Overweight Nurse

Tweety, BSN, RN · Aug 28, 2003

Originally posted by tgibson3770
So why in the hell are so many people defending their cause to live a haphazard life?

I think you've gotten that answer over and over again. The answers are as varied as the number of people in this the thread. Calling people selfish for not looking after themselves isn't going to win anyone over to your side.

There was a health and wellness thread in the Break Room a while back. In it had some great advice. Some people might have found it preachy, I don't know. But the best part of it was the "join me if you want to" attitude, rather than the "you people are selfish and I can't understand it" attitude. There's a difference.

People like us that are passionate about nutrition and wellness need to find a way to encourage without preaching or criticizing. I usually take the silent approach in real life. If someone says "how do you stay so thin", or "are you a vegetarian". I'll talk. I've managed to avoid a middle aged spread, have a cholestorol of 106, been exercising regularly for over 20 years, but as I'm learning (and relearning again), I must be careful in how I share it. But people have crazy hectic lives, live on different incomes and circumstances than I do. Have totally different genes, allergies, metabolism. The one-size fit's all approach as has already been stated won't work. Preaching while continuing to attach a stigma to obesity won't work.

I think a raw food diet, for those with no medical conditions or contraindications, for a few days (not weeks) would do a lot of good for a lot of people. It's not the long-term diet for me though.

Tweety, BSN, RN · Aug 28, 2003

Originally posted by MandyInMS
[b As nurses "I" feel like we need to search for the common ground as to health/wellness..There is no BLACK / WHITE in most instances..I choose to look for the GREY area, and take each situation with it's uniqueness and go from there. [/b]

Excellent point, one from which I can learn. Thanks.

debralynn · Aug 28, 2003

is this tgibson for REAL? If eating better and healthy was all there was to losing weight, then I guess we would not have anyone obese in the world!

My eating unhealthy is just a SYMPTON to what is going on with me!

I mean, do you not watch Oprah or Dr. Phil?

I eat for a fix!

Just like a druggie has to have his drugs for a fix!

I have suffered with depression for years now! My anti-depressants help tremendously with my depression. But sad to say, the 100 plus pounds is still there!

The only way my weight affects my work, is my legs and feet hurt alot sooner than yours.

But I am proud to say, I can still run circles around some people who are alot smaller than me.

I HATE being this way.

But I believe it is more of a mind issue than a food issue. It just so happens it shows up as a weight problem.

Do I feel bad about myself, YOU BET!

Has my weight caused me health problems? You Bet!

Am I defending my way of life? No

I wouldn't want anyone to follow in my shoes!

Have I tried to lose the weight ? YES!

Can I stay on a diet? Apparently not!

But let me say this!

I have people who love me, who think I am fun to be around, my patients appreciate the work I do for them, and basically, I am just a fun person.

So stick that in your peace pipe!

Hellllllo Nurse, BSN, RN · Aug 29, 2003

Originally posted by caroladybelle
Some of us wish for a better life with better bodies and better minds - and that does not necessarily mean thinner.

I see nurses with personality disorders that wreak more havoc and damage to patients/coworkers/friends/family, than they would if merely weight was the issue.

Can I second that "Amen"?

OnMyWay · Aug 29, 2003

I have PCOS and while I am clinically "obese" my BP is 90/60 and my cholestoral has always been very low. I eat a very healthy, low-fat diet and truly eat MUCH less than anybody I know. No matter what I do - my weight will not budge an ounce up or down. If I "preach" to a patient about eating right and exercising - it is something I am doing even though I may not look like it.

That being said - what about all of the unhealthy behaviors nurses may partake in that do not show phsyically such as smoking, drinking, drug usage, eating disorders, etc. What about those that drive too fast or don't wear seatbelts? Those of us who overweight are targeted simply because it can be seen.

At my age, I have learned to accept (if not like) my size and I am past worrying about what others think but I will not let my professioinal abilities or capabilites be questioned because of it!

