Morbidly obese patients

miko014 · Oct 25, 2006

Yes! I feel like I've had millions of them! It sounds like she has "hotel syndrome" - in that she thinks she is in one. We had a pt not long ago who was a young man with pancreatic problems and DM type 1. He would just whine and whine, and be on his call light all the time. I once saw him come out to the nurses station and show his RN a cut on his finger She said "Oh yeah, it looks like you have a little paper cut." He said (very loudly), "But I haven't had any paper!" - he ws very upset about it. Never mind the book he was reading...silly me, I thought books were made of paper. But it was like he was just constantly after everybody. He once came and found me in the break room while I was taping report to ask me for something and HE WASN'T EVEN MY PT! My manager finally sat down with him and they made a contract. It said that he was to get off the phone when the RNs or MDs or anyone was in the room, he was not allowed to come to the station unless his call light had been on for more than 10 minutes, the RN would check with him once every x amt of time, etc, and they both signed it. It helped a little bit. The big thing was that we had to set limits with him. That's really what he wanted. I think maybe someone should talk to her about what her health goals are and why she is there. Maybe she hasn't been in the hospital much and doesn't "get it", or maybe there are some psych issues underneath that make her not want to do anything for herself? Just a suggestion! Hope it helps!

suzy253, RN · Oct 25, 2006

Were you working 3-11 at my hospital last night? Sounds like almost the same patient that we have transferred from another floor...just the med problems were different.

I just do the best I can do and document!

tvccrn, ASN, RN · Oct 25, 2006

I think we have all had patients like this. I agree the aonther poster that said "hotel syndrome". I have always wondered why people come into the hospital if they are going to decline everything we try to do for them to help them recover.

Just nit picking, but the title of the thread doesn't accurately reflect your post. It just happens to be one characteristic of your patient.

tvccrn

Long Term Care Columnist / Guide · Oct 25, 2006

I think we have all had patients like this. I agree the aonther poster that said "hotel syndrome". I have always wondered why people come into the hospital if they are going to decline everything we try to do for them to help them recover.
Just nit picking, but the title of the thread doesn't accurately reflect your post. It just happens to be one characteristic of your patient.
tvccrn

Agreed. Please, let's not turn this into another thread bashing the obese....we already have enough problems as it is.

NurseyBaby'05, BSN, RN · Oct 25, 2006

I was going to say something similar. The woman's obesity seems like it is secondary to her hotel syndrome. Many of our patients want to be waited on hand and foot (on their time schedule, I might add). I had a 18 yr old, 95 pound girl who was able to go out for a smoke q1h and roll around the bed with her boyfriend all night, but got really po'd at me because I handed her pillow cases for her pillows instead of putting them on and fluffing the pillows for her. I won't even get started with my urology patients (who have come in all shapes and sizes) and their wives.

TazziRN, RN · Oct 25, 2006

There needs to be an interdisciplinary meeting about this pt. She needs to have the charge nurse AND her doctor tell her under no uncertain terms that she is there for a medical reason, and that if she refuses treatments and tests then there's nothing more you can do for her. And that she is to stop interfering with your jobs.

Marie_LPN, RN, LPN, RN · Oct 25, 2006

To the OP:

Perhaps this lady needs a psych consult, since there might be an underlying problem aside from the physical ailments.

A side note:

If her physical characteristic is what's limiting her ability to do these things for herself, it's a factor in all of the problems the OP listed. And perhaps the OP didn't know what to title the post, since they are new here.

However, it would be nice to be able discuss anything about obesity on this forum without some people taking it all personally, but i know that's not going to happen.

KIAN · Oct 25, 2006

I agree with a multi-disciplanery plan to set goals for being able to take care of herself. Does she have or need help at home when she is dismissed? Sometimes we find it easier just to do things for them than to devise plans to help them or require them to do it on their own.

This is a difficult patient to deal with. I know I don't have time to coddle them and I sometimes feel resentful (not at all nurse like) and blame their obesity for all their problems.

Katnip, RN · Oct 25, 2006

One thing I fail to understand.

What does her obesity have to do with her attitude? I've had many, many patients who behaved the same way or worse but were not obese.

EmerNurse, BSN, RN · Oct 25, 2006

I think the OPs point wasn't to bash the obese but rather to point out that while ALL demanding patients will drive us nuts, it's a bit tougher when one of them requires more than just one staff member to do anything for her.

I can reposition a 98lb PIA LOL by myself, get her on a bed pan even if I think she's perfectly capable of getting herself on the BSC, but with someone very very heavy, I have to pull other staff to help. That makes it harder.

Not a bash on obese folks, just logistics.

ortess1971 · Oct 25, 2006

One thing I fail to understand.
What does her obesity have to do with her attitude? I've had many, many patients who behaved the same way or worse but were not obese.

I don't think her obesity is responsible for her attitude but when you have a patient who is morbidly obese,capable of moving, but refuses to, then there is a problem. In my hospital, we have a lift team who will come up with a hoyer lift rather than some nurse throwing out her back...I'm NOT bashing the obese, trust me. I'm a big girl but if I am capable of moving or at least helping, I'll do so.