Compassion or reality for obese patients?

3 Hello,
There is an article in this months American Journal for Nursing about nurses showing more encouragement & compassion for obese/smoking patients instead of making the patients feel judged or guilty. I am a pre-nursing student and attempting to formulate a response to this article.

My first instinct when I read this was that it was really sweet, it certainly gave me the warm-and-fuzzies, but it is simply not practical. The United States' obesity epidemic is becoming worse and worse. Researchers now even believe that the avg life expectancy is on the decline for this very reason. I just don't understand why medical professionals are expected to sugar coat their medical advice. Sure, I wouldn't expect a nurse to say, "Holy cow, you're so FAT! Lose some weight!" but I don't see why it would be offensive for a nurse to say, "You need to lose 100 lbs or your diabetes will cost you your legs." In the article it suggested a nurse say something like, "Let's focus on the aspect of your weight issue that's within your control." Does this statement really reflect the severity of the situation? I believe that guilt can be a very powerful motivator in these cases. I don't see guilt being a bad thing when it comes to issues as important as health.


If you would like to just provide a general opinion, that would be great. If you don't mind your opinion potentially being used in my paper, please let me know and I'll send you a message to get more info. Thank you!
Quote from stefanyjoyIn the article it suggested a nurse say something like, "Let's focus on the aspect of your weight issue that's within your control."

Overeating is just another way people self-medicate; I don't think it's any different than using alcohol or drugs or sex, etc. If people could get to the "why" of what is driving them to abuse their bodies (death by fork), perhaps change could occur. Unfortunately, it takes a health crisis for most folks to come out of denial and face reality. And even then, the habit has taken hold of them to the point where change is next to impossible.So perhaps I'm jaded, but "education", the kind done on a med-surg floor at least, where we might get a few sentences in about the dangers of obesity, probably goes in one ear and out the other. People have heard it all before. I think regular counseling or a support group like Overeaters Anonymous, might make a difference.

I'm obese at 5'6" and I weigh 220lbs. The few times I've gone to the doctor's office, the nursing staff was just down right rude and disrespectful to me and made me feel less than a human being. Is this what nursing is about? Yes I'm obese and have been on diet with little success but to kick a person when they're down is the worst treatment a person can receive. This type of behavior is not a matter of concern for my health and well-being but a person acting superior to you just because they're thinner than you. Would it be ok for someone to say well maybe if you just didn't sleep around, you wouldn't have contracted HIV or AIDS? This is the reason why I don't go to the doctor. I have a few friends that are obese and they don't go to the doctor for this very reason. And to say that obese people are taxing to the healthcare system is ********. The government provides programs like detox, rehab, meds, counseling services for people addicted to drugs and alcohol. How much money is spent on these programs? They're just revolving doors and all it does it keep people employed in these centers. Right now I'm trying to get my health on tract and I appreciate the resources online that are available. There were no resources available for me from my doctor. Nothing not even a pamphlet or list of nutritionist or dietitians that could help me. I had to keep asking for something as simple as my vital signs and blood test results. I'm a human being and want to be treated as such. But then I realize that most nurses are women and the catty, teenage like behavior is something that is the norm now. Sad but true. IMO, a nurse is nothing but a bully in scrubs.

Quote from stefanyjoyI believe that guilt can be a very powerful motivator in these cases.

[QUOTE=stefanyjoy;4787905] I believe that guilt can be a very powerful motivator in these cases. I don't see guilt being a bad thing when it comes to issues as important as health.QUOTE]Where is your research to back up that opinion? If you are trying to write a scientifically sound response, you will need FACTS to back up your opinions -- research studies, etc.. You can have as many personal opinions as you want, but you won't be taken seriously by anyone who knows anything about healthcare and/or working with the public unless you can back up those opinions with scientific fact. Most research supports the idea that you get a better response from patients if you are kind to them than if you are blunt and insensitive. Fear, scare tactics, punishments, etc. sometimes work for a while, but have been shown to be ineffective motivators over the long term.And finally ... but perhaps even more important ... You don't have to be "un-real" to be compassionate. A good nurse can be BOTH compassionate AND real. We can show our caring and respect for the patient while at the same time giving him/her the correct information. We can be supportive and kind while also being honest.

I agree with the above, it's much more complicated. As far as communication style is concerned, I would not limit myself to one size fits all. The goal is to help the patient achieve maximum well being. You choose whatever style the individual patient is most likely to respond to. Some patients may need to feel that they're not alone in this while others may respond better to a (verbal) kick in the beans.

There is an enormous difference between guilt and shame. I did not cite my sources here, but I have researched the differences between the two extensively. I did not intend to imply that nurses should make their patients feel humiliated and ashamed.

Give them the info in a nice manner, but do not belabor the point. Ultimately, once they are educated about the risks/benefits then it is their choice what they want/can do.......

Quote from stefanyjoyHello,I believe that guilt can be a very powerful motivator in these cases. I don't see guilt being a bad thing when it comes to issues as important as health.If you would like to just provide a general opinion, that would be great. If you don't mind your opinion potentially being used in my paper, please let me know and I'll send you a message to get more info. Thank you!

It's important to partner with the patient, regardless of their appearance, it's imperitive that you find a commongrounds for educating. I find it EXTREMELY easy to get through to patients on a REAL level once you've become their trusted expert advisor.Talk to these people, get to know them and then present solutions... otherwise it will never stick.

Quote from HorseshoeOkay, my opinion is that I think your assertion that "guilt" is a powerful motivator is nonsense. And just how do you intend to accomplish making an obese patient feel "guilty?" I would be very interested to hear what nursing strategies you would employ in order to accomplish this result.

Quote from njsdcaIt's important to partner with the patient, regardless of their appearance, it's imperitive that you find a commongrounds for educating. I find it EXTREMELY easy to get through to patients on a REAL level once you've become their trusted expert advisor.Talk to these people, get to know them and then present solutions... otherwise it will never stick.