Setting a bad example?

[mattcastens]

I am curious about what people think about working nurses who are extremely out of shape, obese, smokers, etc.

I work in a CVICU where a good portion of the nurses are overweight and out of shape, as well as a couple of smokers. I can't imagine that this makes a good impression on patients when these nurses sit down for teaching about risk factors, or to the general public when they come to visit.

I'm not saying that I am a prime example of fitness, and I'm not saying that nurses need to be triathletes to set a good example. I also realize that there is the added problem of addiction that is hard to overcome.

I guess I don't know what the answer is, but I do know that it bothers me. Thoughts anyone?

[mattcastens]

Originally posted by Susy K

Matt, your question about setting an example really isn't out of line.

>SNIP!

And someone made the comment about their husband who said to the doc "You ain't no Twiggy yourself" which to me tells me that people ARE impacted by example and/or images. We are a very image oriented society.

Thank You! I didn't think it was out of line. Now if I had said "All the black-lung fatties should be booted out of nursing, " that would have been out of line.

NOTE TO EVERYONE: Please notice that the above line is an example. An example. This is not an actual quote by me or by anyone posting in this topic, but an example of an inappropriate comment. I repeat: The above quote was an example only.

Think of this: People will joke about getting marriage or sexual advice from a Catholic priest, saying, "Well, how would he know what he's talking about?" I have a feeling that some patients might feel the same way about getting health information from an overweight, or smoking, nurse.

[fergus51]

LOL! I don't think your question is out of line either Matt, I just think it is not the case necessarily (is that a firm enough answer?). I can see why patients may not listen to fat nurses talk about nutrition, but at the same time there are a lot of women on my unit who don't think that a man can understand what they are going through. Should we eliminate all male OB nurses or OB/GYN docs? Of course not. We need to make the differentiation between knowledge and practice. I can tell someone about testicular exam and why they should do it even though I don't have any testicles, so I say I can teach nutrition even though I could stand to lose about 20 pounds. I only had one patient ever comment on that when I was in nursing school and a little heavier than I am now. I told him that I am a work in progress, just like him and he responded well. Besides, I say I am healthier with my extra weight than I would be if I smoke, drank and never exercised. There's my rationalization for why I continue to eat too many cookies.:)

[fergus51]

And Suzy, don't you love how teaching on L&D and PP is confined to "PUSH" and slap the kid on the breast and you'll do fine. I sure am glad we don't do any real lifestyle education there.

[Q.]

Ahhh Fergus, I know. It all boils down to the same ole argument. You and I and countless other L&D sistas (and brothers) have heard it before. It gets old. Perhaps my passion about NOT just sitting at the bedside yelling PUSH and bringing babies in and checking bands, and of course, all the babies are born happy and healthy and to parents to WANTED them is what lit my fire to respond like I did.

That's why, thanks for your input. And you too VAC. Awesome comment about how birth and breastfeeding ARE major lifestyle changes. Pure awesome. Short and to the point. BAM.

Cool, very cool.

[mattcastens]

Originally posted by fergus51

LOL! I don't think your question is out of line either Matt, I just think it is not the case necessarily (is that a firm enough answer?). I can see why patients may not listen to fat nurses talk about nutrition, but at the same time there are a lot of women on my unit who don't think that a man can understand what they are going through. Should we eliminate all male OB nurses or OB/GYN docs? Of course not. We need to make the differentiation between knowledge and practice. I can tell someone about testicular exam and why they should do it even though I don't have any testicles, so I say I can teach nutrition even though I could stand to lose about 20 pounds.

A good point. However, having experienced being a male nurse during my OB rotation, I can say that I have had women request that I not be their nurse, or ask how I was to teach them about breast feeding without being a woman. This, in my mind proves that image can influence effectiveness.

What if I was the world's leading expert on breast feeding? I am sure that there would be women who would ignore what I have to say, or at least doubt my knowledge, because I am a man. I hear this from women all the time when they talk about the possibility of seeing a male OB/GYN: "Oh, I would never -- he couldn't possibly know a woman's body as well as a woman!" I'm not discounting the skill. But we must acknowledge that skill might be overshadowed by image; therefore, because of image, effective practice might by lessened.

