Overweight issues; uncomfortable with being practiced on by another student

[molybdenum]

Hi Everyone,

I am a very overweight nursing student, and am feeling uncomfortable in a number of situations. Can anyone relate? While I know that the nursing profession, and the medical profession as a whole, includes people of all shapes, sizes, backgrounds, colors, etc, I am coming across situations almost daily that make me uncomfortable.

I have been overweight my entire life. I've lost weight several times, but it has always crept back on. I have been working with a dietician and a counselor for a while now to work on my weight issues. I'm accepting of who I am, but I'm also sensitive about weight issues.

Since starting school, I have come across the following problems: assigned uniforms did not fit properly, I do not fit well in some of the chairs that have "desks" attached to them, the blood pressure cuffs do not fit and the school did not have large adult cuffs available. We are getting to the point of using each other as patients, and this is very uncomfortable for me. We had to change into a gown recently and another student had to do a skin assessment on me, going over my entire body and documenting everything from freckles to scars to stretch marks. Had I realized that this is how labs would be, I likely would not have chosen this school. While I am okay with being a patient in a professional setting, being a patient for a classmate feels inappropriate.

Has anyone else come across similar problems?

Thanks for taking the time to read and respond.

[eatmysoxRN, ASN, RN]

I always laugh at myself. It is a defense mechanism but it works. In the real world of nursing out here, I am infrequently openly judged by patients. Ive had one patient make a snide comment that bothered me briefly, but I remind myself that I am a professional and as such, I had to remain an advocate. I would have been immensely uncomfortable allowing a classmate to perform a head to toe skin assessment on me. I have some private tattoos I wouldn't want anyone but a serious significant other to see.

[Mama_Cashew, ASN, RN]

I am a large woman and while I was lucky to find scrubs that fit, I was terrified when it came to simulating bed baths. Thankfully, the person I was partnered with could have cared less. They were professional and in no way made me feel ashamed because I was big.

We will also being doing a complete head-to-toe assessment as our final check off this semester and it will be complete! Am I freaked out at the possibility of having it done to me? I was at first, but after I have gotten to know quite a few of my classmates I know it will be all good.

It's hard to allow ourselves to "play" patient, but I think in the end it makes us humble and helps us to better understand what our future patients will go through.

**sorry if this is all rambling, but it's a tad early for me and I'm a tad freaked out because I start clinicals today. LOL**

[elkpark]

Had I realized that this is how labs would be, I likely would not have chosen this school. While I am okay with being a patient in a professional setting, being a patient for a classmate feels inappropriate.

This is pretty standard practice for nursing schools -- you would likely have a hard time finding a school where this wouldn't be an expectation.

[Clovery]

I get self-conscious too. Just try to remember that your instructors who will be evaluating your practicums are seasoned nurses and they've seen it all before. They're not there to judge your body, they are there to watch your partner correctly perform the skills. If you can, try to pair up with another overweight student; you might feel a little more comfortable. Also, if there are any CNAs or LPNs in your class, remember they've seen it all before too. But anyone going into nursing must understand that bodies come in all shapes and sizes, and we must take care to allow the patient as much dignity as possible during potentially embarrassing procedures.

This semester we are doing EKGs on each other and I have very large breasts, so I have no idea how that's going to go for me. I don't have the option of wearing a simple sports bra - they don't make them in my size. I will be really embarrassed if I have to take my bra off. Someone suggested that I look into wireless (maternity) nursing bras, as they do make them in large sizes and will allow more access. I also have an issue with the uniform - it has snaps up the front and they are a men's cut & sizes (why?!) so in order to avoid the buttons gaping at my chest I have to wear a men's XXL, which fits across my chest, and then falls over the rest of my body like a tent, making me look even bigger than I really am.

Just keep telling yourself that you're your own worst critic - everyone else is just concerned about the nursing skills involved.

[NellieOlsen]

You got good advice. Take care.

[DawnJ]

My school mostly does lab practice with the mannequins. We do BP, Pulse, Resps, Temp on each other, but bed baths, skin assessments, etc. are done on our plastic patients. We are not allowed by school policy to do blood draws, IVs, NG tubes on each other--that was a big concern of mine. I don't want to be stuck a bunch of times by a student, I have a hard enough time letting an experienced person take my blood! All of that is done via computer sims, the plastic people and in clinicals.

[libby11]

I'm sorry that these things have affected you and maybe even discouraged you from school.

For my fundamentals course, we too had to wear a gown or short shorts (spanky style) & a sports bra for the physical assessments by the other students. And if you've done the cardiac assessment yet, you know that the breast must even be lifted up to correctly hear sounds. The stomach must palpated. It's all in the name of health!

To me, it was no problem, but everyone is different. I thought of it as an opportunity to help another student learn. How awful would it be if the first time we did physical assessments, it was on a real patient!? That would be worse, in my opinion. That's the other choice.

I hope that you continue you in your studies and remember that you are more than a body; most people know this and don't judge you just because of your size. The ones that do judge you, have a million problems of their own They may not be visible, but they are there.

[Anamnesis]

Honestly, I am one of 4 male students in my class. I can't speak for how everyone else feels, but I really don't judge anyone. I think that you should not feel self conscious. I personally have a hard time doing practice sessions on fellow female students so i tend to be shy and stick with my male cohorts. I myself have dealt with weight issues in the past. I just want you to know that in this professions, we will deal with people of all shapes and sizes, and no-one who puts the effort in to become a nurse should feel self conscious about the way they look. We are all working towards the same thing, and in the end, the patient doesn't care about how you look, they care about how good of a nurse you can be, and weight is certainly not a determinate of that.