Sorry for such a long post! Whew, I feel better now!!

kimmicoobug · Aug 29, 2003

While I love veggies and fruit, doing a raw fruit diet for forever just doesn't sound appealing to me. I will stick to the Atkins diet where I eat meat in moderation, dairy in moderation, lots of fresh and COOKED veggies, and fruit in moderation. Seems to work for me. Once again, what works for some people, may not work for another.

iliket3 · Aug 29, 2003

tgibson says "weight loss is simple."

That's exactly the kind of information that gets me down. The mathematical formual is simple - yes. Achieving weight loss is another story all together. I don't doubt the nutritional advice she or he gives.

And thank you for reminding me that if I don't change my habits I'll be six feet under sooner than later. I already know that.

Please don't take this too harshly but if I ever find out who you really are and where you work - I believe I'll request another place of employment. Or God help me if I'm one of your patients.

Thank you to everyone else for the supportive, compassionate advice I have received.

Theresa

WhiteCaps · Aug 29, 2003

Originally posted by shelleybelle
So now I'm back up to almost 200lbs and a size 14 (barely).

Marilyn Monroe wore a size 14. Was that a typo?

mother/babyRN, RN · Aug 29, 2003

No patient has ever had an issue with me and weight. They do have comfort knowing my knowledge, experience and empathy will and does sustain them through not only painful but joyful times.....I don't like that I am overweight but I do not persecute myself...Let others try and do that...My energy is reserved for more important things, like life......Best wishes to you .....

bagladyrn, RN · Aug 29, 2003

To all of those who are the victims of prejudice because of being overweight - It's a good sorting mechanism for keeping those people out of your life! I really have no time or desire to surround myself with people who are so shallow or petty that they would make assumptions based on my appearance!

As for patient teaching, those of us who have been on the receiving end of blanket statements are likely to be more sensitive to the patient's response, and NOT try to tell them - "Oh, but it's SO simple" or preach to them of their shortcomings, but rather to present the findings and explore their thoughts on it.

NICU_Nurse, BSN, RN · Aug 29, 2003

First of all, WhiteCaps, Marilyn Monroe DID wear a size 14- in the 1950's, when a size 14 was equivalent to a modern-day size 8 or 10. Today, the way that clothes are sized, and depending on your height and the way your body carries the weight you have on it, a 5'8" person may be able to fit into a size 14, whereas a 200# person who is 5'3" may only be able to squeeze into a 22. Furthermore, I am wondering exactly what was the point of your posting that...? I'm sure I don't need to elaborate further, because I'm hoping you weren't attempting to actually make a DIG at someone here about their weight?

Secondly, to the original poster: You said that you felt like a hypocrite when you were writing your care plan, and wondered how someone overweight was supposed to look another person in the eye and suggest a healthy diet and exercise program? I'll tell you exactly how you do that.

I am overweight, and though I am 5'9", I have never been thin by any definition of the word. I am curvy, full-figured, buxom, voluptuous, zaftig, whatever you want to call it. I have been since I was 14, and despite numerous efforts on my half, I struggled with a binge-eating disorder that did not stop until I was nearly 24. During high school, I was extremely active- I was a cheerleader, I played soccer, and exercised regularly. I joined a gym when I was 12 and had to LIE about my age to become a member.

I was also in nursing school, just like you are now, and I was faced with the same situation. How do I lecture a 400 pound T2 diabetic about controlling their fat intake when I myself am considered fat? Easy. I sat down in front of EVERY patient I had, skinny or not, and said the same thing:

