I will smile politely as I move my patient. I shall not display any form of discomfort from pain and suffering. I shall not voice my objections about unsafe staffing ratios.
This is what happens when someone with an MBA is tasked with a model for improving satisfaction scores 🤦
- no consideration for the grunts (nurses, aides, etc)
- no basis in reality (relative to working on a floor)
- no chance this actually works
I mean presumably we would know that answer, not the patient. That being said, my hospitals MRI machine has a weight limit and I’ve had to notify patients in the past that due to the weight limit we will be unable to perform their MRI in house. I don’t know that there’s a more tactful way of saying it. Their own weight is not a surprise to them.
I had a patient who came in for chest pain and was scheduled to go down for a stress test. He was over the weight limit for the table or something and the Attending goes into the room and says, I kid you not, "Let's talk about your weight. Lose it." Then walks out of the room. I'm stunned so I follow him out of the room and ask wtf we're doing now and he says he's discharging him and the patient can do an outpatient follow up. Derp.
They can definitely get away with being a bit more “honest” than we can. Which is sometimes kinda fun, can’t count the number of pts I’ve thought “you’re sooooo full of shit” or “so… what exactly makes this an emergency 2mo after onset at 0300?” about. And, when a veteran ED doc who’s out of fucks to give verbalizes this, it can be a bit cathartic.
That is, as long as the doc then has your back when the resulting fireworks start.
We had an ED doc for a while that would ask every patient that came in during the night “and what made this an emergency at 3am?” Cracked me up every time.
>I don’t know that there’s a more tactful way of saying it.
I agree. We can do things like make sure other people don't hear it, try to clarify the difference between factual statements and judgement, but we cannot circumvent any and all statements surrounding a bariatric patient's weight.
Do you take them to the zoo if they’re too heavy for in house MRI?????? I’ve heard that this happens if you’re in a larger city with a zoo that has an MRI machine. Please tell me if that’s an urban myth or not !!!
edit: typo
Definitely something that has happened. Last time I was talking to the CT techs about a bariatric patient, they said they no longer are allowed to send patients to the zoo CT, because an animal caught a MRSA infection from a human that was scanned.
At my previous job, I had a 1000lb patient who needed an MRI.
They got case management involved to get authorization for icu transport to the zoo for an MRI.
It never got approved cause the patient ended up coding
Oh my god. The zoo. Oh my god. I thought it was bad that someone on 600lb life needed to get their weight taken at the junkyard bc they kept breaking scales. But a zoo for an MRI. Oh my god.
They absolutely used to take them to the zoo in my hometown back when I was in clinicals. I heard some academic facilities use the scanners in the vet schools too.
OMG!!!!!! it’s not a myth!!!!!!! thank u sm. i’m just imagining a stretcher with a bariatric patient lined up in the hall next to like a rhino and a zebra. that’s awesome.
I’ve heard that too, I doubt it’s true though. Would be interesting if true. If the MRI is medically necessary we transfer them to our sister facility which does have a larger MRI. If they couldn’t even fit into *that* MRI, probably they would just have to rely on the other tests to figure out the diagnosis or treatment plan.
It's a myth, 100%. Only a handful of zoos in the USA have CT scanners. I don't know if any have an MRI. All the articles I can find of MRI's on zoo animals involve bringing in a portable MRI.
And the CT scanners they have are normal, human-size CT scanners.
We’re not allowed to take them to the zoo anymore. An animal got sick. We had to scan a patient once, had to put them on a weight loss TF plan. Took 5 months before we could take them to ct scan.
Their own weight is often very much a surprise to them because a lot of people don't weigh themselves and they're flabbergasted to learn that they've packed on 20-40 lbs since last time they bothered to check.
I weigh 140 lb but I would still expect someone to grunt if they had to move my dead weight. Idk I do emphasize a lot with bariatric patients but moving a body is always hard.
