When it comes to bariatric patients I have absolutely no sense of humor. I will always be a complete professional, but I will not ever enable them. I will never sugar coat things for them, will never underplay things for them, and the same for their families.
For those of you who don't know what bariatric patients are they are the ones that are over weight, and I don't mean 200 pounds, I mean 400 pounds and above. When I ran the vent trach unit for 3 years I had one ward room with 4 women, and another with 2 men. Sometimes that would change, they would die and others would fill the beds. I guess I learned really quickly that I had a very short fuse when it came to them because I was trying to care for them and my vents. The bariatric patients seldom ever think they can wait for anything. They never seemed to care that someone in the next room wasn't able to breath and was in respiratory distress, they wanted a snack. And they wanted it right that second.
I never usually knew what happened to them in their past, what caused them to be that way, to be so selfish, so demanding, so nasty. Sometimes they had a diagnosis that would support a weight issue, but they took that and used it as an excuse. Bariatric patients always have an excuse for everything. They always have to justify things. The sad thing is that they believe it, and most of the time their family starts believing it too.
When they come to me they start hearing the truth whether they like it or not. I can't tell you how many families I have sat down with to discuss a plan for their family members. All of them say the same thing basically. Their family member can't even get out of bed, can't do anything for themselves. How is it that they keep getting fatter and fatter? The family members always say that they have to get the food for them that they want or they will get mad and yell. I always ask them the same things. Do you love them? Do you want them to live? Naturally they say yes. So I put it right back on them and basically tell them that it's their fault they are getting fatter and dying. They need to learn to tell them no, and if they get mad and start yelling, so what. Just walk out and shut the door. You do that enough and eventually they will be able to get out of bed and come after you, which is a great thing.
These are the patients that I oddly enough feel the worst for because they will die, 100 percent of them will die and unless I or my team, or their family can get them to change the way they think about food, they will all die. When you are sitting at a table with the families telling them like this they sit there crying. They feel bad when they find out that they are the problem, not the solution, and they need to be the solution. Then a few days later you walk into their room and they are sitting there with an entire chicken and a 8 by 8 pan of brownies that they don't plan on sharing with anyone, and do plan on eating it all in one sitting, on top of the meal that we gave them.
I don't mind telling you, I have more than a few times as professionally as possible let them and their families have it. The families actually have the nerve to look at me in the face and tell me that their family member made them go and get them that food. So I tell them the truth, they don't like to hear it, but it's what they need and have to hear.
The sad part is when they die, and they ALWAYS die. Their family member always come to me crying and telling me that they should have done more to help them and that they should have listened to me and why didn't I convince them harder? Well because any harder and I would get in trouble, and because according to some I already cross the line with my bluntness with them, lol. It's really a sad thing. And with every single one of them I had hopes that I might be able to save one of them, but I never could, especially when the family members were going behind my back bringing them food. Their families were guilty of being enablers and loving them too much. I couldn't change that.
Mashie