Clinical placements

Compassionate care for overweight and obese patients

Caring for an obese patient helped nursing student Julie Anderson understand the importance of patient-centred care and treating all patients with the dignity and respect they deserve.
obese

Caring for an obese patient helped nursing student Julie Anderson understand the importance of patient-centred care and treating all patients with the dignity and respect they deserve

In my second year of training I was working with an obese patient, who I will call Mark.

An injury meant Mark could no longer carry out the physical aspects of his job, so he took an office-based role and started to gain weight. When his wife died and he was diagnosed with depression, he started comfort eating and his weight continued to increase.

Mark could mobilise for short distances using sticks, but he would become short of breath quite quickly and need to sit down.

Achievable goals

...

Caring for an obese patient helped nursing student Julie Anderson understand the importance of patient-centred care and treating all patients with the dignity and respect they deserve

obese
Weight gain can result from many factors, and it is important for nurses to take
the time to understand their patients. Picture: Science Photo Library

In my second year of training I was working with an obese patient, who I will call Mark.

An injury meant Mark could no longer carry out the physical aspects of his job, so he took an office-based role and started to gain weight. When his wife died and he was diagnosed with depression, he started comfort eating and his weight continued to increase.

Mark could mobilise for short distances using sticks, but he would become short of breath quite quickly and need to sit down.

Achievable goals

Mark wanted to talk about how to reduce his calorie intake and change his diet, and we had a good conversation about his options, keeping mobile, and setting small, achievable goals.

When another patient overheard our conversation, making rude comments about Mark’s size and how much food he had eaten while on the ward, I managed to include him in our discussion and we talked as a group about the challenges of cooking for yourself, resisting takeaways and staying active.

Mark had a bariatric bed for comfort. On a night shift, I noticed that when he turned, the sheets would come away and get rucked up, leaving him exposed. When he rolled back over, his skin would be on the bare mattress.

Maintaining dignity

To maintain Mark’s dignity and skin integrity I thought there should be bariatric sheets to fit the bed and mattress. When I asked the ward staff about this, I was told that this type of linen was not available.

The trust director of nursing had encouraged students to contact her with any ideas for improving practice or with any questions, so I emailed her to ask if the hospital had any plans to provide special linen to fit bariatric beds.

After conversations with the ward matron and nursing director, it turned out that this had not been considered. However, the matron came to find me a couple of days later to tell me they had spoken to the hospital’s linen suppliers and sheets to fit bariatric beds would be supplied in future.

Time to understand

This experience made me rethink my approach to caring for overweight and obese patients. Up until this point I had only really thought about the needs of this patient group in acute settings, addressing clinical needs, using the correct manual handling procedures and maintaining dignity.

But this experience showed me that weight gain can result from many factors, and as nurses it is important we take the time to understand our patients and the barriers to good mental and physical well-being.

It also made me consider the wider picture in terms of supplies to help make hospital stays for this patient group more comfortable.


julieJulie Anderson is a third-year nursing student at the University of East Anglia.

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