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!
Back to my age: there is absolutely no reason (except for a very few medical conditions) why a person who was able to maintain a healthy weight in their 20's cannot do so for the rest of their lives. It may get more difficult to do so. I understand that. I bet when I have kids it will be very hard to get off the baby weight, and I will have much less time available to go to the gym when I'm juggling being a wife and mother and also working full time. But I will keep health as a priority in my life, and others CAN do the same.
i loved being in my 20's...dead serious.
my confidence was at an all time high, and truly believed i had all the answers.
i was probably one of the most self-righteous, cocky, s.o.b.'s one could ever meet.
i knew this, yet i didn't care.
i was also fanatical about my health, worked-out extensively 4+ times/weeks, and my bmi was 15.9%.
(no, i wasn't too skinny but definitely 'buff'.)
i had a female boss who'd give me the once over and tell me repeatedly, "wait til you turn 30"...or, "wait til you have kids".
well, i proved her wrong as well.
even after 3 more kids, i was active, physically fit, lifted wts, and remained lean and mean.:)
then one year (when i was in my mid-late 40's), 'stuff' happened...one event after the other, which led to me being dx'd w/traumatic ptsd.
between meds and other txs, i gained weight and didn't work out as much as i always had.
then last yr, i was dealt another hefty blow, which necessitated me taking meds that caused me to gain wt.
i also couldn't be nearly as active as i had always been.
was my wt gain, all from the meds/txs?
i believe it was, but if i'm going to be truthful, i also have to acknowledge my feelings of discouragement and even hopelessness...
and often, would have the "what the hell" attitude, which resulted in poor dietary choices and self-sabotage.
i guess what i'm trying to tell you, is 'life' happens.
you can swear up and down, that you won't change, and you'll still have your 6 pack abs in another 20-30 yrs.
i do understand how you feel and what you're saying.
but what i can promise you, is that obesity is not as simplistic as you purport it to be.
while i am not obese, these past 5-6 yrs have presented me with potential and actual etiologies, as to why/how people and their circumstances, change.
i daresay that if it was only as simplistic as eating less, exercising more, our nation wouldn't be in the obesity crisis that we're experiencing today.
obesity is NOT only about losing weight.
it is about totally changing your life-style.
one needs to try and undo and/or manage the situation(s) that got them from point a to b, in the first place.
it takes serious (and ongoing) reflection, contemplation, vision, strategy, support, and commitment.
as has been suggested already, you just cannot stop eating all together, as one would do in other addictions.
and even when one stops using/drinking/smoking, one cannot be truly successful until you get to the root of what led to the addiction in the first place.
it's a lot of back-breaking, lifelong work.
so, all i'm trying to ask of you, is a bit more flexibility in your attitude.
when you're caring for an obese pt, try and look past the excess skin.
i can promise you, that regardless of what you see or listen to, there within lives a suffering soul, living a life of quiet desperation.
why not see how you can add a bit of hope, through your knowledge base, sensitivity, and compassion.:)
not trying to come down on you...rather, i truly related to what you're thinking.
and isn't it ironic, that here i sit, asking you, to lighten up?
Then you must not have seen patients who picked offense because back-up was called for in repositioning him/her.
Nope. Never have in all the years of ICU I've worked. STILL irrelevant to the fact that obese patients have every right to expect to be treated the same as everyone else as it relates to compassion, respect, and basic human kindness.
Specializes in Care Coordination, MDS, med-surg, Peds.
oh my, don't quite know how to respond to this post... I don't disagree that someone who weights greater than 500 pounds has many issues including their weight, health and more than likely mental issues as well, but to classify ALL obese as Mentally ill is overstating it, to say the least. Do you really think that someone who is classed as obese at 10-15 over their IBWR, is MENTALLY ILL? How about those who are 10-15 pounds UNDER their IBWR, are they then also mentally ill, or have they over corrected and now are mentally well?
As far as antidepressants, one of the most common side effects is WEIGHT GAIN. SO how is that gonna help if you are already overweight?
Personally, I think the skinny minnies are the mentally ill ones. :) Just kidding, but think about it......obsession of any type is unhealthy whether it be weight, obtaining money, exercising/dieting too much, etc.!!!
Nope. Never have in all the years of ICU I've worked. STILL irrelevant to the fact that obese patients have every right to expect to be treated the same as everyone else as it relates to compassion, respect, and basic human kindness.
In light of this touchy subject, isn't it interesting how many nurses and other health professionals smoke and are obese? Of all people, we know the dangers and choose to either smoke and over-eat or either or. Who hasn't seen an obese cardiologist? Weight, like any other physical appearance is so touchy. That is why no matter how we personally feel about people who do things we don't agree with, we still need to treat them fairly and stop being motivated by hatred! You should treat your obese patients, your skinny patients, your beautiful patients, your ugly patients, your smelly patients, your homeless patients, your rich patients, etc. with the same kindness you would extend to your own sweet granny! It's not hard. If you can't stand the patients you are paid to provide nursing care for then get off the pot.The average adult changes careers more than once so maybe it's time for some to go. And for the pre-nurses who feel all gung-ho and "I'm gonna change the world!", just wait until you are out in the real world. You're no longer sheltered in the safety of school and you have pressure on you to get a job done. You may have to deal with so many stresses that you will want to take time to educate the obese people who are everywhere, but you may just be lucky to shove them full of their meds and help them to the toilet before running off to the next task. This won't leave much time for trying to use guilt to persuade them to lose weight. Maybe that should be the chaplains job...
P.S. I am in no way trying to be rude, I have a sense of humor and I think we all need to laugh more often! Good luck in your endeavors!
