welcome to the hilton...please dont forget to tip your waitress

mattsmom81 · Jun 15, 2002

Hi, Nursejws, yes there IS a specialty in nursing that is bariatrics. Harris in Fort Worth runs a program and hires nurses to assist with medical management. I know there are others in this area too.:)

Plus Jenny Craig and other similar programs LOVE to hire nurses, as well and the docs who specialize in bariatrics/weight loss.

I have thought about this myself, as I believe we both talked about this on another thread.

"Help me to help you" is a great motto...good luck!!

nrw350 · Jun 15, 2002

I too cannot fathom how people want nurses to do everything for them. Why would someone want to be embarassed because they can not make it to the restroom or can not clean themselves up afterwards? It seems to me that they lack respect for themselves, and in which case are in need of some serious help. If a person lacks respect for themselves, then their chances of getting better are very slim.

I tend to be one of those people who do more than they should when injured or ill. When I fell and nearly broke my ankle, I did not sit or lay for days. I was doing everyhing that I possibly could. (really made some people mad doing it too, but dern I was not going to be an invalid). I went to a local clinic after falling, and I walked (hobbled is more like it) from the waiting room back to the exam room. The nurse was in utter shock that I was walking on the ankle that was swollen past the size of a softball. I guess she could tell I was a tough patient because after looking at the ankle she said she would be right back. When she returned, she had a wheelchair with her. She wheeled me to the x-ray and then to another area where I could lay down while they put a splint on it. The embarassment of having to be in a wheelchair was extreme for me. I am a large fellow, and I feel bad for anyone who has to move me. The nurse was astounded at me, because she said that she could not see how I was not crying from walking or even moving the ankle (like on the x-ray table which really hurt).

When they splinted the ankle, they were taking the best of care not to inflict any more pain on me. I mean, they had the lightest of touch and everything. Perhaps the hardest thing of all this, were the crutches. I can not handle crutches to save my life for some reason. I would have barely sooner been back in the wheelchair. I would adapt to it, and wheel myself.

The reason for bringing this us is that I just fell down the same stairs at work and hurt the same ankle again about 2 days ago. Luckily, I did not hurt it near as bad this time, but it is very frustrating none-the-less.

Oh well, enough of being on my soap-box lol.

Nick

I hope I have not offended anyone with this post, but that is my opinion.

nursejws · Jun 15, 2002

Nick, be careful! I understand what you're saying...I'm not offended.

nrw350 · Jun 15, 2002

I felt like taking a chainsaw and some lighter-fluid to those stairs the other day. They really urk me because of their position and construction.

I am grateful to the doctor I had for the first fall. He was very kind, and explained everythign to me. Even taught me about the anatomy of my foot, and how it would have been better for me in the long run had I broken it even it would have probaly meant surgery. Really good guy, I realize I probaly should go back to him now since the 2nd fall.

Nick

Peeps Mcarthur · Jun 15, 2002

Someone once said "No good deed will ever go unpunished"

I think that about sums up pt care.

ktwlpn, LPN · Jun 15, 2002

Originally posted by mattsmom81
I can see I've bothered some people by what I said, but I notice that one line was ignored. I believe I said I WILL HELP THESE PEOPLE WITHIN MY LIMITS AND ABILITIES. That DOES NOT include hurting myself on them. That DOES NOT include joining the codependant ranks of family members that have enabled her/him to GET to that point

Why do you think, everyone, that so many nurses are injured on the job??? Because they fail to set healthy physical limits/boundaries.

Nurses who fail to set healthy emotional boundaries with patients....doing and doing for them because "they need me' will also pay a price....eventually this codependence catches up with them. It is not healthy.

Take care of yourself nurse. You're all you got. :)

I agree that we must set emotional boundaries for ourselves with all of our pts-fat,skinny,young,old,alcoholic,drug addicted and the nice young man with cancer......And yes-we must protect ourselves PHYSICALLY-that's why proper lifting techniques,equipment and the assistance of another staff member or 2 are so important....Now-I HEAR what you are saying-please HEAR ME-Do you expect to change the behavior of a pt like this in a few days of weeks when it took them years to end up in the condition they are in now? Stripping the dignity of a pt like this for that length of time will not rehabilitate them....Why does the general public think it is ok to openly show prejuduce to an obese person(OK-no more PC talk-a FAT person) It is ok to feel disgust for what this person has done to themselves-but you maintain your professional distance and you do not let them know how you have judged them-or any of your other pts...Please think about what I have said here.....

nursejws · Jun 16, 2002

This is the thinking of MOST of the world when it comes to people who are overweight/obese/morbidly obese, etc...."if you would just stop eating and exercise" OR "if you would make the right food choices". I know this because a) I am obese, and b) this is how my own Mother thinks. I have 5 brothers and a sister, not ONE of them are more than 15lbs overweight. When my Mother married her first husband she had a 19inch waist. I don't think I've ever had a 19in waist!

