, etc use it as a guide. Insurance co's use it too.
For example, I knew a woman who had huge legs, a small waist, small boobs, etc. But she was denied a certain job she went for (can't remember what it was). The Dr told her her BMI was too high (but they didn't say that was the reason she didn't get the job!) She had very little fat around her middle or anywhere else for that matter (she actually showed me). BMI does not take in our differing shapes and sizes as women. She had had two children & breastfed. Every female in her family had big legs, it was the bane of her existence, and she'd tried running, exercise, reducing thigh-diets, diet milkshakes - all that c**p - to no avail. Nothing made her thighs smaller and I mean they were HUGE compared to the rest of her body. It all depressed her no end, and to look at her, she certainly was not obese.
Oh how we the women in our society are humiliated what with all the work we do, raising kids, running homes, working and making sacrifices for the family! That is why BMI is so soul destroying and should be BANNED.
Oh yeah, and we have a doc that once told a patient "I'm sorry, there is nothing more we can do for you: you are just too fat". No joke.
Do you think some Drs use these actual words to try and shock obese patients into doing something re their weight? I've never heard a Dr myself say 'you are too fat' but I've heard a Dr say to a very obese woman that her breathlessness, syncope and blacking out was because she was too obese, putting strain on her heart. This woman absolutely refused to believe him. She'd actually fainted at work and been brought in by ambulance. Her heart was a little enlarged, she had mild hypertension, didn't have diabetes, etc - yet. The Dr was very nice and compassionate, explained the risks of being obese etc etc, spent quite a bit of time with her, and wanted her start off seeing the dietician. He was trying to say that if she did something re her weight NOW, she would probably not have worse problems down the track.
This woman would not believe her symptoms were due to her weight (she'd had numerous tests/bloods etc done on the cardiac/renal ward, NAD). Only that her heart was a bit enlarged & the mild SBP. I offered to go to the dietician appointment with her for support b4 I started work - she refused. I said 'Look at least go to the dietician appointment with me, and see what they have to say - they can work around your lifestyle'. He was also going to send her for a cardiac stress test. But no, she was not having a bar of it.
The Dr was very compassionate as was his intern, but she was so far in denial, she would not even LISTEN to what they said. She still wasn't feeling well, but signed herself out against medical advice. And b4 she left, she was crying after she got a phone call. I asked what was wrong, and she said her boss had just rung her and told her she had been sacked because this sort of thing had happened a few times b4, and she hadn't addressed the problem. So she lost her job on top of being in denial.
I always remembered her. She was a very nice woman, probably good at her job, I don't know and I liked her a lot. But she was so far in denial about everything, sometimes I think back and wonder if the Dr had said something like: 'You really need to do something to address being overweight, or it will eventually kill you. Your heart is already straining under the burden' or something to that effect. Maybe she would have listened then, but somehow I doubt it very much. I honestly think she thought we were being mean, hateful and judgemental.
I often wondered if she was OK after she left the hospital. Maybe a psych consult would have been warranted, but she would not stay for any other interventions. Perhaps she was simply embarrassed and/or angry.
I'm obese at 5'6" and I weigh 220lbs. The few times I've gone to the doctor's office, the nursing staff was just down right rude and disrespectful to me and made me feel less than a human being. Is this what nursing is about? Yes I'm obese and have been on diet with little success but to kick a person when they're down is the worst treatment a person can receive. This type of behavior is not a matter of concern for my health and well-being but a person acting superior to you just because they're thinner than you. Would it be ok for someone to say well maybe if you just didn't sleep around, you wouldn't have contracted HIV or AIDS? This is the reason why I don't go to the doctor. I have a few friends that are obese and they don't go to the doctor for this very reason. And to say that obese people are taxing to the healthcare system is ********. The government provides programs like detox, rehab, meds, counseling services for people addicted to drugs and alcohol. How much money is spent on these programs? They're just revolving doors and all it does it keep people employed in these centers. Right now I'm trying to get my health on tract and I appreciate the resources online that are available. There were no resources available for me from my doctor. Nothing not even a pamphlet or list of nutritionist or dietitians that could help me. I had to keep asking for something as simple as my vital signs and blood test results. I'm a human being and want to be treated as such. But then I realize that most nurses are women and the catty, teenage like behavior is something that is the norm now. Sad but true. IMO, a nurse is nothing but a bully in scrubs.
Obesity is nothing like HIV or AIDS. Have some self control, stop eating, and go for a jog. There are genetic dispositions that can lead to obesity, yes. However, that would not explain the drastic rise in obesity in well developed countries.
You are eating into tax dollars just as a crack addict or alcoholic would be. Your poor health decisions are going to lead to health problems that you have the ability to control. The problem with people today is that they are too afraid of hurting someone's feelings. I'd rather attempt to save someone's like by being honest, than lying to their face to protect said feelings.
