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!
Have you ever been denied or given ineffective treatment because you smoke? Has anyone told you "I'd use this medicine but you smoke so why bother!" Has hospital staff talked about "that smoker" in room whatever and everyone fight not to care for you because you ae a smoker? Has anyone made comments of why should you be cared for when you refuse to help yourself if you would just stop stuffing cigarettes in your mouth? Would you ever tell a gay male with HIV that he got for a blood transfusion......if you would have worn a condom you wouldn't be sick? I don't think so.......
Empathy, tolerance, and patience. Leadership, mentoring and teaching. Kindness and caring.......just my :twocents:
I don't think anyone has insinuated that obese pts shouldn't be cared for. The asthmatic smoker will still get a breathing Tx and the same care as the non smoker,..however as the nurse it is my job to make sure the patient is aware that smoking is contributing to his illness. If a medication isn't going to be as effective while smoking the pt has the right to know that. The obese patient who is contemplating his/her 3rd hernia repair and is furious because the first two failed deserves to know that weight plays a big part in his/her health issues and frustrations. I can't do anything about what has already happened, but I can educate the patient to help prevent further illness and injury.
Obviously no one is going to tell an HIV positive patient who contracted HIV from a blood transfusion that he wouldn't be sick if he'd used a condom. That wouldn't be true. Now if said pt has never received a transfusion and most likely contracted HIV through unprotected sex than yes he should be aware of how he became so sick! His education should include safe sexual practices, right along with how to take meds and his plan of care.
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.
imagine how the obese person feels.
most of them have enough self-hatred, that more than exceeds the disdain of the gen'l population.
yep katie, just a simple matter of "quit chowing".
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.
Pretentious?Because they speak their truth and offer help. Much has been PC'd and sensitised about this subject, everyone alike, pcp, healthcare are reluctant to voice it.
Heck the First lady is even taking heat because of it!
Obese people need some nutritional help and guidance. Do you offer this to your patients or simply say stop eating so much so they can leave the office or center? Great patient teaching. Once again, thank god for online resources.
most of them have enough self-hatred, that more than exceeds the disdain of the gen'l population.
yep katie, just a simple matter of "quit chowing".
now, why didn't we think of that?
leslie
Here goes the guilt tactics to get me into submission. Not everyone can be excused as having an underlying factor.
I speak based on chowing. I too, love to eat but have to weigh the consequences of not being able to eat any and everything in sight. It is a conscious but difficult choice.
Someone once said something along the lines of," with the money models make, they sure look ****** off all the time.". Yup, it's hunger. And then to watch someone chow down mindlessly, it's hard. LOL,reread my comments and laughed at me:clown:
Obese people need some nutritional help and guidance. Do you offer this to your patients or simply say stop eating so much so they can leave the office or center? Great patient teaching. Once again, thank God for online resources.
Like I said in my previous posts, I want to know about my health regardless of my size. Tell it like it is. But don't laugh at me in the process. You just come across as a child and I will not take what you have to say to heart because you show you have no heart.
Pity party. Please!! It just ****** me off that I went and paid for health care and instead of getting it I got treated like ****. BTW, thanks for the correction but I want health information not a grammar lesson.
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."
Just for a moment of comic relief, could we all agree that sugar coating medical advice is probably not the best choice of words.
But seriously, telling someone that they need to lose 100 lbs or they will lose their legs is not the best way to go about things. You can't predict the future. Some patients will have catastrophic outcomes, but others won't. Making a pronouncement like that sounds like you are handing down a sentence, not discussing possibilities. Going for the overly dramatic approach costs credibility, AND, more important, hearing something like this makes the whole shebang seem impossible. It's an invitation to shut down.
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.
This is a part of the equation that is often overlooked. The health care professionals don't have to introduce guilt--it is already there!
What bothers me most about these threads is that I rarely hear anything about asking the patient what it is they want. We make certain assumptions and just run with them. Even if the patient wants what we think they should, our motivation (whether offered as a carrot or a stick) isn't enough to get the job done.
We have to meet people where they are and put things in terms that mean something to them. And it's usually easier to look at taking action to preserve or maintain what we already have than signing on to what seem like impossible goals just to become worthy of someone else's approval.
Talk to your patients. Find out what's important to them. Then link their goals to baby steps that will help them move in that direction.
Not--"You're going to lose your legs if you don't lose 100 lbs."
Rather--"If you can substitute grapes and baby carrots for chips and cookies, you should lose some weight and then your feet won't hurt so much."
Who wants to grapple with a huge goal just so that someone else will find them worthy? Most people I know would prefer to tell that person to take their stingy approval and stow it.
But, if choosing baby carrots over cookies looks like the ticket to my feet feeling better, that really means something. And besides, it's doable!
The struggle to lose weight isn't about guilt. Or shame. Or winning someone else's favor.
It's about believing it can be done. And breaking the big picture into little pieces. And linking the resulting baby steps to small, reachable goals. And building one tiny success upon another.
You lose weight one pound at a time. And you do it because something has made you want to move forward, not because someone has told you something about guilt that you already know.
Please, take the time to connect with your patients. Find out what it is they truly want. You'll be able to help them so much more effectively (and you'll have earned their respect) if you are prepared to listen.
:twocents:
Horseshoe, BSN, RN
5,879 Posts
stephanyjoy,
I just re-read the title of your thread: "Compassion or reality for obese patients?"
Are these two terms mutually exclusive?