Nursing makes me hate fat people

[LifeCrisis]

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.

[brandy1017, ASN, RN]

I'm sorry if anything I said hurt your feelings OCNRN63. I do wish you the best and hope your surgery goes well and everything turns out ok.

[The_Optimist]

The title of this thread is really needlessly provacative and offensive.

I'd hazard a guess that title was written in a moment of pique, hence the no-filter.

[ready4nu]

So you're comparing for example cancer or elderly patients, situations that are out of the patients control, with obesity, a situation where the patient can, or at least could have, done something? Big difference.

I never mentioned cancer or elderly, where did that come from? I simply said "one of the lucky ones", meaning, a person who never needs to depend on another human being for their care.

My post was a reply to the OP's request : "Please share how you deal with these kinds of patients and what I can do to reverse my growing animosity towards these patients".

I suggested that he/she be less judgemental. I see nothing wrong with that. We cannot make the assumption that all people are in their current condition because they did not take care of themselves according to the way we think they should, and take that to the point of feeling that we "hate" them (as the thread title states. A patient may have been in excruciating back pain for years. A judgemental person may look at them and decide that they have back pain because they are obese. How do we know that? Do we have records that show how long they have been obese to compare with the onset of the back pain? Maybe they injured their back, were no longer able to work, their wife/husband left them for their cousin and took the kids. The patient grew depressed and started to eat and are in severe pain so they are not physically active. Maybe. The fact is that we don't know the entire life story, so we should not be so quick to judge. Sure the patient may be able to take charge and do something, as could the old guy with COPD who just keeps sneaking a smoke, as could the young, unmarried/unattached pregnant woman with 3 children from different fathers who is on welfare, as could the young man back for the second time this week for stitches because of another drunken fight. We don't know the whole story and should not judge them because we don't want to ever be on the other end of the judgement that is made.

[TrevyRN, BSN, RN]

You remind me of my honeybunny in surgery that is VERY tired of morbidly obese patients. Sweetums keeps asking "HOW ARE THERE ANY MORE GALL BLADDERS TO REMOVE AND KNEES LEFT TO REPLACE!?" They're extra work and very time consuming, so I know where you are coming from. Like others are suggesting, if there is anyone you can talk to about making it easier for you to work with them (lifts, more help, better equipment, etc) then definitely talk about it. You company probably doesn't want to lose you or have you turn into a workman's comp case. If your company sucks, you can always apply elsewhere... ;-)

[TrevyRN, BSN, RN]

I never mentioned cancer or elderly, where did that come from? I simply said "one of the lucky ones", meaning, a person who never needs to depend on another human being for their care.

My post was a reply to the OP's request : "Please share how you deal with these kinds of patients and what I can do to reverse my growing animosity towards these patients".

I suggested that he/she be less judgemental. I see nothing wrong with that. We cannot make the assumption that all people are in their current condition because they did not take care of themselves according to the way we think they should, and take that to the point of feeling that we "hate" them (as the thread title states. A patient may have been in excruciating back pain for years. A judgemental person may look at them and decide that they have back pain because they are obese. How do we know that? Do we have records that show how long they have been obese to compare with the onset of the back pain? Maybe they injured their back, were no longer able to work, their wife/husband left them for their cousin and took the kids. The patient grew depressed and started to eat and are in severe pain so they are not physically active. Maybe. The fact is that we don't know the entire life story, so we should not be so quick to judge. Sure the patient may be able to take charge and do something, as could the old guy with COPD who just keeps sneaking a smoke, as could the young, unmarried/unattached pregnant woman with 3 children from different fathers who is on welfare, as could the young man back for the second time this week for stitches because of another drunken fight. We don't know the whole story and should not judge them because we don't want to ever be on the other end of the judgement that is made.

Maybe they've gained weight because they're pregnant... ! Sometimes I play that game in my mind to play off someone's obesity and it makes it funny instead of anger inducing. Especially when it's a fat 80 year old man... I'm like "maybe he's put on a few because he's eating for two... maybe it's twins!" Mind games make life better.

[rubato, ASN, RN]

I really hate threads like this. I get sick of people hating others for ANY reason, much less something like weight. But, on the other hand, I get sick of people defending every choice as one that is out of a persons hands.

We are nurses (well, I will be in 6 months). We are there to care for patients, no matter who or what they are. They can be obese (by their own doing or not), they can have cancer that they created by smoking, they can have type 2 diabetes that they created by overeating, or they can have anything.....it is our job to care for them.

But, not at the expense of our health. You are required to be able to lift a certain amount of weight by hospital standards. Anything above that, you shouldn't have to lift. I am not going to lift a 400 pound person alone because I can't. I am a strong, healthy woman who lifts weights 2x a week. But, 400 pounds is beyond my ability. There need to be changes made in the OPs facility. But, you can't blame it on the patient population.

OP, I can understand how you feel, a little bit. But, please don't put your anger and frustration on the poor patient in the bed, put it where it belongs, on your facility.

