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.

[MauraRN]

Too many facilities are trying to get away without the expensive lifting equipment. And a 250 pounder is a lightweight, even for a woman my age (57). When the patient is over 400 lb and there is no lift equipment available, or they are immobile, your back will give you trouble no matter how good your body mechanics are.

[Ticklelicious]

I can relate. I used to work as a nursing assistant and obese people that cannot move makes me cringe because getting help to change her takes a long time. The worst is that the patient doesn't even want us to change her.

[Blue Roses]

I sympathize. I've had 500lb+ patients that required total care and they can be time comsuming and frusturating. There are times I have to dig deep to find empathy for them. But mostly, I just feel so sad for them. Like a deep, aching saddness that I get when I know there is nothing I can really do to help.

You're lucky you're 25 and just now starting to have back pain! My advice, consult a chiropractor... my husband did and his back pain is much less. Nip it in the bud before it gets worse.

[DoGoodThenGo]

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...

Obesity is not just an American phenomenon, but something affecting populations and healthcare providers all over the Western world, and increasingly parts of the East as well.

A quick "Google" regarding "over weight hospital patients" turned up pages of hits with one of the first being a new hospital unit opened in the UK to deal with just obese patients. One current resident in this ward is a man who weighs in at forty-seven stone.

Being as all this may IIRC the nursing profession has one of the highest rates of on the job injury in the United States and elsewhere. This was true going back in the days before the "obesity epidemic", and has only grown worse over the years. You find many older and or retired nurses with back, knee and other injuries from shifting heavy loads (patients).

At least back in the old days a nurse could often summon orderlies to do heavy shifting/work.

When you look at the average size and weight of an American woman versus the same in patients it becomes clear even the best body mechanics often won't save a nurse's back.

[Dragan]

As uncomforting as it is, I'm agreeing with the 'get used to it/it's here to stay' comments, which make it no easier. I'm also a male RN, I'm 240 pounds and 6'4 tall and -you know it-any manual handling needed within sight, I'm the first one called in there; my patient or not. Your best bet is to be honest to your back, yourself, your colleagues and your patients. Look after your back at all times, no matter how busy it gets, which means sometimes waiting while equipment gets organised etc. There will be frustrated staff and patients who'll hurry you along, but you must follow correct protocol, no matter who's screaming their head off. Your back (nursing) is your bread and butter, you ruin that and...you know. The most frustrating factor is patients who won't do anything about it, despite education and resulting poor health and then we have to move them around. They should ultimately make every bed a bariatric bed, that's how bad it's getting.

[brithoover]

I feel your pain. I have a severe back injury from working LTC. For all those that say all injuries comes from improper mechanics..untrue. It's easy to say grab 4 people to help but those 4 people are busy with their own work. When you have 50 residents to care for you don't have the luxury to wait around for other people. Many facilities are under staffed and under equipped.

[gaonsi]

This is such a touchy subject. I sympathize for my make coworkers because unfortunately, they get asked to turn our barbaric patients. I don't have any advice besides putting yourself and your health first. Good luck! I think this is a prune example of a greater issue. We need to start focusing preventative medicine, and not reactive. But that's another rant for another day.

[Not_A_Hat_Person, RN]

This month's American Journal of Nursing has an article on caring for patients with a BMI of 40 or higher. Most of the difficulties caring for that patient population are caused by lack of policy and procedures, inadequate equipment, and insufficient staff.

[mmc51264, BSN, MSN, RN]

I am lucky that we do help each other. We also have the turning beds and lifts. Most of the people I have talked to have gotten hurt trying to keep someone from falling: trying to "catch" them.

[jadelpn, LPN, EMT-B]

This is a issue that should be brought up to risk managment. if people are throwing backs out, then it does little to help their workman's comp situation. Not to mention that hospital acquired decubitus is something that insurances may not pay for. When it hurts their wallet, then perhaps a no lift alternative can be researched.

Patients are what they are, and given a choice would probably not choose to be obese and have multiple other issues that restrict their ability to move. So to "hate fat people" is not productive to try and change how they are cared for. Think of the fact that they are essentially trapped in their own bodies. Don't judge on how they got where they are, just how it is that they are going to be appropriately cared for at this point forward.

I would see if your unit project could be to research some no lift hospitals and their policies. Even your community relations office can help to find funding for this. Grants, that type of thing. It is becoming more and more of a norm for hospitals to be no lift. Be pro-active.

[Psychcns]

Do others feel the same way? Could a group speak to management about what you need? Ie equipment, policies for safe lifting? Could the union help negotiate safe working conditions?

How about inservices on body mechanics and safe lifting?

[LuvScience]

I used to work at a LTC with a vent unit. We had some obese total care patients and the facility got us some equipment that was really helpful for turning these particular patients. I don't remember what they were officially called but it was basically a set of two canvas sheets with handles. The sheets could be placed under the resident and would act like a slip and slide against each other. It made it much easier to turn, reposition and boost up heavy residents.