Wake up and smell the coffee...I guaran-damn-tee you, if losing weight and MAINTAINING the weight loss were that simple, we'd all be rich. Maintaining the weight loss is the problem. Everyone can lose weight. I cook good meals at home, I read the labels when I shop, I swim in the pool, walk...you name it, I've done it. Yet I have not lost any weight. Last July I went to the dietician at my dr's office to go on a diet. During this time I was bowling on a league once a week, and going to water aerobics 3x a week. From July until February 11th of this year, I lost and gained the SAME 8lbs, and at my final weigh in on 2/11 I gained the 8lbs back PLUS 2 more lbs.

It's NOT okay to feel disgust or judge anyone, because I promise you...you have no idea. I used to think this way, until I met my husband. When I met my husband, and I met him online, after talking to him for three days in a row he wanted to meet me. I agreed to meet him at the mall. He was everything I was looking for, educated, professional, had his own place, new truck, funny, and a gentleman. We met at a restaurant for lunch, I told him what I would be wearing and to wave at me when he got there. I waited and waited and waited and saw some big old guy wave at me. I was like, what?!?!?! Finally, I walked out to the entrance and saw this young blonde guy sitting on the bench(the guy that waved at me), and he was a big guy. I immediately thought no way....I never dated a big guy, and considering I'm a big girl, I thought I was doing pretty good thinking about the relationships I had in the past and the guys. I enjoyed his company and we went out a few times when I had to put the brakes on. I did not know if I could fall for this guy, even though he was everything I wanted, I overlooked the blond hair and blue eyes, even though he was everything else I wanted, I didn't know if I could get past his size. I thought about it, and we still talked during this time...I told him to be patient with me as I was still scared about getting so close and in a relationship. Finally, I thought to myself, if I don't give this guy a chance just because of his size, especially when he has so many wonderful qualities, and we have such a good time, etc, etc, than I'm no better than anyone else who brushes me off for the same reasons. 9 months later we got married. I am very happy with the decision I made. I can't tell you how many times I've been discarded because of what's on the outside. Btw, my husband and I are pursuing wls together so we can live longer and healthier. We've exhausted all other efforts of losing weight. That's OUR choice.

There are three sayings I try to follow/live by in my life:

1) Don't judge a book by it's cover.

2) Do unto others as you would have them do unto you.

3) What comes around, goes around.

Life is really too short - which is why I treat everyone the same. People are people (great song by Depeche Mode, btw)...I pass people everyday, I say hello, they sneeze, I say bless you. I guess this is why I want to work in bariatrics. I would also like to work in L&D.

Anyway, just my thoughts...please do not judge me for what you see on the outside. I promise you will be surprised.

As far as the posts about wiping, bathing, etc, etc. I will observe what the patient can/cannot do. My goal is HELP ME HELP YOU.

LasVegasRN · Jun 16, 2002

Originally posted by ktwlpn
I agree that we must set emotional boundaries for ourselves with all of our pts-fat,skinny,young,old,alcoholic,drug addicted and the nice young man with cancer......And yes-we must protect ourselves PHYSICALLY-that's why proper lifting techniques,equipment and the assistance of another staff member or 2 are so important....Now-I HEAR what you are saying-please HEAR ME-Do you expect to change the behavior of a pt like this in a few days of weeks when it took them years to end up in the condition they are in now? Stripping the dignity of a pt like this for that length of time will not rehabilitate them....Why does the general public think it is ok to openly show prejuduce to an obese person(OK-no more PC talk-a FAT person) It is ok to feel disgust for what this person has done to themselves-but you maintain your professional distance and you do not let them know how you have judged them-or any of your other pts...Please think about what I have said here.....

Well said, that was the point I was trying to make.

RNforLongTime · Jun 16, 2002

Well, I had to change this post

Brownms46 · Jun 16, 2002

Originally posted by ktwlpn
I agree that we must set emotional boundaries for ourselves with all of our pts-fat,skinny,young,old,alcoholic,drug addicted and the nice young man with cancer......And yes-we must protect ourselves PHYSICALLY-that's why proper lifting techniques,equipment and the assistance of another staff member or 2 are so important....Now-I HEAR what you are saying-please HEAR ME-Do you expect to change the behavior of a pt like this in a few days of weeks when it took them years to end up in the condition they are in now? Stripping the dignity of a pt like this for that length of time will not rehabilitate them....Why does the general public think it is ok to openly show prejuduce to an obese person(OK-no more PC talk-a FAT person) It is ok to feel disgust for what this person has done to themselves-but you maintain your professional distance and you do not let them know how you have judged them-or any of your other pts...Please think about what I have said here.....