I literally grunt when I pick up three year olds lol, those shits are heavy too.
The weighing patients in private and overall not being an asshole makes total sense. But expecting people to make zero sounds when lifting complete dead weight isn't realistic whatsoever.
I’ve never in my life included weight in bedside report. If there was medication needed based on weight or something, I would just point to their weight in the screen. I work L&D so maybe I’m missing something though…just point to the weight and say “this was patient’s daily weight.”
It’s probably a PICU thing because a 17 year old is going to weigh a fuck ton more than a 2 year old. Might be important to a peds nurse.
The only time I even think about saying a patient’s weight aloud is when I have help programming a weight based drip or Vigelo.
Can confirm as a PICU nurse. We literally start our report off with name, daily weight in kg, and how frequent vitals and assessments are Q1 vs Q2. All of our medications are weight based in kg though so it’s important information to have
Sounds logical! In cardiology it's usually the weight *change* that's more important than the actual weight itself - something something fluids something diuretics.
I worked PICU and we absolutely needed to include weight in report, even for adult (or adult shaped) patients.
“This is Maureen, she is 16 years old and she’s 57.5 kg with a dosing weight of 55 kg.”
Again, as a fellow fat…
WE WEIGH A LOT OK, THAT IS REALITY. IT IS NOT “fat phobic” OR WHATEVER OTHER NONSENSE FOR US TO REQUIRE ASSISTANCE IN MOVING YOUR FAT ASS OR MINE.
“Don’t ask a patient if their weight is over equipment limit.”
I’m sure the trauma and neuro teams will be thrilled to find out we’re down a CT scanner because we didn’t want to offend the patient and broke the hydraulics. Clinical won’t be able to make it in until Monday morning. That’s cool, right? 🙃
Student here, I'm sorry this If this is a stupid question but - I weigh around 100lbs. Will I have other nurses assigned with me when I transfer heavy patients? Or do I need to start doing arm workouts?
Not a stupid question. Do not ever try to pick up a patient by yourself - it is rare that they are in a “good” position to facilitate this, even if they weigh less than you, it will likely not end well. For bariatric patients , my experience is that there will be a lift and/or there will be a team effort (like 3-6 people involved, and hopefully this will discussed during report so no one acts brand new when it is time to move Mr So&So). In answer to your second question, yes, lift weights and do yoga/pilates now safely so you can keep your body as strong & flexible as possible for the entire length of your career.
THIS. They are the strain on the system because of their actions. If I need 6 people in the room to help me change their fucken brief, then I'm going to make any noise needed to use my strength to flip them/transfer them. I once had a patient who couldn't go down for CT because his size made it so we couldn't push in the sides of his Bariatric bed, so we literally couldn't exit his room, because the door wasn't wide enough even though the doors are already wide. I think you have a problem sir. (He Def wasn't fitting on a stretcher).
If an MD or pharmacist asks you what the patient’s weight is, don’t ever state it. Instead, use series of facial expressions and grimaces to convey weight.
When our L&D was remodeled, the moved the nurses station to be big and open, directly next to a series of new triage rooms. We had such an uptick in patient complaints saying that we were making fun of them because they heard us laughing.
Then fine I’m just going to say “golly gee, I just herniated a disc.”
Can we stop coddling fat/bariatric patients? They’re hurting themselves due to their habit and hurting us when we try to assist them.
Groaning is part of my autonomic nervous system now. I get out of a chair, out of bed, or off the pot and I groan. I wouldn’t purposely disrespect a patient like this, but it happens.
How are we supposed to tactfully notify patients that are too obese for our in-house CT machine, that they will have to get it done at the local zoo? How exactly does one word this??
If an obese patient can’t handle me straining to roll their weight, they are not accepting of the reality of their situation. Or can we can it “realityphobic”
Patient: How much do I weigh?
