Jump to content

"if you weren't so obese, you probably wouldn't have 1/2 the illnesses you do"

Posted

Has 4 years experience.

i'm not sure if this is a vent or just an effort to regain my sense of nursing compassion, but WHAT HAPPENED to honest patient teaching? some of the RNs on my floor seem scared to address the obvious- being an obese smoker who seems allergic to any type of a healthy lifestyle is the main reason a majority of our patients are here, on our med/surg floor.

The main illnesses I see? uncontrolled Hypertension, uncontrolled type 2 diabetes, CHF etc. How can I be more compassionate yet still addressing the truth?

At least in the children, the odds of them being "at fault" for their illness are very, very slim- I'm considering a transfer to Peds.

How can I keep "the hunger" I started with when I see so many chronic diseases that are intrinsicly linked to poor lifestyle choices?

Please help. i dont want to become a RN who is there to clock in and clock out while secretly wanting to smack some common sense into them, lol

Thank you all, in advance.

linearthinker, DNP, RN

Specializes in FNP. Has 25 years experience.

I don't state the obvious "You need to lose 100 pounds...." I leave out the word "you."

"Research suggests being at an ideal body weight:"

lowers the micro and macrovascular complications from diabetes...

or

lowers serum cholesterol

lowers blood pressure

"Research suggest that 30 minutes of exercise 5 days a week:

lowers the micro and macrovascular complications from diabetes...

or

lowers serum cholesterol

lowers blood pressure

"Research suggests eating diet low in saturated fat, high in fiber..."

you get the idea.

They aren't stupid, and they need to be held accountable.

yetanotheramanda

Specializes in neurotrauma ICU.

"if you wern't so obese you wouldn't have 1/2 the illnesses you do"

and my back wouldn't hurt so bad....

You do seem to have lost your compassion. Less judgement, more teaching might help. Judgement comes across on your face and your expressions and doesnt help the patients at all.

nursemike, ASN, RN

Specializes in Rodeo Nursing (Neuro). Has 12 years experience.

I'm fat. If you disapprove, that's completely meaningless to me. I'm accountable to myself. Period.

linearthinker, DNP, RN

Specializes in FNP. Has 25 years experience.

I think you are inferring incorrectly. The OP seems to be seeking a compassionate way to meet her obligation to address important but sensitive issues.

OCNRN63, RN

Specializes in Oncology; medical specialty website.

IDK. My back was up the minute I read the title. It would be like me saying to one of my patients, "If you hadn't smoked, you wouldn't have lung cancer and be sitting here getting chemo." True, but hateful.

linearthinker, DNP, RN

Specializes in FNP. Has 25 years experience.

yes, but what would you say if they were still smoking?

I have the same problem as the OP. As a CNA working in an ICU stepdown, I couldn't go to bed without taking painkillers for my back. And yes, I did lift the right way and use all of the equipment available to me! I couldn't help but feel that so many patients wouldn't be in the hospital if they altered their lifestyle, and so many nurses wouldn't be out with back injuries.

Like the OP, I'm going into peds when I graduate (I hope... the NG outlook isn't so great!) These adult patients deserve a more compassionate nurse than I am capable of being in this situation, and I deserve to not have a broken back by the time I'm 30! I know it sounds harsh, but I feel like I understand my boundaries, and I really don't think anyone deserves anything less than the most compassionate nurse. Plus, I love working with kids, and even without the back problems, I'd still want to work in peds instead.

I agree with the previous person- this comes across as very hateful. And no, not every person who is overweight/obese and/or has health issues is that way because of choice. And even if they are, they are probably VERY aware of their condition, and a condescending nurse telling them to just put the doughnut down is not going to do a bit of good. Overweight/obese people are the only group of people that it is "socially acceptable" to discriminate against and treat poorly because of a physical characteristic. It is a sad, shameful thing. Treat them with decency and respect and ask them what their perception of their health is. THEN try to teach them.

IDK. My back was up the minute I read the title. It would be like me saying to one of my patients, "If you hadn't smoked, you wouldn't have lung cancer and be sitting here getting chemo." True, but hateful.

And not useful.

