Obesity in the hospital

husker-nurse, LPN, LVN · Jul 24, 2004

Yes, I have to agree that obese patients require more care, and also more STAFF. We actually had a patient who, when we had to turn her, demanded every staff member in the house to be present; she demanded that one nurse move her breasts, another to move her belly, 2 for her legs, and so on........

zenman · Jul 24, 2004

We've had several in the 500 pound range that required quite a few people to reposition.

Mary Austin · Jul 24, 2004

We've had several in the 500 pound range that required quite a few people to reposition.

We are staffed according to "acuity". I find it interesting that there is nothing in the Van Slyke acuity system to capture the care and time that it takes to move and care for an obese patient on orthopedics. However a heparin lock gives us 15 points for just sitting there in the arm! The acuity system is a farce and naturally in favor of the hospital. Does anyone else use such an acuity system?

Hardknox · Jul 24, 2004

Years ago I had a 400 lb. patient who burst a AAA. The fact that she was obese saved her according to her doc. The fat helped seal the tear until they brought her in--she had a lengthy recovery with every complication in the book. The residents, med students, nursing students and the rest of the staff had to assist with moving her and getting her OOB. My first back injury :uhoh3:

nurseygrrl, LPN · Jul 24, 2004

We have so many obese pts. in my LTC facility, that each unit now has an oversized shower chair and a special mechanical lift for those up to 500 lbs. I find these pts. very difficult to care for. They are difficult to position, to care for and to assess their skin integrity.

Destinystar · Jul 24, 2004

it's part of our job. we are obligated to promote comfort and safety and equipment that will acommodate people based on their individual differences. we have special lifts to assist patients with mobility. we train the staff how to use them. most people are overwieght including the staff. :) i am not about to minimize a human being just because they are obese. no this issue is not the highlight of my career. my daughter when she was 15 did volunteer work at the hospital and cared for a lovely woman who had a gastric bypass done. she died as a result of the surgery. we still have the wreath that she made by hand and gave to my daughter for christmas. we take it out every year and remember how happy she made everyone in the community with her crafts. my daughter loved her more than any one else and did not mind helping her out cause she was a sweat heart. :)

last month abc news did a series on obesity titled "critical condition" one of the segments they was on how obesity has affected hospital care. hospitals are under the gun to provide among other things bigger beds and wheelchairs. the wheel chairs are enormous! there is even a company that specializes in humongous coffins and busines has been very brisk.
how has obesity affected all of you in the workplace?
i recently spoke to an er docotr who told me that it takes twice as much effort and time to care for an obese patient. she even said that she had to treat several emt workers for injuries to their wrists and back after carrying an obese person down a 6 story walk up.
do you find similar situations where you work?

pnurseuwm · Jul 24, 2004

Speaking of back injuries, I'm starting nursing school this fall and I'm afraid of back injuries.... I know anyone can get them, but I'm on the skinny side, with "spaghetti arms." I dance and workout though. As nursing students will there be any education on how to protect our backs and how to strengthen those muscles? I'm concerned.

Tweety, BSN, RN · Jul 24, 2004

Our everyday wheelchairs hardly fit anyone these days. We've had to get oversized wheelchairs, bedside commodes etc. And when they are bid ridden, oh my aching back.

Of course we give the best of care without judgement. But, especially with the baby boomers being overweight and sick I've definately noticed an increase in overweight patients over the years. My only hope is some of us can take some preventative measures while we're healthy. :)

Tweety, BSN, RN · Jul 24, 2004

Speaking of back injuries, I'm starting nursing school this fall and I'm afraid of back injuries.... I know anyone can get them, but I'm on the skinny side, with "spaghetti arms." I dance and workout though. As nursing students will there be any education on how to protect our backs and how to strengthen those muscles? I'm concerned.

Absolutely. The first semester in fact a good deal is spent on proper "body mechanics" that tell you how to protect you back. Good luck!

tiroka03, LPN · Jul 24, 2004

I do see people more wiling to care for normal sized pts. When an obese pt rings, most people will groan and slowly drag over there. When they are in the room with the pt, of course they are pleasant and friendly. But generally I see an obese pt waiting longer for their light to be answered, as an discussion takes place, it's your turn, I'll do three of these if you do that one. I know for a fact it takes much longer to care for an obese pt. They take longer to move, and some seem to expect people to lift them up single handedly. I figure not all obsity is a persons fault. But the obese pt needs to take a little responsibility in helping themselves whenever possible. It's not my fault they are that way. I will be polite, but if pressed I will tell them, they are too heavy for me to care for, or position alone. If they don't like the reference to their weight, I didn't shove the food in their mouths for years to get them this way.

I am slightly overweight myself, although not in the realm of the extrememly overweight person. I would not expect someone to lift me, or never grunt when using every muscle in their body to move me one inch. I feel bad for the overweight pt, but not so bad that I don't use common sense.

Katnip, RN · Jul 24, 2004

We had a patient over 700 pounds. We had to order a bed that would tilt from side to side, but still it took 11 people to turn him for wound dressings. He was a super nice guy. It was sad to see someone who would let himself go to such an extreme. He didn't qualify for a gastric bypass either. Unfortunately, people who are that big are too much of an anasthesia risk and the docs at my hospital required that patients must be able to walk from the parking lot to their office under their own steam.

The bariatric docs were looking for ways to help him though.

It was routine for us to have patients well over the 300 poun mark. Even with those extra wide wheelchairs, some would barely fit. And pushing them isn't easy either.