Overweight nurse unable to physically manage her responsibilties

Specialties LTC Directors

Published

Advice please..

We have a very heavy nurse that works in our SNF. She is very pleasant to both residents & coworkers, she is very reliable and always comes to work, picks up extra shifts when needed, etc. Her actual nursing knowledge is average at best (does need some guidance with appropriate decision making skills related to resident clinical needs). She has been employed by the facility for several years now.

The problem.. she has always been very heavy and as she has aged (probably around mid to late 50's now) she is having increasing difficulty moving about the facility and being able to manage physically providing care. She requires a cane to walk on the the unit, leans heavily on the handrails for additional support. Takes an office chair with her on med rounds so that she can sit as she is gathering meds for each resident, leans on resident beds to support herself for treatments (think both elbows on the bed propping herself up and only using her fingers) and I can't imagine she could ever do CPR.

We admittedly have been turning a blind eye to her for some time because she is really a nice lady with a big heart. Not only do we not want to "hurt her", we also have to take the whole disability act into consideration. We also know she is probably the only working adult in her family and they rely heavily on her income.

The ugly.. We can't keep ignoring this. We have had 2 family complaints within the past week. Both families saying, "although we really like Nancy nurse, we are afraid if Mom had a medical emergency Nancy Nurse will be unable to physically care for Mom." Once said her physical disability is impairing her ability to provide safe care (it takes a very extended period of time just for her to get down the hallway).

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For all you experienced managers, how do we best handle this?

Specializes in Geriatric (LTC & SNF).

Does your facility have any policies about yearly physicals? At my facility, all employees have to an annual physical and they have to be able to do certain things, like lift a certain amount of weight etc. to maintain employment.

Specializes in School Nursing.
I can relate, I would ask the Adm to get legal advice on what to do with this nurse.

You sound like you really empathize with her and maybe you can help her find an appropriate position in another facility perhaps as school nurse or in a Dr.'s office...

OK, OK, I know I'm being too fussy, but please don't imply that school nurses don't need to move around. When I get called to the football field (which is probably 1/4 mile from my office) because someone in phys ed passes out, I need to be physically able to get there. And if someone needs CPR, guess who gives it? Sorry, know I'm off topic, I'll go away now.

Specializes in amb.care,mental health,geriatrics.

I'm an office nurse and contrary to general belief, I run my behind off all day around that place, and multi-task like crazy. I'm never on my chair for more than five minutes straight! OK, that's off topic too but I hadda get it out!:redpinkhe

Look at it like this: where is this situation headed? It doesn't sound like it's going to improve itself or go away, unless Nancy Nurse gets ill and unable to return to work, etc., which may or may not happen. And I don't see it so much as a case of whether she has a disability; rather, is she able to do her work? Regardless of the reason, if she can't do her job, or even if it gets done but only because other nurses stretch to cover part of her work as well as their own, which jeapordizes their patient care as well because they're overextended or distracted, then it's an issue.

It is sad. We had to downsize where I work, and we knew that everyone there really needed their jobs badly. It hurts. We want to care for our own, too, and no one wants a nurse to be hurt or rejected. And her big heart is definately a special thing, and her particular contribution to her field.

That's one of the many, many, many reasons I don't like management!!!! Too many tough things like this to handle. My best wishes are with you and Nancy Nurse.

Specializes in Nursing Professional Development.

The expertise that the OP needs is not nursing expertise ... it is legal expertise. I suggest she talk with her Human Resources department and get the corporate counsel and/or risk manager involved in the discussion before ANY action is taken. It could blow up in her face if it is not handled correctly.

For example: The facility could be sued by the employee if the facility does not follow the relevant employment. But the facility could also be sued if they do nothing and a serious incident occurs and someone gets hurt. "D****** if you do and d***** if you don't."

Specializes in acute care and geriatric.
OK, OK, I know I'm being too fussy, but please don't imply that school nurses don't need to move around. When I get called to the football field (which is probably 1/4 mile from my office) because someone in phys ed passes out, I need to be physically able to get there. And if someone needs CPR, guess who gives it? Sorry, know I'm off topic, I'll go away now.

Meah Culpa if I unintentionally insulted anyone,I know that school nurses and office nurses do need to get around, but I understood that this nurse still does that(just with a cane and I don't discriminate- many people with canes get around just fine!).

While I personally believe that all nurses are important equally (I believe that the OR nurse and the ER nurse and the dialysis nurse and the camp nurse and the oncology nurse and the pediatric nurse and the MDS nurse etc., etc. all fill important functions and not one of those nurses are worth less or are less intelligent- it wasn't an insult that I suggesting a change in venue for this nurse.

I was just throwing out a half baked idea- comes from being on the computer too late at night!!

Specializes in Staff nurse.
OK, OK, I know I'm being too fussy, but please don't imply that school nurses don't need to move around. When I get called to the football field (which is probably 1/4 mile from my office) because someone in phys ed passes out, I need to be physically able to get there. And if someone needs CPR, guess who gives it? Sorry, know I'm off topic, I'll go away now.

I can't imagine being a school nurse! You do more than pass out midol and kotex to the girls (this was the perception when I was in high school 38 years ago) and your responsibility with limited personnel and resourses is so risky. Esp. today when so many students come to school physically and mentally ill...baggage...

I'm sure it wasn't meant to be a negative remark...

Specializes in School Nursing.

Sorry guys, didn't mean to be oversensitive.:icon_roll Didn't try to hijack the thread, either. I'm drinking coffee now, so I'll be better.

To the OP, I agree that this is an issue it would be hard for us to advise you on. I think legal counsel is needed. I wish you weren't in this situation. I also feel bad for the overweight nurse who obviously needs her job.

Specializes in LTC, Hospice, Case Management.
"D****** if you do and d***** if you don't."

Yep, that about sums it up. Thanks for all the replies.

Specializes in ICU, CM, Geriatrics, Management.
... I'm sure it wasn't meant to be a negative remark...

Agree.

Happy everyone's had the opp to enjoy their coffee / snack now.

Specializes in ICU, CM, Geriatrics, Management.

As stated previously, the approach taken needs to revolve strictly around job performance and resident / staff / visitor safety to remain on solid footing legally.

Of course, if the facility has a bargaining unit, compliance with any applicable standards need to be reckoned with as well.

Specializes in Geriatric (LTC & SNF).

Do you have a regional/corporate nursing/clinical manager that you can talk to about this?

Specializes in LTC, Pedi LTC, EMS.

Have you offered her a wheel chair to use at work? Would your insurance pay for bypass or other weight loss surgery (or knee replacement if that is the problem)?

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