Hi All....I have a discussion group coming up and one our subjects is:
Should obese adults or individuals who smoke have healthcare withdrawn until they redress their lifestyle choice?
I have lots of my own opinions and have researched this thoroughly on the net, I just thought I would post it on here and see what others thoughts were, as in britain they're so many initiatives and programs in place for healthier lifestyles etc, but if people dont start taking these on board is it acceptable to expect the NHS to pick up the bill?
Anyway, hope u guys have some good opinions about this.
Specializes in Med/surg, ER/ED,rehab ,nursing home.
All are treated here in the USA. Even without insurance. BY the way that cost comes out of my taxes, and raises my insurance rates,too. But I am more concerned about the health and welfare of those that have to be lifting that 600 lb patient. Nurses can get hurt no matter how many are attempting to roll the log. Pt beds are not wide enough for most 200 lb patients. ( divide by 2.2 for kilograms) . My job discription states that I am to be able to lift 50 lbs. With most of our patient load, it would take 4 staff members to do so. Most patients can help some, but not all.
I would give a choice to these patients that are obese of a lapband, stomach bypass, etc. Smokers are being so limited now in the states that many have quit FINALLY. Now our hospitals are saying they will not allow anyone to smoke on campus...which means out doors anywhere on the property. I do not know how it will be inforced, esp. with visitors. I work with 3 excellent nurses who smoke. Two of the three abuse their break privileges to the extent that the non-smokers can't get off the floor for a break.
What about diabetics and CHF patients that don't follow doctors orders.
Specializes in renal,peritoneal dialysis, medicine.
your beds are small in the usa!
in the uk we are not allowed to lift patients, we 'move' them
human nature is what it is, head down in sand like an ostrich, bum in the air waiting for the inevitable kick it gets from one advice group or another, when its not conforming to what is 'normal'
we have special equipment to move very obese patients, larger commodes/beds/hoists etc, doesnt the usa supply any of this equipment???? for the comfort of their patients/nurses??????
Considering the NHS is often seen as a second rate system it looks like we are guarding the health of our nurses at work when handling larger patients quite well!
In response to Brads 2nd paragraph I just wanted to add that gastric surgeries (banding/bypass) are not as simple an answer as they might seem.
At my hospital we carry out such procedures & they cost the patients around £8000 (not many can get their surgery on the NHS.)They involve serious, life-changing diets & the consequences, nutritionally speaking, for the patients (especially young women who may want chidren in the future) can be potentially serious.
Most patients think, as we 21st century humans do, that it's a quick fix answer to their problems but it's a lifelong change that we still don't know the full outcomes for - as none of them have reached old age yet!
Of course it has health benefits for those patients too - their diabetes risks, heart disease risks etc etc etc are dramatically cut - as long as they follow the diet (which is another problem too) but I doubt many have thought beyond the 1st couple of years post surgery.
Specializes in renal,peritoneal dialysis, medicine.
girl on my ward has had this procedure, personaly i would rather remove my eyes with a spoon without analgesia than have a gastric band, she spends her whole life trying to work out how she can cheat it, has had to have it revised cos it moved and lost a couple of stone in two years
no thanks
having said that surgery can work... but you still need to have input yourself
Specializes in Medical and general practice now LTC.
Surgery can work, I have lost 7 stone with gastric bypass but it is a tool and there are days I push it but soon my body reminds me I can't. Surprising how many though think it is a be all end all when it isn't and still needs input from yourself
You really do have a wonderful way with words EN - if you don't get your greencard soon maybe you should start writing books instead!:chuckle You'd give Jeremy Clarkson a run for his money at any rate!
Gastric banding has the highest failure rate because people can cheat on it more easily than the other surgeries. That higher failure rate is solely due to the person and not the surgery though. It does have the least impact on nutritional intake though and a much lower incidence of "dumping syndrome."
This all goes to prove that a patient undergoing weightloss surgery must have a proper consultation, including psychiatric & dietician. If you have the surgery through groups such as "Transform" the chances are you're not going to get that & may end up tomorrows headline in the newspaper - "How I burst my gastric band in just 6 weeks" type of thing!
Specializes in Medical and general practice now LTC.
Well done SD! I'm sure you'll atest how much hard work you have had to put in to it all though.
It does work but it's not effortless or a quick fix, is it??
How come you were posting the same time as me AGAIN!!!!
It is not effortless or a quick fix and now after 2 years although I can't eat big meals (usually use a side plate as I still even now overfill plate) my eyes can be bigger than my tummy. If we go out for a meal I always leave atleast half and then get strange looks from staff thinking something is wrong but I did enjoy it.
snip......... personaly i would rather remove my eyes with a spoon without analgesia than have a gastric band, ...................................snipf
:uhoh3: now don't beat around the bush just say exactly what you mean
200lb is 90 odd kilo or just over 14st whilst not svelte its harldy abnormally big.
most beds should cope with that, its people over the normal range for beds/hoists ext that the need arises to get equiment.
however if siad 200lb patient was unable to mve self at all i would have every aid in place glide sheets, hoist, a hig spec mattress on a profiling bed as possible and if 2 weren't enough to turn position with aids i'd grabb as many staff as were free so that no one was strainging.
however had a physio do movig and handling and went through hw t get pt going wt and apparenlty none of the laws siad liffing is banned just that to redue risk of injury as mcuh as possible espically repetive and unessary move/lifts.
:uhoh3:
XB9S, BSN, MSN, EdD, RN, APN
1 Article; 3,020 Posts
My thoughts exactly EN, I enjoyed the debate the first time around