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!
Sorry you guys...I've learned this after many years of self-education. If you read my first post about how I work with my patients; this is entirely different than what I have posted here. This is for the nurses who want to loose weight. I am not Paris Hilton. I have worked hard and prayed hard and given a lot of discipline to my life. You can think that I am bragging all you want. I have given sound advice to anyone who wants to really loose weight and be healthy. I'm sorry if I made it sound easy. It is not. I struggled with weight as I mentioned from youth till adulthood. Now that I am 48 YEARS OLD , I feel that I can be a resource. So dont' come off as if I am some movie star. I am letting all the obese nurses know that no matter how full their lives are, the first place to look for health is themselves. I am responding to the nurses here who have asked for advice. As Jesus Christ said, "physician, heal thyself!. It is NOT EASY. But the rewards are great. It's not about looking good. I added the stuff about the 25 year old guys as humor. Again, nothing worthwhile is ever EASY. This was simply a step-by-step way if one is truly ready to commit. As I said, I don't give a patooty what you look like.....I care for all equally. But you must admit, this thread has more than the patient in question. Many have mentioned their personal desperate attempts to find balance. I am just saying that if you want to get in shape, you need to be disciplined. I'm sorry if that freaks people out in this instant gratification world. No offense. But I feel a little offended. But hey, when one sticks their neck out there lies always the possiblility of having their head chopped off.NaMaStay.
Case in point....Can't strap a pre-schooler to your back while on the eliptical.
There are very real, very practical reasons why what works for some won't work for others. Diet and exercise advice needs to be tailored exactly to the details of the individual's unique life/schedule/responsibilities if it is to work - the more mismatched to the individual's unique situation, the greater the impetus for non-compliance.
How they ever let these young discriminatory shallow fools into nursing, Ill never know. If they're all so perfect, why aren't they hanging with the Kardashins or Paris Hilton. Why pick nursing?
Are you saying that people thinking that obese people should lose weight in order to become healthier is "discriminatory"?
Yes, Stephany, that's exactly what I'm saying. I think anyone can cover up discrimination with a pretty little label attached to it.- " It's healthier" I think it would be "healthier" if shallow, elitist people would just keep their 'controlling' attitudes to themself and stop offending others. I personal think the ypounger nurses hair dos like like "Olive Oil" from the Popeye Cartoons ad that to their obsession with the waf look of anorexia and you have a nursing unit full of Olive Oils.
Excuse me. My original post re: patient care was post #89. May want to refer to my nursing judgement. Again, the most recent posts were directed towards nurses who are at their wits end about their obesity. And within nursing judgement I will add, if you have renal issues, things will be very different re: my weight loss advice. Protein can not be so accentuated. Now, I also stated I've spent much of my life being, yes....OBESE. So don't try that judgement on me. Look to thyself with that! I agree, diet and excercise needs to be tailored. I was giving advice to the bedside 0700-1900 RN. No you can not strap a preschooler to your back. But if you have a husband, an older child, a neighbor, a teen.....all doable. When my son was too old for the backpack, I did yoga at 0300, as I stated. And I learned it from a BOOK, not a class, reading by KEROSENE LAMPS. Yes, it was HARD. It was also hard having the love of my life DIE. It was HARD, living on 40 acres in the outback without electricity or running water! It was HARD, going through college and nursing school with a child this way! What I am saying is that if I could find a way, any nurse can find a way to fix whatever is ailing her!!!! Geez. Sorry if I sound mean, but I have been offended myself here as well. I simply am telling those who have asked what to do....how to work with their metabolism!!! So get off me here! I am venting now! Exxxuuuussse MEEEEE." Shallow "is such an insult! Try watching your beloved husband die in the prime of his life, and try to make a new life alone for your child and yourself! And then if you can make it that far....try to see the rewards...OK? Blessings, already.
I think it's foolish after all these years of trying various methods of approaching dangerously obese patients with weight loss goals to think that being gentle or realistic about consequences of obesity will make much difference. Both result in watching them proceed to not give a crap, eat junk, despise exercise, deteriorate, and become a societal burden in terms of lost productivity and increased medical care costs. You're not 'educating' a fat person when you tell them that being fat has consequences. If you think you are, you're deluded.
The problem is that people are lazy; let's give them all lap bands, lipo and drug therapy. Making things easy is the real solution to obesity. Of course, that's a modest proposal.
Right on Debbie Anne! It warms my heart to know that someone got something out of my posts besides anger. Doesn't hurt to try. Love and self-actualization to all....patients and nurses alike.
I am an NP and an LPN instructor, and I totally disagree with the "guilt" method. My approach would be "Let's get your Hgb A1C under control." If her A1C is around 6.5, her eating is under control, and her weight shoudl at least stabilize. Give her a realistic, achievable goal. And BTW, I am technically "obese." (30 pounds overweight.)
I assure I have no jealousy issue to be taken here. I don't know what they are teaching young nurses now a days. The role of the nurse is not to cram ,force your views on your patients There are boundaries to the Therapeudic Relationship and patient harassment and abuse. The nurse gives the information to the patient. It's the PATIENT's decision whether or not they want to take it. The nurse DOES NOT engage in a fight, a test of wills, with the patient. The nurse treats ALL patient with dignity, respect and without judgement. That's nursing's Standard of Ethics. The proposals on these threads about obesity and smoking are not only violating peoples CIVIL rights but a breach in the Ethical standards of practice. That is a suable offense. Punnishing, yes, punnishing people with unemployment, the denial of a American liberty to earn a living, that to is in the US CONSTITUTION. That's all these CEO's want- they want to bend the rules to suit them selves. They are employing young inexperienced minds to help them. They are perfectly aware that the older seasoned nurses are are of their tyranical BS and won't go along with it. When I say older seasoned- It's those of us who have had years of the hard knocks, rasied familys, the ups and downs of life, paid bills, battled for our own personallife struggles- wether it be with a mortgage company, tax collector or on the nursing job. Our minds are not that soft of persuasvie Bull crap and know bull when we hear it. It's called LIFE experience.
