Thursday, March 13, 2008
fault
I overheard an interesting point of view tonight at clinical. A patient was admitted to the floor, apparently had been nauseated and over-sedated in the ER, came to the floor and complained of major pain, then began to projectile vomit. Lovely. The nurse was advocating strongly for the patient, saying "I need pain meds for this patient, they are hurting badly" and generally agitating to get the patient's meds ordered right away. But then behind closed doors, I heard the same nurse saying that she didn't feel any sympathy at all for the patient, because the chronic pain issues are the result of blown-out knees secondary to morbid obesity. In fact, the nurse said something along the lines of, "I feel sorry for the patients with brain tumors because they didn't do anything to bring it on, but the ones with problems from obesity I don't feel sorry for at all because they made that choice."
Wow. That's not very compassionate. And it made me wonder: Is this attitude okay? Does the patient with morbid obesity deserve less sympathy than anyone else? The nurse didn't appear to TREAT the patient any differently... but her attitude was pretty clear. And I also wondered if it's even fair - once someone gets overweight for whatever reason, it is really really hard to lose, especially if you have blown out your knees and can't exercise effectively.
What do you think?
Wow. That's not very compassionate. And it made me wonder: Is this attitude okay? Does the patient with morbid obesity deserve less sympathy than anyone else? The nurse didn't appear to TREAT the patient any differently... but her attitude was pretty clear. And I also wondered if it's even fair - once someone gets overweight for whatever reason, it is really really hard to lose, especially if you have blown out your knees and can't exercise effectively.
What do you think?
Labels: nursing
Comments:
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I think the more important issue is that she advocated for the patient and saved her own opinions for the lounge. Good for her. Opinions are what they are; the problem comes when we let them interfere with our care. Interesting story!
# posted by 
: March 13, 2008 9:16 AM
: March 13, 2008 9:16 AM
For one thing, the nurse was aware of her biases and her judgments and hopefully was making an effort not to let it interfere with her treatment of the patient. We all have values and judgments that we enter nursing with, but the key is being aware of what they are before you step into the pt's room. On the other hand, no morbidly obese person ever woke up one morning and said, "Gosh, I think I'll just eat until I weight 500 pounds." It wasn't a conscious choice. We all have habits or coping mechanisms or even addictions that allow us to cope with our lives on a daily basis, it just happens that sometimes those coping mechanisms cause health problems or are even illegal.
I think part of the problem is when medical professionals (often MDs, honestly) think they know more than anyone else and therefore get to judge other people. The nurse did not--and could not--know the whole story. People become obese for all sorts of reasons, which do include laziness and self-destructive tendencies. I have chronic thyroid trouble and arthritis and I am quite proud that I just got my BMI down to only "overweight" and not "obese." And I exercise over 10 hours a week, I don't sit on my couch eating bon bons. Many massively overweight women were/are abused or molested, so the fat is sort of a protective layer for them. Who knows why this woman is so heavy? Just because you have a medical degree doesn't mean you're God. (Not that you would ever think that, dear!)
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