You know...I'm going to try once more to get an understanding here. But I doubt if I will succeed!

First no one has stated any prejudice against obese people or any people for that manner!

Second...What was stated is that allowing a pt. to slide backward in their progress by doing what they can do for themselves... is not a caring endevaor, or in their best interest!

Third If you do everything for them....you take away any incentive for them to do for themselves! YOU create an invalid..and you have not met their needs! If you allow them to become less than what they're capable of being...you have failed them in your role as their nurse!

No where in here...did I say...that obesity was the problem! What I said was...it they have the ability to get up to the bathroom...they should! It just happens that the person I was talking about was overweight...and maybe her weight and lack of self respect for herself...was at the route of the probelm!

But no one should NOT be allowed to regress just because it is easier to do so! And catering to someone like this ....and thinking you're preforming a service and being a good nurse...is totally wrong. I would hope and pray....that if I am injured in anyway...that whatever nurse takes care of me....will not think she is doing me any favors by not strongly encouraging me to do for myself...no matter what I weigh!! I'm totally aghast that any nurse would support a pt's desire to lie in their own filth if they have the ability to do otherwise! I'm totally appalled by the ignorance I have read here! You could not in a million years have told me, that I would be reading such posts from nurses...and/or possibly nurses to be! This scares me to no end! :eek:

Why does this scare me?? The thought of some nurse actually giving me a reason not to strive to reach the height of my former abilities...makes me cringe! How many have had pts who begged for you not turn them, or get them out of bed??? How many of us have steeled ourselves...and ignored their pleas....and gave them no choice but to turn, deep breathe, and cough, no matter how much they complained??? Or even the ones who swore they couldn't get OOB and walk...were soon walking up and down the halls...totally pleased with themselves..and showing off to you?? How many said...hey Brownie...look at me...while smiling from ear to ear....even though they were in pain, and who were the very ones saying...I CAN'T??? Please...YOU think about it.. :cool:

Peeps Mcarthur · Jun 16, 2002

Brownie,

I would have to agree so wholeheartedly with your ideas.

I have seen this kind of mental pathology many times in respiratory disorders. I worked at a hospital ten years ago that was on the leading edge of rehab. About as many times as the metabolic cart pinpointed the problem as simple nutritional intake, or lack thereof, there existed an overwhelming number of patients that were just afraid to try. The resp therapists, nurses and doctors that failed to recognize or chose to ignore that weakness simply took the easy way out.

In these cases the mental pathology, instead of being recognized and treated, had been encouraged to grow by well-meaning caregivers. Once you have facillitated thier weakness how do you say "no, you must care for yourself to get better"? When everyone around you is just taking the easy "PC" way out. You have to have a team of professionals that are insightful and working together, right through the administration that needs to have that same philosophy or it CAN NOT HAPPEN. Even when everybody is working together it is MUCH more difficult than just facillitating the pathology and getting kudos from all the other facillitators as some kind of mother theresa.

It has absolutely nothing to do with the patient being obese or having any other externally apparent weakness. It's about healing and I have seen this kind of "tough love" therapy work when nothing else could have saved thier quality of life.

We have to include someone else on that team. We need that person to help us, trust us and "buy-in" to what we are trying to do, otherwise we are just hanmadiens to people feeling sorry for themselves, so to speak.

Obviousely, the person that we need so desperately on our side to make it work is the patients themselves.

When we facillitate a mental pathology to obtain that...........................we become it's slaves.

I would work on your team anytime Brownie.:kiss

catlady, BSN, RN · Jun 16, 2002

I see a huge difference between encouraging patients to achieve a goal and the contempt for patients I've read in some posts of this thread. People who are sick enough to be admitted to the hospital are frightened, in unfamiliar surroundings, usually in pain, and have rarely been consulted on the 'plan of care.' The goals are set by nurses. It is *normal* to see a certain amount of regression when one is ill, or perhaps none of you ever curled up in your bed and whimpered just a little bit the last time you had a bad cold??? If your patient is "showing off" to you, while you haven't relieved their pain, perhaps they're just terrified of what you're going to do to them if they don't follow your orders. I certainly have done my share of pushing people to get out of bed, do their own care, etc., but I always recognized that they were in charge. It was my job to educate them on the risks of continuing to do things their way, and the benefits of doing things my way, but ultimately the decision is theirs, not mine. They're the ones who are going to have to go home (or not go home) in the state of health to which they have contributed.

My outrage was with the poster who dumped on "lazy overweight women" as if obese women are necessarily lazy, don't have the right to be ill, and when they are hospitalized, it is their fault.