Eating properly is the ONLY way that you will feel better. Exercising and moving your body will help you feel like a new person. By continuing to eat the wrong foods, or in the wrong portions, or too often indulging because you feel deprived, you are essentially disabling yourself. And I can see by the look in your eyes that you're thinking to yourself, "Where does this girl GET OFF, lecturing me about cutting back and taking care of my body when she obviously hasn't?" And I'll tell you right now that you're half right. I'm fat AND I smoke. It is PRECISELY because of those two things that I can tell you something that many other nurses or doctors can't or won't: I UNDERSTAND WHAT YOU HAVE TO DO AND I *KNOW* HOW DIFFICULT IT IS. I have struggled with my weight for 10 years, I have struggled with an eating disorder, I have struggled with deprivation and stress and have learned to depend on food as a comfort and cigarettes as a stress-reliever and these are unhealthy habits that I HAVE to break, just as you do, or I will die. I am not going to sit here and lecture you and act all high and mighty, because that WOULD make me a hypocrite, but I will say this: We both have to try. We can't change the world in a day, any more than we can overhaul our entire lifestyles just because someone else says it's good for us, but we can do SOMETHING, *anything*, ONE thing, to make a difference in our own health. Whether it's smoking one less cigarette a day or skipping the mayo on that sandwich or eating an apple instead of a brownie, we can do one thing a day to change the way we eat or live. And when you realize, like I now do, how simple it is to change ONE TINY THING, then *maybe*, just maybe, you can change something else. I'm not asking the world of you, all I'm asking is that you consider what I'm saying: What small change can you make right this second that can help, even a little bit?

And you know what? You'd be surprised what happens when you say that. You've opened up lines of communication between yourself and the patient, you've brought yourself to an equal level instead of standing over them and being critical that they want a Ding-Dong so bad right now that the desire is overwhelming. You've shown them that you understand that it's difficult and you've also shown them that perhaps, just perhaps, it's not IMPOSSIBLE. That maybe it IS within their control, and maybe we're not perfect, and we can't stick to a perfect plan, but we can try something infinitely more reasonable and have nothing to lose because the effort in itself is what brings the change, whether others see it as significant or not.

I can't hide the way I look, and I don't try to. I don't expect anyone to do that, and I have respect for ALL PEOPLE in one way: because we all struggle with the same universal issues, whether we feel superior or not is completely irrelevant. I don't have to KNOW you to know that we feel the same things. I don't have to be FIT AND HEALTHY to communicate with my patients how important being FITTER AND HEALTHIER *IS*. What I do know is that struggling with your weight is devastating to your health and self-esteem, and that helps me to speak to my patients in a certain way that others don't or aren't able to do.

Yes, the THEORY of weight loss is indeed a simple one. The practice, however, is certainly not, and it would benefit many of us to keep this in mind when we are discussing this issue. In fact, theory is often more simple than practice in MOST issues. The world is complex, and we need to be able to depend on each other, and acting in a condescending manner towards those who may in fact want to make a real change in the way they live their lives is not going to get you anywhere but the doghouse, and it certainly has worse consequences for THEM, because you have now squelched your opportunity to impart some real and helpful knowledge. Furthermore, you have lost an important opportunity to RELATE to someone and teach them something valuable, and this patient has now lost the feeling of trust that they held for their healthcare provider; trust that their nurse or doctor could relate (or at least understand in a meaningful way) to their struggles and help them learn how to make beneficial changes, rather than make them feel like less of a person for not meeting certain ideals or standards.

tgibson3770 · Aug 29, 2003

http://www.nurseweek.com/news/features/01-01/food.asp

Food for thought

Nurses dish up advice for healthy eating

By Ed Frauenheim

January 8, 2001

Nurses keen on improving their diet are finding encouraging trends. New nutrition research provides a clearer picture of what foods are healthy, and hospital cafeterias are wising up to the importance of nutritional meals.

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Nurses more than most people know that an apple a day keeps the doctor away. But working alongside doctors in today's often hectic health care industry can make good nutrition a challenge for nurses.

"There's always something to do," said Nancy Whitehead, a nursing instructor at the Milwaukee Area Technical College who has lectured on nutrition. "We're eating rushed, probably choosing [foods] that are easily prepared."

But nurses keen on improving their diet are finding encouraging trends. New nutrition research provides a clearer picture of what foods are healthy. Hospital cafeterias are wising up to the importance of nutritional meals, and role models are showing that even busy nurses can eat right.

Leading by example

Take Donna Davidson, MSHP, RN. Davidson, 63, supervises nurses at three hospitals in the Salt Lake City area but manages to eat five servings of fruit or vegetables a day, keep her carbohydrate intake low and down soy milk shakes with protein powder.

She always has a bottle of water at her desk and keeps one in the car for trips between her job sites. This strategy keeps her hydrated without the calories that sodas carry.