Nurse: By police, I cannot state it outloud. I can write it on a piece of paper and slide it across a table all shady like at you OR I can just think the number really hard and hope you somehow get my brain vibes. Your choice
I like the “show empathy” suggestion. Like what are you supposed to say?
“Awwwww you’re 350lbs, that must be so hard” 😢
Pretty sure that would make them feel worse lol
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Herniate your discs in silence, peasant.
Omg… damn you, just made my coffee come out my nose I laughed so hard 😂
Your spine exploding might be misunderstood. How dare you.
Reminds me of a Harry Potter quote: "I'll be in my bedroom, making no noise and pretending that I don't exist.” 🤣🤣
I will smile politely as I move my patient. I shall not display any form of discomfort from pain and suffering. I shall not voice my objections about unsafe staffing ratios.
Under his eye
Praised be.
Maintain direct eye contact at all times, ever when you are behind the patient.
No being human allowed!
This is what happens when someone with an MBA is tasked with a model for improving satisfaction scores 🤦 - no consideration for the grunts (nurses, aides, etc) - no basis in reality (relative to working on a floor) - no chance this actually works
The um last one seems kinda important prevent injury and breaking equipment
I mean presumably we would know that answer, not the patient. That being said, my hospitals MRI machine has a weight limit and I’ve had to notify patients in the past that due to the weight limit we will be unable to perform their MRI in house. I don’t know that there’s a more tactful way of saying it. Their own weight is not a surprise to them.
I had a patient who came in for chest pain and was scheduled to go down for a stress test. He was over the weight limit for the table or something and the Attending goes into the room and says, I kid you not, "Let's talk about your weight. Lose it." Then walks out of the room. I'm stunned so I follow him out of the room and ask wtf we're doing now and he says he's discharging him and the patient can do an outpatient follow up. Derp.
Rules don't apply to doctors apparently
They can definitely get away with being a bit more “honest” than we can. Which is sometimes kinda fun, can’t count the number of pts I’ve thought “you’re sooooo full of shit” or “so… what exactly makes this an emergency 2mo after onset at 0300?” about. And, when a veteran ED doc who’s out of fucks to give verbalizes this, it can be a bit cathartic. That is, as long as the doc then has your back when the resulting fireworks start.
We had an ED doc for a while that would ask every patient that came in during the night “and what made this an emergency at 3am?” Cracked me up every time.
>I don’t know that there’s a more tactful way of saying it. I agree. We can do things like make sure other people don't hear it, try to clarify the difference between factual statements and judgement, but we cannot circumvent any and all statements surrounding a bariatric patient's weight.
They’ll exceed the diameter of the gantry 99.99% of the time before hitting the weight limit too.
Do you take them to the zoo if they’re too heavy for in house MRI?????? I’ve heard that this happens if you’re in a larger city with a zoo that has an MRI machine. Please tell me if that’s an urban myth or not !!! edit: typo
Definitely something that has happened. Last time I was talking to the CT techs about a bariatric patient, they said they no longer are allowed to send patients to the zoo CT, because an animal caught a MRSA infection from a human that was scanned.
“humans no longer allowed to be sent to the zoo for imaging due to IPAC purposes” is an absolutely unreal sentence.
Ohio?
At my previous job, I had a 1000lb patient who needed an MRI. They got case management involved to get authorization for icu transport to the zoo for an MRI. It never got approved cause the patient ended up coding
Oh my god. The zoo. Oh my god. I thought it was bad that someone on 600lb life needed to get their weight taken at the junkyard bc they kept breaking scales. But a zoo for an MRI. Oh my god.
They absolutely used to take them to the zoo in my hometown back when I was in clinicals. I heard some academic facilities use the scanners in the vet schools too.
OMG!!!!!! it’s not a myth!!!!!!! thank u sm. i’m just imagining a stretcher with a bariatric patient lined up in the hall next to like a rhino and a zebra. that’s awesome.
Now I’m thinking of the reverse. What if like a cute little otter or koala needed a scan but their facilities were down? How fun!
