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.

Specializes in Certified Med/Surg tele, and other stuff.

Holy cow. Yeah, the bariatric (not fat) people can have challenges, but it's not for me to judge them.

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It does not sound like you "hate" fat patients as people as much as you are just tired of the toll they are taking on your own body, a body you take care of as opposed to their bad lifestyle choices that led to their obesity. I think that is pretty normal, to see your own health jeopardized because of someone else's bad choices. Maybe it would help to focus on the things you can do and that have been suggested to make that part of your job safer? Obese people are here to stay I am afraid. However, it is not your job to lay down your own health just to take care of your patients. I would just focus more on finding strategies to address the patient care challenges and worry less about the reasons those challenges exist. Also, to be honest, the facility where you work should be taking these things into consideration and not piling it onto you. Just my opinion.

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Specializes in Family Nurse Practitioner.

One of the reasons I'm stepping away from the bedside. It is physically draining and frustrating to deal with some of those patients. I'm only 35 and too many more years to work to lose it all due to a back injury. Insensitive? Maybe but at the end of the day it is me that is taking care of my kids so it is what it is.

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Specializes in LTC, assisted living, med-surg, psych.

May I remind everyone that not all fat people are that way because of bad choices? Most, yes, but there is a significant number of people who gain weight because of a metabolic problem, or because they take such medications as prednisone, which is notorious for causing patients to balloon when taken over long periods of time. So are a lot of psychiatric medications, with anti-psychotics being some of the worst offenders.

I vote with the folks who are offering solutions here instead of worrying about how obese people got that way. Good work!!

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Specializes in Surgical, quality,management.

By the time we see them we cannot fix decades of poor diet lack of exercise in an inpt setting in a few weeks. Talk to your OH&S committee, use 2 or even 4 slide sheets see about getting a hover mat to assist as well see if the orderlies from all over the hospital can be put on a turning schedule- they may not like it but tough. Make sure they are on a big enough bed both weight and width wise. I had to put a lady who was 4ft10 on a bariatric bed because all her weight went width ways as there was no height to distribute it through. Do you have an OT? They can be a great resource as well.

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I'm not skinny by any means but I'm actively trying to lose weight and take better care of myself. It's hard but I know it has to be done so I can have a better quality of life.

When I have a bariatric patient (which I frequently do and often times the super morbidly obese patient because I'm a float nurse) I put the bed in trendelenburg and get help if I have to pull them up. If they are not on the proper bed the hospital that I work at rents specialty beds so I insist that they are placed on the correct bed. These beds help with preventing skin breakdown and often have a turn assist mechanism. There are certain rooms that have ceiling lifts so I inquire about placing the patient in those rooms. And if I have a super morbidly obese patient I set a time where I can round up 6-8 or however many people needed and we clean the patients up. This is tough though because I hate to leave them sitting in stool but it's very hard rounding up half the floor several times a day to assist with care. So I try to set intervals for help if the patient is incontinent so their skin won't breakdown any further.

Even with the proper tools and help your back and body can still suffer. Reason #5737376 as to why I'm getting away from the bedside.

Sent from my iPhone using allnurses.com

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Specializes in LTC Rehab Med/Surg.

Isn't physical and emotional wear and tear a hazard of any nursing job?

Sure, large pts put your body at risk, but I'll take them over the seeker or detoxer any day of the week. I'd rather deal with the physical aspects of my job, more than the emotional roller coaster I endure with a pt who's trying to scam the system for drugs.

It's too bad the OP and I don't work together. I'd take the big pts, and he could have the psychs.

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Specializes in PCCN.

Ive always wondered how these types of pts stay that way. I mean,really,they've been hospitalized for a long period of time. Sometimes vented, as op says. How on earth do they maintain this weight? They hardly eat. Talk about 0 metabolism :(

Yes, I think op is tired of the care involved, the danger of it, and the fact that his cowrkers either cant or wont lift a hand to help. Someone like op describes usually takes 4 + personel to T+P, change , etc. Sometimes that leaves only two nurses for the whole rest of the floor. And a change, T+P like that usually takes about 20 minutes, maybe even longer if they are cdiff( as soon as they are cleaned up, they are going again. ugh) whole process starts over.

Why dont the powers that be see this. Oh, dumb question....where's the beating dead horse icon. :(

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You probably hated fat people before you became a nurse. Some overweight patients are difficult, and therefore the bias is reinforced. Fatness is socially stigmatized, and as a health professional you must acknowledge your anti-fat bias in order to get provide the best care for that population (just like you might have to acknowledge racial bias or bias against someone with AIDS).

Try to keep in mind the number of unhealthy patients who are frequently thin, and the overweight patients you have who are easy to take care of.

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Oh, for heaven's sake. Anti-fat bias? I'm guessing you haven't worked a nursing floor lately?

I put in 7 years on an ortho floor (just quit recently). Do you know how physically difficult it is to turn and change large, heavy people? And a lot of the sickest ones are pure dead weight -- they can't help if they wanted to, and it is a recipe for back injuries for the staff. I really think it's unfair and judgmental to label OP as biased. You can't blame him for wanting to protect the only back he'll ever have.

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

Also re: the person you quoted - good mechanics and proper equipment go only so far. A person's body has limitations.

Same with time management. You can manage only so many activities in a certain amount of time. There is such a thing as "too much".

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