[Dragan]

I certainly wouldn't last in this job if I hated any group of patients, for a start. As with a lot of threads on the site, this one (although it could have been worded better), represents a genuine, relevant increasing concern for nurses, so discussing it does not mean being judgemental, its just another nursing challenge.

[DoGoodThenGo]

I really hate threads like this. I get sick of people hating others for ANY reason, much less something like weight. But, on the other hand, I get sick of people defending every choice as one that is out of a persons hands.

We are nurses (well, I will be in 6 months). We are there to care for patients, no matter who or what they are. They can be obese (by their own doing or not), they can have cancer that they created by smoking, they can have type 2 diabetes that they created by overeating, or they can have anything.....it is our job to care for them.

But, not at the expense of our health. You are required to be able to lift a certain amount of weight by hospital standards. Anything above that, you shouldn't have to lift. I am not going to lift a 400 pound person alone because I can't. I am a strong, healthy woman who lifts weights 2x a week. But, 400 pounds is beyond my ability. There need to be changes made in the OPs facility. But, you can't blame it on the patient population.

OP, I can understand how you feel, a little bit. But, please don't put your anger and frustration on the poor patient in the bed, put it where it belongs, on your facility.

Nurses having *issues* with this or that patient for a vast and bewildering array of reasons is nothing new. Pick one: race, ethnic background, religion, sexual preference, social issues (abortion, sex worker, criminal history, etc...) and so forth all have been covered. Worse when compelled to do so said nurses often provided care in such a passive-aggressive manner it could be seen by some as ground for some sort of disciplinary action. This even often applied to nurses that were members of religious orders, which in theory should have made their behavior different.

Suppose it would be wonderful if the awarding of a professional license would cause nursing professionals to check their prejudices at the front door when they arrive for duty, but sadly again that often is not so.

The best way to sort such nonsense out is to for management and or administration to sit someone down and listen to their complaints. If they are valid then perhaps they can be addressed, but under no circumstances should such petty matters interfere with patient care. If caring for "X" patient population bothers someone that much then perhaps they ought to seek employment elsewhere, cause here things are what they are.

[ComeTogether, LPN]

I'm going to refrain from commenting on the opinions made since I'll likely get in trouble.

There are lots of ways to turn heavy patients, alone even, without hurting yourself. It depends on the patient, but someone with r sided weakness can be changed almost completley by only rolling to the right side and using their left side to help hold themselves up. This requires bending the left knee and having them reach with the left hand while you pull on the pad or sheet under them to get them to start turning. Also, if they are as far over to the opposite side of the bed to the side they are being rolled towards it helps a lot too.

You can also use the bed itself to help you in pulling them up, among other things. I put beds in trendelenberg a lot to help with gravity. Usually between doing that, and having the patient help if able I can get almost anyone up in the bed by myself.

Then, there is the hoyer, which is pretty nifty if the patient is especially "heavy"

[Dragan]

What's a Hoyer?

[LadyFree28, BSN, LPN, RN]

What's a Hoyer?

It's a brand name for patient lifts:

http://en.m.wikipedia.org/wiki/Patient_lift

[LadyFree28, BSN, LPN, RN]

Nurses having *issues* with this or that patient for a vast and bewildering array of reasons is nothing new. Pick one: race ethnic background, religion, sexual preference, social issues (abortion, sex worker, criminal history, etc...) and so forth all have been covered. Worse when compelled to do so said nurses often provided care in such a passive-aggressive manner it could be seen by some as ground for some sort of disciplinary action. This even often applied to nurses that were members of religious orders, which in theory should have made their behavior different. Suppose it would be wonderful if the awarding of a professional license would cause nursing professionals to check their prejudices at the front door when they arrive for duty, but sadly again that often is not so. [/quote']

It IS sad; one of the MAIN themes in my nursing education (PN and RN) was that one's PERSONAL bias has NO PLACE in nursing care; it was thoroughly discussed in Fundamentals of Nursing, and reinforced throughout each course; I have a Critical thinking and nursing Judgement book that reinforces this; this is ESSENTIAL in making sure our practice and standard of care is optimum.

The best way to sort such nonsense out is to for management and or administration to sit someone down and listen to their complaints. If they are valid then perhaps they can be addressed, but under no circumstances should such petty matters interfere with patient care. If caring for "X" patient population bothers someone that much then perhaps they ought to seek employment elsewhere, cause here things are what they are.

http://nursingworld.org/MainMenuCategories/WorkplaceSafety/Healthy-Work-Environment/SafePatient

There is a federal push to make more workplaces a "NO LIFT" facility; meaning, no manual lifting is allowed.

I worked in places where a part of orientation was body mechanics and safe handling: transfer/gait belts, bed slides and Hoyer lifts are routinely used; at my current employment, if the pt cannot get up from a fall independently, you MUST use a lift with a two-person transfer; there have been people fired in the past that did not follow policy.