If an IV drug abuser patient comes into the hospital are they now refused care? It does seem where this is going we do need socialized medicine( putting practice issues, patient rights and worker's rights into the hands of the feds who do uphold the laws of this land), and more primary providers because given the rate of these discussions, these people whose lifestyles and habits the nurse, the CEO's and administrations personally don't agree, find distasteful, or offensive will be left in a corner to die. This is not jealousy. This is unethical elitist behavior, that goes against the very grain of the nursing profession. DO NO HARM!! When some on is denied employment, and FORCED to live on public assistance, and have to grabble for their basic needs( as per maslow), that is doing harm. Serious harm. Why stop there. If there are to many female babies born in the country- Euthanasia?, to old- euthanasia?, certain race or religion- eiuthanasia? There are countries in this world that do this. Then there is female castration- look up refugees from the country of Myamar/Burma- we have these patients in our hospitals also. Do we treat these womwn with disgust and distain? Nursing is a small cog in a big wheel but nurses are the front line- if these CEO's can influence the nursing staff to practice a certain way- it' makes their job alot easier- for what end purpose- their mega buck pay check security.
To the original thought- If a patient is obese and the doctor has deemed it permissiable, give that patient the infor, and tell the patient if they have questions , leave the dialogue open to asking. Do NOt force your beliefs on them. If they are an adult with a cognitive impairment- you are talking to a brick wall. and you have to realize that. It's called readiness to learn- it's part of the nursing care plan(either written or electronic)
I used to work at a wound clinic. We fired a patient because of his non compliance with weight and not off-loading. He had a diabetic wound that wouldn't heal and had cost the government a million dollars. He had to stay off it and lose weight...he gained 75lbs and the doctor let him go. I gave him a diet to follow that I follow myself and he lost at first then went off of it.
I have been a nurse since 1995 and have seen in my life and others what a huge impact nutrition has on life in most all areas. I am 45 and have not allowed myself to get obese. I could not imagine trying to help an obese patient if I could not practice what I preached. It's like talking to a patient about his heroin addiction as he watches me shoot up.
Hello,
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!
Specializes in LTC, CPR instructor, First aid instructor..
Nightenglenurse, This message is for you hon. I too have been where you were; without running water, I collected rain water for my household use. I also was without electricity. I used a kerosene lantern. I raised 2 children who now have masters degrees in the professions of their choosing, and both are happily married. Could I ask for more? I have been truly blessed. Now, I'm not bragging either. I'm just stating the facts of my life here.
I grew up as a thin child, was a thin mom, and when I did gain some weight, I went to Weight Watchers to lose it. I was very successful for many years. Then when I graduated nursing school in 1996 at age 55, I had gained a little weight back. I then was wearing a size 16. So I went back to Weight Watchers, and managed to get my weight back down. Yes, I walked and walked, and walked some more.(I looked very healthy at age 60.) However, in 2001, I suffered a PE that nearly took my life. I was placed on massive doses of prednisone, blood thinners and pain meds to keep me alive. I also suffered from steroid induced myopathy, and was so weak I was unable to raise my head, but was I ever HUNGRY. The hunger took over my life for a while. The following year, I began a downward spiral. Pneumonia x 4, respiratory failure x 2, septicemia, CHF, and the diagnosis of COPD which I still have and will suffer from the rest of my life, and that's not all.
I am currently wheelchair bound and am on oxygen 24/7 and am wheelchair bound. I am also well over 200 pounds, but I saw a machine I think I can use in our pool room where I live. It's a machine I can sit on and paddle like a bike in a recumbent position. I aim to try that out. So you see hon, not all of us are able to exercise the way you suggest.
You raise some very valid points, and I like your plan, so please don't take offense at this message. None is intended. I am just trying to do the best I can by eating a sugar free, low fat diet that includes lots of vegetables and fruit, plus some protein, and get out and about in my chair with my one legged friend who lives down the hall from me.
I love to laugh, and I know that helps reduce stress, and I love my life even though I am a large person now. I have thought of a positive way to handle the fat. Yes I have thought of donating my extra skin to a skin bank. I love people, and I still want to help them.
nightengalegoddess
292 Posts
Sorry you guys...I've learned this after many years of self-education. If you read my first post about how I work with my patients; this is entirely different than what I have posted here. This is for the nurses who want to loose weight. I am not Paris Hilton. I have worked hard and prayed hard and given a lot of discipline to my life. You can think that I am bragging all you want. I have given sound advice to anyone who wants to really loose weight and be healthy. I'm sorry if I made it sound easy. It is not. I struggled with weight as I mentioned from youth till adulthood. Now that I am 48 YEARS OLD , I feel that I can be a resource. So dont' come off as if I am some movie star. I am letting all the obese nurses know that no matter how full their lives are, the first place to look for health is themselves. I am responding to the nurses here who have asked for advice. As Jesus Christ said, "physician, heal thyself!. It is NOT EASY. But the rewards are great. It's not about looking good. I added the stuff about the 25 year old guys as humor. Again, nothing worthwhile is ever EASY. This was simply a step-by-step way if one is truly ready to commit. As I said, I don't give a patooty what you look like.....I care for all equally. But you must admit, this thread has more than the patient in question. Many have mentioned their personal desperate attempts to find balance. I am just saying that if you want to get in shape, you need to be disciplined. I'm sorry if that freaks people out in this instant gratification world. No offense. But I feel a little offended. But hey, when one sticks their neck out there lies always the possiblility of having their head chopped off.NaMaStay.