No Winning for Losing

Every year, the day after Halloween marks Opening Day of Seasonal Gift-Eating. Nurses, you know what I’m talking about. All over America, nurse lounges abound with gifts of food given to us by patients and doctors offices. Huge canisters of gourmet popcorn, boxes of chocolate, and homemade delicacies arrive and cover all available counter space. Even if there’s no time for a lunch break, there’s always a few seconds to grab a piece of fudge. So it’s a little unfair, in my opinion, that health care is focusing on the issue of obesity, even though I know it’s right.

Many patients, female in particular, cringe when I ask them to step on the scale at their appointments.  I don’t say their weight out loud, but simply enter it into their chart. In the December issue of the American Journal of Nursing, Carol Potera reports on the emotional impact on patients of words used to describe their weight in Words Can Hurt. The information comes from a study led by clinical psychologist Gareth Dutton. I found the study’s contrast of words used by physicians versus words used by nurses to describe patient weight enlightening.

Medscape published an article Is “Fat Bias” Making You Ineffective? by Marilyn W. Edmunds PhD, CRNP, in which she calls upon health care providers to reflect upon our biases and how they impact our patients. She also asks us to consider cultural differences in perception of weight.

We’re not the only ones looking and judging, however. Recently at an art opening, another artist told me I am the only nurse he’s ever met who isn’t overweight, and it wasn’t the first time someone has said this to me. I find this public stereotype of nurses more troubling than Dr. Oz’s sexy nurses, who were really women who lost weight, although I agree the entire debacle was in poor taste.

I want to throw one more point into this post. A patient came in raging about fast food chains. I didn’t really get it until he explained that fast food is cheap, so for people living on the limited resources of disability, it is affordable. All the fat, all the sodium, the lack of nutrients from over-processing, is all he can afford. And then he comes in for his appointment and gets lectured on his A1C Hgb results, hypertension, and obesity. In his opinion, there’s no winning for losing.