Stretched Thin

I have heard stories. Patients being weighed on scales used for large animals. Patients breaking toilets. Patients being dropped because there were not enough hands on the lift team. A team of four nurses needed to lift one arm so that it could be washed.

It is no secret that obesity is on the rise in America and medical care for patients who qualify in this category poses difficult challenges. It is both a reality of size and the current health care system’s ability to service that need. For instance, how does one transport and care for the 350 pound patient, the 500 pound patient, and the 600+ pound patient? Stories abound of people being moved on planks, tarps, in panel trucks – being brought into the hospital  through the garage because the regular doors aren’t wide enough.

And it is not just a case of physical needs but mental anguish as well. The EMS crews from counties in the D.C. area talk about the patient’s embarrassment as multiple crews show up to move them.

“Watching maybe a dozen people file in is enough to raise a patient’s anxiety all by itself. And many of these people start out by apologizing to us and asking us to be sure we don’t hurt ourselves or them,” says James Augustine, former medical director for D.C Fire and EMS (Washington Post, 2/11/10).

And that is a good point. We don’t want to hurt or embarrass obese patients but at the same time – dealing with a patient weighing more than 400 pounds requires more hands and more strength in a time when nurses are already stretched thin. The number of patients with large girth is on the rise and the number of nurses is not. The math is not difficult and the question of service to these patients is dubious.

Hospitals can widen the doors, buy specialized lift systems, and have heavier duty equipment on hand but if it takes 12 people to lift a patient on a floor where the patient-to-nurse ratio is 8:1, where are those people going to come from? Lift teams can only do so much, especially ones that involve numerous people. The potential for back injuries is now a given.

You can’t buy your way to safe patient care for the obese patient through equipment alone. Hospitals would do well to remember that.

Super-size equipment helps D.C. area EMTs move the obese,” The Washington Post, February 11, 2010.

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