I can't imagine that anyone in the hospital for uncontrolled HTN, Type II DM, etc. hasn't been told that they need to change their lifestyle. Evidently, they haven't been successful. We can blame them, or help them figure it out.

How about a conversation asking the patient what they've tried in the past? Maybe find out what changes they'd like to make but are having a difficult time? Do they live in an inner city with limited access to a proper supermarket, which makes buying non-processed food more difficult? Do they work two or more jobs, so finding the time to exercise is challenging?

These are things we'd never know if we just blame them and give them the prescribed "education" on how to adopt a healthier lifestyle.

StNeotser, ASN, RN

Has 10 years experience.

I've heard physicians use the no nonsense teaching method.

Nurses have to be far more tactful for we can lose our jobs due to customer service.

When I smoked, I knew I smoked and it was bad for me.

I know that my mother, a 50 year pack a day smoker who has had a quadruple CABG is told every time she has an MD visit that she needs to stop in no uncertain terms.

Though I know she needs to stop and that smoking is killing her, I would hate for someone, physician or nurse to be mean spirited towards her lifestyle choice. I can't stop her smoking, yes she will kill herself from it, but she is my mother and I love her.

THINK about the whole person before you judge. The obese patient may also be a wonderful teacher, mother, volunteer, daughter, nurse, doctor, gosh, anyone who contributes to society in any way. This is how nurses are meant to deal with patients, not just stick labels on patients, obese, smoker, alcoholic, drug addict.

You get the picture?

linearthinker, DNP, RN

Specializes in FNP. Has 25 years experience.

There is data to support that the ore times people are told they need to quit smoking, lose weight, etc, the more likely they are to do so. With that in mind, I'd say it is the obligation of HCPs to say what needs to be said. Needn't be rude, but it has to get out there. Obese is not a dirty word, and if it is accurate, it isn't a crime to use it.

I would have to agree with MJB2010. I don't know if you are new to the profession or prejudiced. That being said, simply insisting people take your advice, lose weight and all will be well is too simplistic and callous. Sure, so many things we could all control regarding our health and well-being but we don't. Consider why this particular thing is bothering you. People do listen to what you say, they just can't always go right out and do it. The best you can do for your patients is deliver your care in the most empathetic, caring non-judgmental way while they are in your care. No patient wants to be obese or ill or diseased. It's much more complex than that. You won't get away from these things by going to Peds. Figure out what is really bothering you. You can't control what they do but you can control how you care for and understand your patients. Their time with you is just as important to them as it is to you. You will have a greater impact by checking your bias at the door. If you think they don't sense your disdain, rethink how you approach and interact. I hope you do not lose your compassion but regain it with gusto. Always put yourself in their shoes first. Best of luck.

linearthinker, DNP, RN

Specializes in FNP. Has 25 years experience.

I totally disagree that it is callous to address important health issues w/ patients just because they may not like it. It is the height or irresponsibility to ignore the elephant in the room.

Another piece of the equation is money. Poor health "choices" cost all of us in additional health dollars. Our insurance and taxes go higher every year, yet the pts with self inflicted (for lack of a better term) problems suck up the bulk of the care dollars.

I don't want to be hateful, but when you see thousands of dollars, and so much time, energy and grief these problems cause, it is hard to stay nonjudgemental. My mother died of lung cancer after ignoring pleas to quit smoking, yet my sister has STARTED smoking. So frustrating!

OCNRN63, RN

Specializes in Oncology; medical specialty website.

yes, but what would you say if they were still smoking?

Nothing. I mean, they have CA, the damage is already done. They have the info on stopping smoking, they know by now what the risks of smoking are; they face it every time they come in for chemo. What better object lesson could you possibly have? What am I going to say to a Stage IV lung CA that he/she doesn't already know?

AgentBeast, BSN, RN

Specializes in Cardiology and ER Nursing. Has 7 years experience.

God, grant us the...

Serenity to accept things we cannot change,

Courage to change the things we can,

and the Wisdom to know the difference

Patience for the things that take time

Appreciation for all that we have,

and Tolerance for those with different struggles

Freedom to live beyond the limitations of our past ways,

the Ability to feel your love for us and our love for each other

and the Strength to get up and try again even when we feel it is hopeless.

- Reinhold Niebuhr

Guest
This topic is now closed to further replies.