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

[SNB1014, RN]

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]

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]

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

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

[MJB2010]

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]

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

[linearthinker, DNP, RN]

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]

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]

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

[RachH]

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.

[MrazFan]

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.

[CuriousMe]

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]

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?