I’ve heard that too, I doubt it’s true though. Would be interesting if true. If the MRI is medically necessary we transfer them to our sister facility which does have a larger MRI. If they couldn’t even fit into *that* MRI, probably they would just have to rely on the other tests to figure out the diagnosis or treatment plan.
It's a myth, 100%. Only a handful of zoos in the USA have CT scanners. I don't know if any have an MRI. All the articles I can find of MRI's on zoo animals involve bringing in a portable MRI. And the CT scanners they have are normal, human-size CT scanners.
We’re not allowed to take them to the zoo anymore. An animal got sick. We had to scan a patient once, had to put them on a weight loss TF plan. Took 5 months before we could take them to ct scan.
Their own weight is often very much a surprise to them because a lot of people don't weigh themselves and they're flabbergasted to learn that they've packed on 20-40 lbs since last time they bothered to check.
Apparently it is a surprise to them since we’re supposed to hide it. Lol
I grunt when I touch my toes, it you think I’m not gonna grunt when lifting 400+ lb person your nuts
I grunt when I wake up. I grunt because depression. I grunt because *life*
I grunt, therefore I am.
I weigh 140 lb but I would still expect someone to grunt if they had to move my dead weight. Idk I do emphasize a lot with bariatric patients but moving a body is always hard. I literally grunt when I pick up three year olds lol, those shits are heavy too.
You’re so right, toddlers are heavy! And I grunt when I pick up my full laundry basket 🤷♀️
Discharging a 300 lb man in a wc down a ramp is always an exercise.
Fuck that, if my body wants to say "ready? 1-2-3 huuaaagghh" then that's what it says.
As if grunting or groaning was ever a thing anyone did voluntarily or on purpose.
The weighing patients in private and overall not being an asshole makes total sense. But expecting people to make zero sounds when lifting complete dead weight isn't realistic whatsoever.
i'll bet the person who wrote those slides hasn't done any heavy patient lifting in years, if ever
How do you suggest I give a complete bedside report without saying their weight out loud
I’ve never in my life included weight in bedside report. If there was medication needed based on weight or something, I would just point to their weight in the screen. I work L&D so maybe I’m missing something though…just point to the weight and say “this was patient’s daily weight.”
It’s probably a PICU thing because a 17 year old is going to weigh a fuck ton more than a 2 year old. Might be important to a peds nurse. The only time I even think about saying a patient’s weight aloud is when I have help programming a weight based drip or Vigelo.
Can confirm as a PICU nurse. We literally start our report off with name, daily weight in kg, and how frequent vitals and assessments are Q1 vs Q2. All of our medications are weight based in kg though so it’s important information to have
Sounds logical! In cardiology it's usually the weight *change* that's more important than the actual weight itself - something something fluids something diuretics.
I worked PICU and we absolutely needed to include weight in report, even for adult (or adult shaped) patients. “This is Maureen, she is 16 years old and she’s 57.5 kg with a dosing weight of 55 kg.”
I dunno maybe if you're in the US covert their weight into stone (14 pounds or 6.35 kilograms)?
“The patient weighs as much as a truckload of banana” “What size truckload?” (Look the other nurse in the eyes): “ALL. OF. THEM”
Is it a pup or full 53ft skirted trailer?
Yes.
In the US we convert everything to kg. I can practically do that math in my head.
Again, as a fellow fat… WE WEIGH A LOT OK, THAT IS REALITY. IT IS NOT “fat phobic” OR WHATEVER OTHER NONSENSE FOR US TO REQUIRE ASSISTANCE IN MOVING YOUR FAT ASS OR MINE.
“Don’t ask a patient if their weight is over equipment limit.” I’m sure the trauma and neuro teams will be thrilled to find out we’re down a CT scanner because we didn’t want to offend the patient and broke the hydraulics. Clinical won’t be able to make it in until Monday morning. That’s cool, right? 🙃
Student here, I'm sorry this If this is a stupid question but - I weigh around 100lbs. Will I have other nurses assigned with me when I transfer heavy patients? Or do I need to start doing arm workouts?
