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

[SNB1014]

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.

[grannyrn65]

Rapid Response I hit the wrong key. Meant to give you Kudos Sorry

[Blackheartednurse]

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.

Do you believe that they will actually listen to her teachings?? I had some obese patients and I was very straight forward with them and actually told them " You ought to loose some weight" They said "yeah you right" but did they listen? No,they still ate 3 doughnuts everyday in the morning..Yes there are other risk factors besides obesity but being obese is one of the leading causes for developing diabetes,heart disease and chronic kidney disease.

[Blackheartednurse]

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

Just dont complain when you'l become a short of breath..

[Marleyna]

Maybe the title of the message was a little inappropriate but I think the OP means well and is trying to see what are some ways to deal with the issues she has come across. Obesity is certainly a huge issue and I do not see how it is wrong to educate patients about changing their dietary needs, physical activity and etc.

Where I work there is a growing population of obese patients and it definitely changes the way the workflow goes. I find myself to be extremely sore and tired following my shifts because unfortunately there just isn't enough safety resources to utilize within the hospital. They are slowly integrating ceiling lifts within most units and trust me that would be very helpful.

It becomes an issue both for staff and patients. So what is wrong with educating patients? I do it as often as I can but do approach them as individuals, with no judgement and in hopes of understanding their entire living circumstances.

I always wondered, patients that suffer from anorexia are giving opportunity to regain their health through continuous therapy involving multiple health care providers but why shouldn't obese patients have access to therapy and the same type of treatment? Food is an addiction for some of these patients and I believe it should be treated as such rather than expecting patients to just be discharged home and hope they somehow lose weight. Instead these patients return a few weeks or months down the road with additional weight gain. For that reason, it would be important to incorporate as much teaching regarding eating habits and exercise regimens.

If we all just ignore it then the issue will persist.

[sabrina_RPN]

I like to sit down with my patients who need a lot of health teaching and find out about their lives, where they are from, childhood, work, family etc... And ask them if they have questions about their lifestyle. Such as things that are static that cannot be changed, and things that can. I ask patients what they have tried in the past for their specific problem, be it smoking, obesity, drug addiction etc...I find out how motivated they are to make a change, and see if there is a consult that I can try to set up. Such as physio, psych, pharmacy, or a dietitian. This way the patient has the right to choose, and you have done your job as a health care provider to health teach and show that there are options. You can recommend help-lines or websites that are credible. As most things now a days are so revolved around technology. This can be time consuming and sometimes physically and emotionally draining. But you have to do your best. When I feel how you do, I try to go back to my roots of what nursing is all about...

Good Luck,

Sabrina

[PostOpPrincess, BSN, RN]

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.

Blame it on the "politically correct" wave going through society.

There are only so many ways to avoid what needs to be said.

[Spikey9001, BSN, RN]

Only in America are the minority of people within their weight range and in good physical condition.

[CuriousMe]

Just dont complain when you'l become a short of breath..

Very therapeutic approach.

[dazyRN]

As a nurse it is our duty to teach and educate our patients on their health issues. Obesity, smoking, CHF, and DM are all diseases that we should discuss with those patients that it applies to. If we do not teach them about this then we have failed them.

[PostOpPrincess, BSN, RN]

I often see a "come to Jesus" moment when obese patients have a difficult time after surgery--i.e. they can't move, can't breathe, and seem so much more miserable after surgery--with many factors influencing it, of course, but obesity--plays such a major part.

I have seen many realize, at that particular moment at least, how much of a hindrance extra adipose tissue imposes.

I don't say much because it's very sad to watch them as they struggle post op...especially the orthos...

I feel very bad for them.

[grannyrn65]

And I wonder why some choose to blame the patient. And feel it is just a simple matter of changing some habits. Good heavens, if it were, my nursing life would have been a lot easier and simplar, as would have been the patients.

GrannyRN65

[sistasoul]

The only thing that upsets me about obese people is that they don't care who breaks their back tryting to hold them up. I am not saying all obese people are like this but a lot of them are. When I was an aide I had one obese lady tell me that her legs would not hold her up. As I was trying to help her I told her that she would have to try to because I certainly could not hold her up. If your legs cannot hold you up you would think that would be an incentive to lose some weight. I think with most obese people that a psych isssue plays into the reason for why they overeat. Maybe low self esteem, anxiety , depression, etc. Why else would you allow yourself to become so large? I know some people do have medical reasons for being obese but I think the majority do not. Maybe if their thought processes were healthier they would not overeat. Just my humble opinion.