"I was once told, 'If you drink soft drinks, water will never taste good. If you stick to water, it'll taste good to you,' " Davidson said.

But being smart about what she eats and drinks is only half of Davidson's story. The other is exercise: She usually manages to squeeze in a 45-minute workout on her treadmill or with weights six days a week.

"That means I'm often up at 4:30 in the morning," she said. "If I'm not up by then, I don't have time for my exercise, and it's that important to me."

Davidson's company, Intermountain Health Care, encourages employees to follow her example. Intermountain's "Healthy Balance" program asks workers to set goals in the fields of nutrition, exercise and preventive medicine--for example, getting screened for cholesterol or glucose levels. Savings the company realizes from healthier employers are returned to the workers.

Davidson's motivation to monitor her diet and activity level stems in part from observing too many colleagues ignore theirs.

The numbers don't lie

"I see so many unhealthy nurses," she said. "The statistics we see around the country about the increase in obesity, we see in our staff."

In fact, nurses are more likely to be obese than Americans in general. The U.S. adult rate was 17.9 percent in 1998 according to a study by the CDC. The rate for female nurses in a Harvard Medical School study is roughly 22 percent--although the women in that study are aged 54 to 79.

The Harvard study also shows that about 56 percent of nurses could be classified as overweight.

The study, a collaborative effort with Brigham and Women's Hospital known as the Nurses' Health Study, has been tracking the health of 121,700 female nurses since 1976, so plenty is known about nurses when it comes to diet and exercise. For example, the average nurse consumes about 1,700 calories a day, a typical amount for adult women, according to Nurses' Health Study researcher Diane Feskanich, Sc.D. Nurses appear to eat more fruits and vegetables than most Americans, she said.

Working in a workout

But they don't excel when it comes to getting off their duffs for a workout.

"Physical activity is very low," Feskanich said. "About 25 percent report no leisure time [exercise] activity."

Thirty minutes a day of moderate to vigorous activity is widely recommended.

Most nurses don't have to get up at 4:30 a.m. to start sweating off those pounds. Nurses willing to pay attention to their diet can benefit from the latest findings in nutrition research.

Eating green

The American Heart Association recently revised its dietary recommendations to stress eating a larger proportion of plant-based foods. Five servings of fruits and vegetables each day and six servings of grains still are recommended. The association also still promotes whole grains, low-fat dairy products, fish, lean meats and poultry. But in the wake of new research on the importance of oils known as omega-3 oils, the association now calls for two weekly servings of "fatty fish" such as tuna or salmon. Other sources of omega-3 fatty acids are flaxseed oil, canola oil and nuts.

The association also warns people to cut down on saturated fats--typically found in animal products and tropical oils--and "substantially reduce" intake of trans fatty acids--the hydrogenated oil found in many commercially prepared foods and some hard margarines.

Of course, hospital cafeterias and vending machines provide plenty of not-so-healthy offerings, including junk foods oozing with trans fatty acids. That's one of many factors working against good nutrition choices for nurses. Nurses who feel pressured to fill out paperwork, care for patients and comply with doctors' requests may not have the time or energy to focus on finding the whole-grain bread. The strains of raising a family also can mean skimpy breakfasts or no breakfast at all.

The payoff

Even doing a good job can backfire when it comes to eating right: Grateful patients are more likely to bring in a box of doughnuts than a platter of fruit.

Still, Whitehead, a nurse for 22 years, is hopeful. She notices hospital cafeterias serving healthier meals, and nurses taking the cue.

"I see nurses eating a lot of salads or foods that are good for them," she said.

Monitoring what goes in your mouth pays off: The Nurses' Health Study found that subjects who most closely followed the "food pyramid" guidelines (similar to the heart association's recommendations) had a 14 percent reduced risk of cardiovascular disease.

To Davidson, nurses' nutrition is critical to the profession's mission.

"We just don't do a good job of taking care of ourselves, and we need to [because] the work is demanding," she said.

Of course, a sound diet also goes to the heart of nurses' own quality of life.

"If you lose your health," Davidson said, "you lose everything."