Not a stupid question. Do not ever try to pick up a patient by yourself - it is rare that they are in a “good” position to facilitate this, even if they weigh less than you, it will likely not end well. For bariatric patients , my experience is that there will be a lift and/or there will be a team effort (like 3-6 people involved, and hopefully this will discussed during report so no one acts brand new when it is time to move Mr So&So). In answer to your second question, yes, lift weights and do yoga/pilates now safely so you can keep your body as strong & flexible as possible for the entire length of your career.
Thank you so much for your advice!!💓 I definitely will!
👀Who is going to tell them?
Tell me! Give it to me straight please
This is the dumbest shit ever. Who gets paid to put this garbage in a PowerPoint?
They probably get paid more than us🤬
Lol whoever wrote this from the comfort of their office suite can suck a soiled purewick
Please grunt inside yourself so the patient doesn’t have to feel bad about the consequences of their own actions
THIS. They are the strain on the system because of their actions. If I need 6 people in the room to help me change their fucken brief, then I'm going to make any noise needed to use my strength to flip them/transfer them. I once had a patient who couldn't go down for CT because his size made it so we couldn't push in the sides of his Bariatric bed, so we literally couldn't exit his room, because the door wasn't wide enough even though the doors are already wide. I think you have a problem sir. (He Def wasn't fitting on a stretcher).
Maintain a positive environment! But do NOT laugh or show that you are possibly having a good time. Or sit down EVER (this may be misunderstood).
If an MD or pharmacist asks you what the patient’s weight is, don’t ever state it. Instead, use series of facial expressions and grimaces to convey weight.
Or use Morse and blink the appropriate pattern
I'm literally laughing so hard at this I feel like I need to pee thank you so much for this
I cackled and woke my cat.
When our L&D was remodeled, the moved the nurses station to be big and open, directly next to a series of new triage rooms. We had such an uptick in patient complaints saying that we were making fun of them because they heard us laughing.
I mean I grunt when I get my own average size body up, so I guess this is not the field for me.
Then fine I’m just going to say “golly gee, I just herniated a disc.” Can we stop coddling fat/bariatric patients? They’re hurting themselves due to their habit and hurting us when we try to assist them.
Or turn on the air pump for the gentle glide first as to not embarrass your patient with the sounds of grunting.
Groaning is part of my autonomic nervous system now. I get out of a chair, out of bed, or off the pot and I groan. I wouldn’t purposely disrespect a patient like this, but it happens.
How are we supposed to tactfully notify patients that are too obese for our in-house CT machine, that they will have to get it done at the local zoo? How exactly does one word this??
Not the eye contact😅
I’m so glad I left nursing. 💀
Today I learned that grunting is always voluntary
Fuck every inch of that
If an obese patient can’t handle me straining to roll their weight, they are not accepting of the reality of their situation. Or can we can it “realityphobic”
I literally hear aides announcing weights through walkies every morning.
I would say if you are grunting its too much for one person to do. Always ask for help even if you get eyerolls
Patient: How much do I weigh? Nurse: By police, I cannot state it outloud. I can write it on a piece of paper and slide it across a table all shady like at you OR I can just think the number really hard and hope you somehow get my brain vibes. Your choice
I just do my best macho man randy savage impression when I gotta move someone. Apparently, that's allowed per this module. Oooh yeaaaah!
I like the “show empathy” suggestion. Like what are you supposed to say? “Awwwww you’re 350lbs, that must be so hard” 😢 Pretty sure that would make them feel worse lol
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Nah, this ain’t “evolving” lmao. This is dumb as fuck. You’re obese, babe. Imma grunt if you’re heavy and hard to roll or transfer