Nursing makes me hate fat people

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Ok, first off let me say I know this topic will probably generate a lot of strong opinions. I will also state that I am not a perfect person and don't take care of my health 100% so please don't think I am trying to be an elitist or something in posting this.

Disclaimer aside, I want to know if other nurses sympathize with me.

I am going to try and be as brief as possible in my story. First of all we have 2 resident patients on my floor that have been there over a year. They are obese and have suffered strokes. They require total care. These particular patients are about 250lbs and 1 has hemiparesis and the other has use of 1 arm (not sure what to call that).

The patient that really has me over the edge is one that is over 300lbs, vent dependent, unstageable sacral (of course, no one wants to turn this patient which is a whole other issue), lower extremities contracted with knee replacements, on dialysis, PEG feeding, restrained because she pulls any tube in sight, and contact isolation for c diff and acenotibacter. This patient has been on the floor for 3 months so far because no LTC facility will take her (understandably).

Not to mention all the cellulitis patients and other comorbities we deal with on admissions.

I am a 25 year old male and starting to feel back pains. This really has me over the edge as a combination of lazy/uneducated coworkers and heavy (literally) care.

Please share how you deal with these kinds of patients and what I can do to reverse my growing animosity towards these patients.

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Perhaps you should not be a nurse in America where majority of the population is not a size 4 or smaller . There are skinny people just as bed bound as the heavy people . It takes team lifting for heavy people. Also nursing homes rarely take vent dependant people regardless of size.

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You want suggestions, here they are.

1) Get a grip on the reality of patient care-- you don't have to like it, but big people are here to stay

2) Make sure your employer has all the current research on injury to care staff related to improper lifting, inadequate staffing for safe lifting, or inadequate lift technology

3) Make sure your employer is making strides to obtain proper lift technology in the building, including technology for caring for bariatric patients

4) Get your risk manager or case manager to get that poor person with the sacral pressure ulcer a proper bed surface, or your risk manager may have more to deal with than back injuries

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You want suggestions, here they are.

1) Get a grip on the reality of patient care-- you don't have to like it, but big people are here to stay

2) Make sure your employer has all the current research on injury to care staff related to improper lifting, inadequate staffing for safe lifting, or inadequate lift technology

3) Make sure your employer is making strides to obtain proper lift technology in the building, including technology for caring for bariatric patients

4) Get your risk manager or case manager to get that poor person with the sacral pressure ulcer a proper bed surface, or your risk manager may have more to deal with than back injuries

I would say you are right on the money. While the care is heavy I would say we are understaffed (although I don't have the title to make that decision).

Never more than 2 PCA on the floor despite the census up to 39 patients, unless we have a 1:1 and then it doesn't matter because that person can't help with care.

I wish there was some kind of standard on how many people are needed for care based on a patients weight.

Can you link me some evidence based studies on employee injuries? We have a union here so if anything I can work through them.

Also I will bring up to my floor nurse manager about getting an air mattress for this patient.

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Specializes in Acute Rehab, IMCU, ED, med-surg.

So, to me, it doesn't sound so much like you resent bariatric patients, as you are experiencing a work setting underequipped to care for them. You come across as a person who wants to give good care, but has inadequate support to do so.

I agree with the risk management suggestion. Are there wound care nurses who can get involved? Is there a possibility of installing lifts to make turns with one person more doable? Or can there be a lift team?

Sounds like you have an opportunity to be a change agent where you work! Good luck!

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Specializes in Emergency & Trauma/Adult ICU.

I'm going to try to say this gently ...

If you are being pushed over the edge by 250-300lb patients ... I'm guessing you haven't been practicing very long. Where do you think 400-lb.+ people end up, in significant numbers? In LTC.

As another poster noted above -- this IS reality, and it is here to stay. The resources required to care for these patients can be enormous, no pun intended.

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I would say you are right on the money. While the care is heavy I would say we are understaffed (although I don't have the title to make that decision).

Never more than 2 PCA on the floor despite the census up to 39 patients, unless we have a 1:1 and then it doesn't matter because that person can't help with care.

I wish there was some kind of standard on how many people are needed for care based on a patients weight.

Can you link me some evidence based studies on employee injuries? We have a union here so if anything I can work through them.

Also I will bring up to my floor nurse manager about getting an air mattress for this patient.

An air mattress is completely inadequate. Have her contact the local reps for specialty bed companies and ask to have a couple of them come to do an onsite eval (free) to determine the best one for the patient AND for the staff.

Google "work injury prevention when working with bariatric clients" and you will find a lot of resources, some of which cite research studies. Go get 'em! You can be an instrument of change.

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Specializes in Med-Surg, NICU.

250 lbs? Ha ha! I have had patients more than twice that size. 250 lbs is nothing when one comes across their first 500+ pound patient (and yes, this patient coded and had a multitude of other problems). That being said, NEVER try lifting a patient by yourself. I know too many nurses and aides who have literally broken their backs because they tried to do it on their own. Also, pull some other nurses and aides to help out, as there are strength in numbers. I imagine with a 250-pounder, you only need one or two more people to help out. Five hundred pounds...that is another story.

Also, does your unit have any lifts or auto-turning beds or air mattresses? This can help reduce the risk of injuries, and I find them to be my back's guardian angel. :)

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Specializes in Med/surg, Tele, educator, FNP.

I know taking care of heavy patients is hard, but guess what? You are a nurse, that's your job, that's what you do. Now if your back hurts, you are not using proper body mechanics or you are not asking for help, or not using equipment meant for bariatric patients like a hoyer lift.

Sent from my iPhone using allnurses.com

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I know taking care of heavy patients is hard, but guess what? You are a nurse, that's your job, that's what you do. Now if your back hurts, you are not using proper body mechanics or you are not asking for help, or not using equipment meant for bariatric patients like a hoyer lift.

Sent from my iPhone using allnurses.com

Funny, whenever help is needed no one is to be found...

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America is fat. People don't take care of themselves. I have met a few studs who are 55+ and in better shape than me once in a while but when I go to work and see people who are 35-40 looking like they are 70+ it makes me cringe. Some of the blame can be placed on actual disease but for the most part its negligence.

Just something you have to get used to...

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Specializes in ICU.

Sounds like they've got you working! Don't think for a moment that what you are seeing is unique. Welcome to the club fellow nurse! :)

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