So compassion, respect, and kindness is only reserved for ICU patients? Or ICU patients aren't awake enough to feel embarrassed when it takes four people to move them up in bed? I assure you I've seen plenty of obese patients in ICU who were not on the vent and awake and aware enough to see that a whole crew has been called in to move them up six inches in bed.
Look, its obvious you have personal bias against obese patients. That was crystal clear when you used the word "chowing" for the fourth time to describe how obese people eat. I really hope for their sake that you are able to disguise your absolute revulsion and disdain for them.
in light of this touchy subject, isn't it interesting how many nurses and other health professionals smoke and are obese? of all people, we know the dangers and choose to either smoke and over-eat or either or. who hasn't seen an obese cardiologist? weight, like any other physical appearance is so touchy. that is why no matter how we personally feel about people who do things we don't agree with, we still need to treat them fairly and stop being motivated by hatred! you should treat your obese patients, your skinny patients, your beautiful patients, your ugly patients, your smelly patients, your homeless patients, your rich patients, etc. with the same kindness you would extend to your own sweet granny! it's not hard. if you can't stand the patients you are paid to provide nursing care for then get off the pot.the average adult changes careers more than once so maybe it's time for some to go. and for the pre-nurses who feel all gung-ho and "i'm gonna change the world!", just wait until you are out in the real world. you're no longer sheltered in the safety of school and you have pressure on you to get a job done. you may have to deal with so many stresses that you will want to take time to educate the obese people who are everywhere, but you may just be lucky to shove them full of their meds and help them to the toilet before running off to the next task. this won't leave much time for trying to use guilt to persuade them to lose weight. maybe that should be the chaplains job...
p.s. i am in no way trying to be rude, i have a sense of humor and i think we all need to laugh more often! good luck in your endeavors!
Obviously someone that destroys their body, whether it be with drugs, alcohol, food or food deprivation has emotional issues. Anyone with mental illness deserves compassion.
This is not rocket science, and I am not talking about 10-20 lbs. over weight. I am talking about those who distort their body so badly that they barely resemble what is human. Mental illness definitely plays a part.
No, not everyone who is morbidly obese has emotional issues, some are physiological. However, obesity, like anorexia and bulimia are rooted in mental illness, I believe.
Specializes in Clinical Research, Outpt Women's Health.
Thank you for clarifying that. I actually agree with you now.
Morbid obesity (I am talking the 350 lbs plus) is I believe reflective of serious issues of self. Although not in every single case, but surely the majority.
You may now have kids - I am no longer worried!:lol2::lol2:
Well the "chart" states that I should weigh 150 at 5' 11". I would look like a cracked out giraffe so my very hot 175 will suit me juuust fine. In hindsight I honestly did have some serious emotional/mental issues at the root of my years as a fattie. I NEVER would have admitted it back then though so... I was a fattie so yes I can call it that if I like. Obese just sounds like something that needs radiation treatments.
:lol2:
leslie :-D
11,191 Posts
i loved being in my 20's...dead serious.
my confidence was at an all time high, and truly believed i had all the answers.
i was probably one of the most self-righteous, cocky, s.o.b.'s one could ever meet.
i knew this, yet i didn't care.
i was also fanatical about my health, worked-out extensively 4+ times/weeks, and my bmi was 15.9%.
(no, i wasn't too skinny but definitely 'buff'.)
i had a female boss who'd give me the once over and tell me repeatedly, "wait til you turn 30"...or, "wait til you have kids".
well, i proved her wrong as well.
even after 3 more kids, i was active, physically fit, lifted wts, and remained lean and mean.:)
then one year (when i was in my mid-late 40's), 'stuff' happened...one event after the other, which led to me being dx'd w/traumatic ptsd.
between meds and other txs, i gained weight and didn't work out as much as i always had.
then last yr, i was dealt another hefty blow, which necessitated me taking meds that caused me to gain wt.
i also couldn't be nearly as active as i had always been.
was my wt gain, all from the meds/txs?
i believe it was, but if i'm going to be truthful, i also have to acknowledge my feelings of discouragement and even hopelessness...
and often, would have the "what the hell" attitude, which resulted in poor dietary choices and self-sabotage.
i guess what i'm trying to tell you, is 'life' happens.
you can swear up and down, that you won't change, and you'll still have your 6 pack abs in another 20-30 yrs.
i do understand how you feel and what you're saying.
but what i can promise you, is that obesity is not as simplistic as you purport it to be.
while i am not obese, these past 5-6 yrs have presented me with potential and actual etiologies, as to why/how people and their circumstances, change.
i daresay that if it was only as simplistic as eating less, exercising more, our nation wouldn't be in the obesity crisis that we're experiencing today.
obesity is NOT only about losing weight.
it is about totally changing your life-style.
one needs to try and undo and/or manage the situation(s) that got them from point a to b, in the first place.
it takes serious (and ongoing) reflection, contemplation, vision, strategy, support, and commitment.
as has been suggested already, you just cannot stop eating all together, as one would do in other addictions.
and even when one stops using/drinking/smoking, one cannot be truly successful until you get to the root of what led to the addiction in the first place.
it's a lot of back-breaking, lifelong work.
so, all i'm trying to ask of you, is a bit more flexibility in your attitude.
when you're caring for an obese pt, try and look past the excess skin.
i can promise you, that regardless of what you see or listen to, there within lives a suffering soul, living a life of quiet desperation.
why not see how you can add a bit of hope, through your knowledge base, sensitivity, and compassion.:)
not trying to come down on you...rather, i truly related to what you're thinking.
and isn't it ironic, that here i sit, asking you, to lighten up?
afterall, we all have our skeletons...
no matter how deeply buried.
leslie