PS: You need to remember that you are an amazing person and are going to make such a difference in so many peoples lives.

Also, my heart goes out to you, I just really don't want you to be discouraged by something so trivial. I feel so strongly about this that your post made me register on this site. Don't feel insecure. You are awesome.

[flyhawkfly]

Honestly, the best advice is to just to take a few deep breaths, realize that there are many overweight patients that nurses have to deal with on a daily basis, and let your partner get some practice in.

I'm fairly large too, and I've had the same problems with uniforms, and feeling uncomfortable in class (like during the obesity lectures). I also have a fear of being examined (I don't like going to the doctor for anything), but I did what I had to do my first semester. I had two partners, and they were both thin, ex-military girls, but they were very professional, and after a couple of labs with them, we became really comfortable with everything.

On the other hand, there was another girl in my clinical group that was also very large that had severe body issues. When it came time to practice physical assessments with her partner, she actually left a couple of times because she was so stressed out and worried about it. This was extremely frustrating for the rest of us, because someone else had to go work with her partner instead, and even our instructor was upset about what to do. Eventually, she got through it, but only because if she missed another lab and didn't participate, she would fail the semester.

I know it's hard, but just remember that they are letting you practice on them, and just because they are thin, doesn't mean that they don't have to overcome the same mental issues to let you examine everything on them. It helps to really discuss this with your partner-once you have an understanding, they may be more sensitive, and it makes things more comfortable. Good luck!

[RainbowDash]

As a big girl myself I can totally empathize with you! I was very upfront with my nursing dean about the possibility of having to strip down to my skivvies for the purpose of learning. Thank God she looked at me and said "why on earth do you think we have such expensive SIMs? no offense, but we don't really want to see any of you in your Fruit of the Looms! just as you wouldn't want to see ME in a string bikini I am sure!" This cracked me up and I felt much better.

I have worked on my confidence for years. Just because I appear (well, AM) heavy doesn't mean I am not capable. People are often shocked at my level of strength and fitness. I can keep up with the very best of them. I've learned that I am intelligent, caring, trustworthy, dependable... and I carry myself with comportment and pride. But I do not feel that having to let my peers write down my thousands (that may be a bit of an over-estimate) of big girl/pregnancy stretch marks is necessary for learning. Should a student endure some discomfort to better relate to their patients? In my opinion, absolutely. Does the price need to be your modesty in front of your peers and potential future colleagues? Not in my book. I'm terribly sorry for you. I know I would have been mortified had it been me. I wish I had advice but all I can do is say I'm sorry you felt the way you did, and that I completely understand.

As for uniforms, by the grace of God ours is actually one of the best looking RN program scrub sets I've seen - a white scrub top with blue embroidery, and navy cargo pants. They come in a vast array of sizes, I was actually really surprised by how large you can get them. They do fit like crap though... my pants like to shimmy south over the course of the day, but if I go a size smaller they grip my thighs like a vice. Can't win them all. At least I'm not stuck in the dweeby polo shirts and VESTS that the local community college has to wear.. yikes!

ETA: I would invest in a large size sphygmomanometer to carry with you. When I used to do MA school I had my own, and it was invaluable. We had one large one floating around the ENTIRE SCHOOL and there are many programs, so I hated to have to say "Alright, which one of you knows where the fat girl cuff is?!"

Chin up and I hope it gets easier for you. If nothing else, remember that the end result will be worth the struggles and discomfort and sacrifices :)

[lifelearningrn, BSN, RN]

I relate completely. I got used to the assessments, and my partners never seemed to let it be an issue. I do feel embarrassed about the chairs w/attached desks, and the constant lectures on obesity, diabetes, and all the other issues that they link back to it. I've had a fellow student tell me I need to lose weight. She meant well and I brushed it off (as if I DON'T know).. I don't currently have any health issues due to my weight (other than SOB when I'm over exerted).. but I realize this wont always be the case. I know I need to lose weight, and I know how since I've done it a million times in the past. I don't know why I can't get in the mindset to do it either. I do feel like it's something I'm aware of every minute of every day. I feel like that's all people see. Perhaps we should start a Nursing Student weight loss club??

[FutureCRNA?, BSN, RN]

I had a weight issue prior to starting nursing school. I felt like I couldn't get it under control (BMI 34, obese) and it is an issue that an overweight person tends to think about everyday, all day.

I chose to have weight loss surgery (VSG) and 4 months later, my BMI is 25, normal (my goal is a BMI of 22). I have lost 60 lb so far. I feel as if the surgery has literally saved my life. I don't feel fat any more & it's not an obsession like before. Although I did NOT have insurance that would cover my surgery, lots of insurances will these days.

Not to say that it's easy, but the surgery has given me a tool that is helping me to succeed, whereas all the knowledge in the world couldn't seem to help me before. I pack all my snack/meals (I eat around 1000-1200 calories a day right now) and I make sure that I exercise 4-5 days a week. I just made a PR in 5K at 29:50 :) Very excited about that! That's all I have time for now, but after NS, I'm going to do a half, then full marathon.

I'm off insulin (been on it for over 10 years), BP meds, cholesterol meds, anxiety meds. After 19 years with diabetes, I'm only taking a 2 mg oral med & synthroid. I only wish I had found a way to do this 10 years ago!