Resources for caring for Eating Disorders??

[ChickenHealer]

So to start off, I am a mental health technician, graduating nursing school soon. I float to many different units, but my usual unit is adolescent/children psych.

Anybody have any resources on care for patients with eating disorders? My hospital doesn't offer any specific guidance or resources other than requiring that we lock their bathroom doors for 30 minutes after meals. I don't see a lot of patients with eating disorders at my facility, but it can feel like we don't offer anything other than medication stabilization for these patients. Our therapists do not offer specially tailored psychotherapy for patients with eating disorders- my unit's therapist often says that she is more of a "paperwork-signer" than a therapist due to the scope that she is given.

I've tried blind weights, but other staff are not compliant. Discussing relationships with food and building a support system seem to be the most effective methods that I've used with these patients, but I am pretty inexperienced when it comes to these patients, sometimes it can be hard to know what to say. Usually I can get the conversation started, but sometimes I feel like I hit roadblocks. For example, an adolescent patient was telling me that she feels extremely fat and that she was raised to measure her waist daily, and if the number is above a certain threshold, her family used to starve her and tell her to make herself throw up. (The patient was slightly underweight). I talked to her about taking one step at a time, deviating away from strict standards, maybe loosening up her calorie counting, and she seemed to be understanding what we were talking about, but then she told me that she feels that she can improve how she feels about food, but she doesn't want to because it never worked for her before. I offered some motivational words and praise for her effort in identifying problem behaviors and verbalizing some realistic goals, but she told me that our conversation wouldn't matter and that no positivity would change her mind. I felt a little lost as to where to go next.

 

Any advice or resources would be appreciated, be it about treating eating disorders or about the specific scenario.

[hppygr8ful, ASN, RN, EMT-I]

It sounds like you are in a crisis stablization unit. If so your job is to provide treatment that addresses the immediate crisis. Treatment of the eating disordered is a complex issue requiring more that pep talks. 

You are not going to fix this problem in a short stablization admission. It took the adlescent 13, 14, 16 years etc to get where they are - we are not going to fix it in a few days time. 

Hppy

[maggie0, BSN, RN]

I agree with the above. Eating disorders are long-term, complex issues that need specialty care. I like to focus on basic body-positivity, health, and self-esteem with adolescents, and we definitely avoid showing kids their weights or talking about calories. (If your coworkers are showing adolescent patients their weights, I might bring that up with management. Not okay.)