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

Nurses General Nursing

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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.

Specializes in FNP.

It is not judgmental to point out to the obese person that he/she is not at a healthy weight and their co-mobid conditions would improve if they lost weight. Not by a long shot. No one is suggesting anyone name call or belittle the person for crying out loud.

Specializes in Med/Surg.
Some of these patients are just clueless also! I am fat myself, but I am at least educated about my own situation! I also have a huge heart for these folks! I know how addicting food can become!

I had a patient today (in clinical) who was easily 450 lbs+. In the course of asking stupid questions for a care plan I had to asked her how she would describe her health. Her answer - "GREAT!"

She has bad COPD, CHF, history of MI, 2/3+ edema all over the place and DQ's to boot!

Really? Great huh? LOL! I don't know if it was denial or just what she truly thinks!

:lol2: sounds like she's got one foot in the grave and the other one on a banana peel.

Specializes in acute care med/surg, LTC, orthopedics.
Some of these patients are just clueless also! I am fat myself, but I am at least educated about my own situation! I also have a huge heart for these folks! I know how addicting food can become!

I had a patient today (in clinical) who was easily 450 lbs+. In the course of asking stupid questions for a care plan I had to asked her how she would describe her health. Her answer - "GREAT!"

She has bad COPD, CHF, history of MI, 2/3+ edema all over the place and DQ's to boot!

Really? Great huh? LOL! I don't know if it was denial or just what she truly thinks!

A patient in this scenario would be almost impossible to change, which is a lot worse than someone who at least owns up to their shortcomings. I'm not sure how nonjudgmental I can be if the patient truly feels there is absolutely nothing wrong with their deadly lifestyle choices.

Specializes in Rodeo Nursing (Neuro).
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?

You could say you care. But I doubt it needs said. They probably know.

Specializes in Oncology; medical specialty website.
I'd remind them each and every time I saw them their outcome odds would improve if they quit. If they don't want to quit, there seems to be little point in getting chemo, lol.

LOL? You think this is funny?

Do me a favor. Stay out of onco.

Specializes in Cardiology and ER Nursing.

There are people who despite watching 20 people in front of them jump off a bridge and die still think "that is not going to happen to me!" Then proceed to jump off the bridge and die. You do what you can to help educate the patient. However, ultimately the responsibility for change rests with the patient.

Specializes in FNP.

OCNRN, You are overreacting. It's ironic. There is no internet acronym for that, AFAIK. ;-)

Specializes in Oncology; medical specialty website.

I fail to find the irony. Addiction to nicotine is so strong that it can even precent someone with a lethal cancer dx from quitting. It still doesn't mean the patient doesn't want or deserve treatment. It's too simplistic to say "Just quit." It's heartbreaking to see people do things that are harmful for themselves, but understanding the addiction aspect makes it more understandable.

I try not to judge. There but for the grace of God go I. I'm certain I have lousy health habits some nurse-Nazi could tag me for. I'd rather establish trust and give patient like my cancer patient the best time they have left. And if that means letting a terminal pt have a ciggie, doggone it, I won't stand in their way.

Specializes in FNP.

Well, as they say, doing the same thing repeatedly and expecting a different outcome is the definition of insanity.

LOL. ;-)

Specializes in Rodeo Nursing (Neuro).
Some of these patients are just clueless also! I am fat myself, but I am at least educated about my own situation! I also have a huge heart for these folks! I know how addicting food can become!

I had a patient today (in clinical) who was easily 450 lbs+. In the course of asking stupid questions for a care plan I had to asked her how she would describe her health. Her answer - "GREAT!"

She has bad COPD, CHF, history of MI, 2/3+ edema all over the place and DQ's to boot!

Really? Great huh? LOL! I don't know if it was denial or just what she truly thinks!

Granted, this is a pretty extreme case, but it could be argued that the patient has met her health goals. Of course, if one were truly at their goals, they wouldn't be a patient. There's a difference, to be sure, between this scenario and, say, deciding not to undergo chemo or signing a DNR order. But the difference isn't as clear cut as some seem to think. There probably is a strong element of denial, but if we are only free to be or do what someone else thinks we should, we aren't free and we aren't going to be happy. So, really, why prolong life?

Elsewhere in the thread, it was mentioned that people who live unhealthy lifestyle increase the cost of healthcare for everyone. This has lately been a very popular excuse for minding other peoples' business. My question is, fine, where's the rebate for all the uncollected Social Security?

Specializes in Rodeo Nursing (Neuro).

You need to lose weight. You need to lose weight. You need to lose weight. You need to lose weight. You need to lose weight. You need to lose weight...

Wait...

Specializes in OB, ER.

I think asking instead of telling is a great approach to avoid judging, understand what the patient knows already, and it gets the patient more involved in the teaching. They learn more if they are part of the problem solving. It's easy to tune someone out who sounds like they are lecturing or uncaring. Also talk to the future not the past. They can't change what they did to get themselves in the hospital this time but they can prevent it from happening again.

What changes do you think you could make to prevent this from happening again? What questions do you have about your health and how you can improve it? Are you happy with your health, energy level, fitness now? If not how can we get you to that place where you are healthier and happier?

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