I have said before that some of the unhealthiest nurses I work with are also some of the best. When it comes to a code or recovery from surgery, no, I don't think the patients care about what their nurse looks like. But in the next phase -- the education phase, what if the patient thinks that he's not going to listen to the nurses advice, because she can't follow it herself? Worse yet, what if the patient simply gives up his quest for a healthier lifestyle, thinking, "Well, if a nurse can't do it, I sure as hell can't!"

You're response of being "a work in progess" is a good on. Perhaps one of the ways to counteract the preconceptions is to acknowledge them and add the suggestion that "we're all in this together."

[ZAROZINIA]

1) We are all human.

2) we as nurses should try to be none judgemental.

3)It is our job to give patients information to empower them in making health decisions.

4) People have rights.

Matt, what on earth do you expect?

As for women talking about breast feeding, Im sure some people are more comfortable talking to someone of the same sex about certain subjects. As nurses we talk about a huge range of very personal/ icky issues and sometimes forget that this is not the norm.Its not just that a patient doesnt respect/ trust your knowledge.

I think there are too many issues involved here( culture, backgrounds, experiences, intelligence, sex, age, status etc), you cant have a perfect world. If you did then you wouldnt need many nurses , would you?

[Q.]

It's not so much about wanting a perfect world, but more so about what that husband said:

YOU AIN'T NO TWIGGY YOURSELF

I'm curious on the views that Matt's opponents hold on this statement - and this perception that America holds of images.

[fergus51]

Exactly what I am talking about Matt! And do you think you could not have been as good as a female OB nurse? Do you buy that even for a second? Probably not, because you know image is important, but it isn't everything. Most of us don't have any of the diseases our patients have yet we are considered qualified to teach diabetics how to monitor their blood sugar and asthmatics how to take inhalers, etc. We DON'T have to live through everything we teach. Why does a perfect diet have to be the exception?

I think nurses should be working on making image less important, not enforcing the idea that it's more important than it really is. I don't believe that patients should even have the right to refuse a male nurse or a fat nurse anymore than they should be able to refuse to have a black nurse or a hispianic one. We are too obsessive about image.

[night owl]

What about the nurse who's bad habits do not show on the outside? What about the drug addictive nurse, or the alcoholic nurse? Would you want him/her taking care of you? Food is addicting/comfort to some people under alot of stress, yet alot of times people are looked down at because of their weight. They eat for reasons other than being just hungry. They know full well that they are over weight and should lose the excess baggage, but they need more than to just go on a diet. Losing the wt isn't the problem, keeping it off is. It's not an easy road to travel, more like the Ho-chee-min trail! (don't even try to make me spell that one!) We can survive without alcohol or illegal drugs, but we cannot survive without food. We do need to make changes in our behavior/eating habits, but sometimes change is difficult if you're not used to the new changes. There will be slip-ups and let downs, but one must keep struggling to achieve a goal and then to maintain it as well. You skinnies don't know how lucky you have it and the fatties only wish they could be like you without the struggle. But please don't judge the fatties for what they look like for most of them are crying on the inside and yet they have a heart of gold...just my lil ol humble opinion...

[RNKitty]

Originally posted by mcl4

At six hours, how much teaching, if any, can be done.

Quite a lot, actually, since the nurse to patient ratio is 1:1. Also, we telephone them at home the next day, and visit them at home on the second day. We do EXTENSIVE teaching, preadmission, during the stay, and after they leave.

[RNKitty]

I still maintain that if we desire our patients to eat a healthy diet, we need to serve them healthy food in the hospital. Show by example WHAT comprises a healthy diet. I think that tasty, nutritious food will win them over better than the nurses lecturing to eat whole grains and veges, then serving mac and cheese with jello.

[Q.]

RN Kitty-

I agree, actually. The garbage that comes our way from the cafeteria is pretty pathetic - but at least it's not junk food, I guess.

Could be worse.

Like when the cafeteria would close for third shift (gee, I guess no babies are born on third shift, thus no mom's need to eat. Oh, I guess teaching isn't done then either)

and for food for the nurses the cafeteria would leave out big vats of old food, uncovered, unrefridgerated, etc. We would pick from those room-temp scraps and hope we wouldn't get food poisoning.