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!
Thank god for online resources!! I can now find information I never received or learned from my PCP or other health care professionals. I truly want to get healthy just so I don't have to come in contact with health professionals that don't see me as another human being. It would be great if others do this and put these pretentious health care workers out of a job.
There is an incredible bias against very obese people in the hospital and it sickens me to hear otherwise perfectly reasonable, caring professionals lash out in the break room (for example) about the very large patients. Yes, it's hard to move them. No, they don't smell great a lot of times... so WHAT? A very obese person generates the same exact negativity among healthcare professional as someone who abuses ETOH or uses IV drugs.(not that that is ok either) "How can people do that to themselves? I have no sympathy.." Not everyone was born with good coping mechanisms or a stable homelife or even a positive role model. Sure, some people might be lazy or self absorbed or weak or whatever but SO WHAT? Do your job and take care of them and get off your judgmental soapbox. None of us is perfect.
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 bulls**t. 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.
Are you a nurse yourself, or a disgruntled patient? I can't imagine what sort of response you are looking for when you call nurses "bullies in scrubs".. when you're talking to nurses. Just because your doctor's office apparently is insensitive and/or does not meet your needs does not mean you are free to generalize about all nurses.
With regard to your post, saying that obese people are taxing to the health system is not "********" - it's a very real fact.
Wow- making someone feel guilty is a good thing? If this is your idea of motivation, I hope you're never my nurse or the nurse of someone I care about. There is not an overweight adult out there that doesn't KNOW that they have a weight problem and how to fix it. EVERYONE knows the difference between healthy food and unhealthy food. If you ask me, I think medical professionals are often too quick to dismiss health issues on the physical assessment of weight. If an obese person goes into the doctors office with the flu- they don't need to be guilted (or educated once again) on their weight. They have the FLU because someone coughed on them. Or because they touched something infected. Not because they ate a hamburger for lunch.
I kind of agree with this. I'm obese myself, I know it, and I feel guilty about it all the time - I know I should "be a better person" and lose the weight, but guilt is part of the reason I eat and why a lot of America eats. Guilt-tripping someone who is overweight because they are an emotional eater only compounds the problem. I think Leslie put it well, also. We know we're overweight. Trust me. And I also agree that it has really deep psychological things - I still think it's better than coping with tobacco or alcohol or illegal drugs.
The reason some health care workers find it easier to say nothing is because the PC police will immediately show up and start to harass you. In my experiences obese patients are extremely sensitive about their weight and think that you are judging them when you haven't said a word. Heaven forbid you are fit and attractive they become convinced that you are looking down on them and wish them dead. I have seen it too many times in 17 years to count. Either say it or don't. It's like telling someone you don't want to date them. It doesn't matter how you say it, they'll take it hard and think you're an insensitive jerk who was mean to them. Our society has become a politically correct herd of cowards and you see the result of that everywhere.
I disagree. I've been thin and fit most of my life and have not experienced what you describe. I have, however, found it very helpful to avoid pointing out the obvious (they're obese) and focusing instead on some small steps they can take to begin improving their health. For an obese person, saying they need to lose 100 lbs or simply "eat right and exercise" is just too nonspecific. I have gotten results with the following:
"Your diabetes is really a threat to your health. Did you know that even losing just 10% of your body weight can reduce your blood sugar significantly?" Also, "you do not have to spend 3 hours a day at the gym to decrease your medications or get off them completely. Did you know that brisk walking 30 minutes to an hour a day can reduce your risk of heart attack just as much as jogging?" Giving a patient small, obtainable goals will go a whole lot further than lectures of how their obesity is killing them. When an obese patient hears that there are some small things they can do which will pack a big punch, you get their attention. And they become more open to other small things they can do, instead of being overwhelmed with some huge goal which will take a year or two to obtain. And small successes often lead to more successes. One week of just getting rid of creamy sauces or greasy fat sounds more doable than completely overhauling their diet overnight.
Show them respect and compassion, give them honest answers to questions, avoid judgments, provide simple, obtainable steps which will lead them down the path to better health, and provide them with resources, and you'll affect some of these people. Some of it will go in one ear and out the other, no doubt. But at least you can go home knowing you provided valuable information without breaking someone's spirit-I think the success rate will absolutely be higher than any short term results you get from "guilting" someone into losing weight.
Finally, I always make it clear that you can absolutely be healthy without being skinny. It's the behaviors, not the number on the scale, which most impact health, and maintaining a reasonable weight, which is much more attainable for most, will keep them just as healthy as the skinny person (if not healthier). Fitness level, not weight, is a better predictor of health and longevity.
I'm both a student nurse and patient who happens to be obese. I don't want sympathy or for someone to sugarcoat my health. I am fat. But I do want respect and guidance from someone who is supposed to be a trained and educated health professional period. Talking about some and laughing about them outside there room or were a patient care hear you is disrespectful, teenage behavior which I'm sure you all have NEVER done as nurses.
Thank god for online resources!! I can now find information I never received or learned from my PCP or other health care professionals. I truly want to get healthy just so I don't have to come in contact with health professionals that don't see me as another human being. It would be great if others do this and put these pretentious health care workers out of a job.
Oh my, I'm sorry you must have had a negative encounter before, but you shouldn't paint everyone with the same brush. I would like to think that most nurses and doctors are geninunely concerned for your health. Maybe you should consider focusing your anger into more positive outlets. You would certainly feel better. A previous poster stated she gets on a real level with her patients... maybe you just haven't found the right PCP for you? Not everyone feels comfortable with just any PCP.
Specializes in Clinical Research, Outpt Women's Health.
I hope I never receive care from anyone on this post. I feel bad for any obese patients you come in contact with. Please!! Not all obese patients are jealous of fit patients. Is this the best you can come up with!!! I dislike rude, superior behavior no matter what the size!! Get over yourself!!
Really? There are plenty of posts here that do not say that at all. maybe you need to go back and re-read again.
Is the best thing to do in this situation to pat everyone on the back and agree with all they have to say? I think it's my responsibility as a nurse to educate my patients and give them all the facts I can that will allow them to make responsible decisions and choices. When they chose to make poor choices I still take care of them, but re educating is part of that care! Sugar coating the real issue isn't in the patients best interest. It might make them feel less awful at the moment but is doing nothing to empower the patient to be healthier!
Ummm, but don't you think there is a whole lot of middle ground between "sugar coating" and providing harsh, judgmental, and ultimately ineffective criticism? Surely we've got a whole lot of strategies within our reach which neither entail "sugar coating" nor using "guilt" as the primary motivator.
It is never okay to mock or ridicule patients, or purposely make them feel terrible. That certainly was not something I said in my original post, or any follow-up posts. Just wanted to make that clear.
No need being PC about it. If you're fat, you're fat and need to quit chowing.Losing weight and keeping it off can be a menace as most of us know,but when you see a very obvious obese person chowing down, it's upsetting.
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Thank god for online resources!! I can now find information I never received or learned from my PCP or other health care professionals. I truly want to get healthy just so I don't have to come in contact with health professionals that don't see me as another human being. It would be great if others do this and put these pretentious health care workers out of a job.