Going on a diet is not the only way you can lose weight. Every hour you are off work and not busy take 5 minutes and do push-ups, curls, jog, whatever. If you say you don't have time to do that I'm going to say that you do not care enough about your situation to do something about it. I take 8 classes, work a full time job, and still have plenty of time to workout.
Yes this is harsh, but you really need a reality check on where your health is going. Dieting isn't working, get off your butt and do something about it.
I am obese, I am a RN. During school my eating had become so compulsive that I could not control what I put into my mouth.I wish my doctor would have mentioned to me about my weight. I really didn't even notice it skyrocketing while I was in school and when I did. It took me going going to the doctor because of feelings I was gasping for breath every night to realize it was my weight. When they had me get up on the scale I could not believe my eyes. I literally could not breath because I was so FAT!
I am now trying to get this under control by exercising more and eating less. I watch the biggest loser for inspiration, and I have also gotten on a medication to control compulsive behavior. With the medication, I now eat with a purpose, and have lost 9 lbs in a month without "dieting" at all. I am going to start a diet this month and hopefully within the next 6-9 months I will be at my goal weight.
My vote is for Reality!
Good on you! I was wondering could you share more of your experiences re how you lost weight?
We should start a thread for people with ANY eating problems, whether they are skinny or fat, whatever. We might just inspire each other. I love hearing re other people's problems and weight loss/gain whatever, it inspires me and I think it gives others hope too to know they are very much not alone.
i always remembered her. she was a very nice woman, probably good at her job, i don't know and i liked her a lot. but she was so far in denial about everything, sometimes i think back and wonder if the dr had said something like: 'you really need to do something to address being overweight, or it will eventually kill you. your heart is already straining under the burden' or something to that effect. maybe she would have listened then, but somehow i doubt it very much. i honestly think she thought we were being mean, hateful and judgemental.
i often wondered if she was ok after she left the hospital. maybe a psych consult would have been warranted, but she would not stay for any other interventions. perhaps she was simply embarrassed and/or angry.
i think he should have said that-there's nothing inherently "not compassionate" about those words. i could say that exact sentence without imposing a judgmental tone. those words are not inflammatory or even remotely cruel.
by definition, however, someone in denial often remains in denial even when the most blunt and brutally honest language is used. think of all the addicts in the world who deny, deny, deny no matter how they are approached. she may have been that deep into it.
I personally have heard a doctor tell a patient that he could not give her proper care because she was so fat - in those words - WHILE she was in active labor. After we left the room I personally hauled him into an empty room and told him exactly what I thought of his behavior and how and where I would write the complaints if I ever heard him address a patient in that manner and circumstance again.
I have many times heard coworkers expressing all kinds of negative, derogatory, really nasty things about obese patients in the breakroom or at the desk. Being the direct person that I am I've been known to remind them "Hey - fat lady sitting right here" only to hear them reply "Oh, we don't mean you - you're not THAT fat"
Message - some of you might want to consider how destructive some of the things you are saying may be to those reading these threads....
Message - some of you might want to consider how destructive some of the things you are saying may be to those reading these threads....
Baglady, the sad fact is that people on this board who say those things don't give a rat's patoot about how "destructive" they are to those reading the thread. In fact, I think they derive pleasure from it.
Baglady, the sad fact is that people on this board who say those things don't give a rat's patoot about how "destructive" they are to those reading the thread. In fact, I think they derive pleasure from it.
I do agree that many don't, but speaking up when someone makes such prejudiced statements about any group is something I have to do for myself.
Obesity is nothing like HIV or AIDS. Have some self control, stop eating, and go for a jog. There are genetic dispositions that can lead to obesity, yes. However, that would not explain the drastic rise in obesity in well developed countries.
You are eating into tax dollars just as a crack addict or alcoholic would be. Your poor health decisions are going to lead to health problems that you have the ability to control. The problem with people today is that they are too afraid of hurting someone's feelings. I'd rather attempt to save someone's like by being honest, than lying to their face to protect said feelings.
Going on a diet is not the only way you can lose weight. Every hour you are off work and not busy take 5 minutes and do push-ups, curls, jog, whatever. If you say you don't have time to do that I'm going to say that you do not care enough about your situation to do something about it. I take 8 classes, work a full time job, and still have plenty of time to workout.
Yes this is harsh, but you really need a reality check on where your health is going. Dieting isn't working, get off your butt and do something about it.
She stated plainly she knows about the problems of obesity... You don't need to educate with your 20 year old wisdom. I'll tell you what, come back in 15 years when you have lower metabolism, kids, a house to keep, a full time job and no energy and preach... I was a perfect size 4 with all the answers at 20 too...
Conqueror+, BSN, RN
1,457 Posts
Exactly. That is what I have experienced far too often. They are hurt and upset over a perception that may be simply that. A perception.