Issues challenging obese population.

Many research studies have addressed ways obesity affects the human body biologically, but few have actually highlighted other surrounding issues that affect obese population such as discrimination and lack of accommodation in public places. Therefore, this paper will highlight and address great roles that nurses can play to bring a change in perspective of “other” ignored issues about obesity. Joe Njenga
To make this possible a nurse can implement the following strategies.
1. As health care provider, the nurse can set a good example by not practicing bias and discrimination against obese population.
2. As a manager of a health care organization, the nurse can mobilize resources to ensure equipment like oversized beds, commodes, walkers and wheelchairs are available and ready for use by bariatric patients.
3. A nurse can act as an educator to help in creating public awareness about obesity with the correct perception.
The first strategy is for the nurse to be open-minded, understanding, resourceful and free from bias and discrimination. This can prove to be a big challenge to the body image obsessed society which has done little to help address and solve issues of obesity. Instead, the society has marginalized and labeled obese individuals as lazy, irresponsible and, generally of less worth. As a result, many obese individuals are hesitant to go out in public places like colleges, churches, hospitals and gymnasiums.
A research study found physicians and nurses to be among predominant groups that were most stereotypical about obesity. Physicians associated obesity and other negatively perceived conditions with poor hygiene, noncompliance, hostility, and dishonest. Doctors were less motivated and less optimistic when caring for obese patients because they viewed them as unsuccessful, weak willed and unintelligent. (Puhl & Browell, 2001)Therefore, it is important that nurses set a good example for the rest of the society to follow by caring for obese patients with dignity and an open minded approach. For instance if a bariatric patient requested for bed change and the nurse needed some help to turn the patient she should kindly respond, “Let me get someone to help me” instead of “ You are too heavy I need someone to help me roll you over”.
A second strategy involves the nurse as a manager of a healthcare organization and a patient’s advocate. A nurse can mobilize resources to ensure that facilities and equipment can safely accommodate obese patients. This goal can be achieved by construction of infrastructure that can support the growing obese population such as investing in wider beds that can accommodate weights between 300 and 800 pounds, building wide doorways, purchasing or renting wider wheelchairs, lifts, commodes, gowns, bariatric beds, commodes, and walkers. In addition, hiring more staff to help in safer transfers of obese patients is key to avoid back injuries as, Gallagher (2005) explains “Injuries that result from manual lifting and transferring of patients are among the most frequent causes of nurse related injuries with more than half of strains and sprains being attributed to manual lifting tasks while assisting dependent patients with their mobility needs” (Pg 1). Although this may mean additional expenses, this will serve as a long-term investment as the numbers of overweight patients persistently keep rising.
The third strategy is education of the public. Nurses can change the way the public views obesity through education and enlighten on cause of obesity and surrounding factors. But before the healthcare professionals can educate the public, Maxwell (2005) urges all healthcare professionals to educate themselves and other hospital staff first on ways of being sensitive to the plight of the obese people. In her article Obesity: Pain and Prejudice (2005) she exemplifies, “Don't be like the doctor who told his patient that she would have to be weighed at the zoo” (Pg 4). In comparison to HIV/AIDS epidemic, education about obesity will lead an overall public awareness and change of attitude hence change of behavior. Additionally, early education on obesity is paramount to young children to serve as a preventive measure before they turn into young obese adults by creation of healthy food programs in school such as reduction or eradication of vending machines in schools and promotion of Physical education (Malone, 2005)
After, the nurse sets a good example by not practicing bias and discrimination against obese population, mobilize resources to ensure equipment like oversized beds, commodes, walkers and wheelchairs are available and ready for use by bariatric patients and, educate people to create a public awareness about obesity. This will improve empower and encourage public awareness about obesity with the correct perception and aid obese population to lead healthier lives.
Reference:
Gallagher, S. ((2005)). Caring for the Child Who is Obese: Mobility, Caregiver Safety, Environmental Accommodation, and Legal Concerns. Batriatric Nursing Surgical Patient care , 1.
Malon, S. (2005). Improving Quality of dietary intake in the school setting. Journal of School Nursing , 21, 70-76.
Maxwell, B. (2005). Obesity: Pain and Prejudice. Medscape General Medicine , 7, 3.
Puhl, R., & Browell, D. (2001). Bias, discrimination and obesity. The NOrth American Associaton for the study of Obesity , 9, 788-805.






















Joseph Njenga
NUR 211
John Miller
Research paper
2/4/2008

Intervention 1

As a manager of a health care organization, the nurse can mobilize resources to ensure equipment like oversized beds, commodes, walkers and wheelchairs are available and ready for use by bariatric patients

Disadvantage 1
One major disadvantage of this intervention is lack of enough funds to meet the need of this intervention. Limitation in coverage of most bariatric procedures by insurance has done little to improve the situation at hand. With scarce resources that the facilities have to depend on, tight budget cuts in many healthcare facilities have been enforced leaving no room for expansion in provision of bariatric services and purchase or required equipment. In a research study to find ways of predicting cost by a bariatric clinic, Mosti states, “Although bariatric surgery is highly effective for controlling obesity and its complications, it is uncovered by third-party payers in many countries. High cost and unpredictable expenses account for the lack of coverage”

Disadvantage 2
The second disadvantage is multiple stages of managerial approval in many organizations. The more the stages of approval the hard it becomes to approve any policy in an organization; this is because each stage of a policy approval questions the chances of success in implementation of an idea. Although it is essential to assess the chances of success of any policy before investing, this practice discourages creative employees from coming up with good idea that would in fact help the organization grow. For instance in the Wikipedia encyclopedia (Espo, 2007), the Stem cell research has gone over multiple challenges and yet it has not been approved as illustrated:

The bill passed House of Representatives by a vote of 238 to 194 on May 24, 2005.[1], then passed the Senate by a vote of 63 to 37 on July 18, 2006. President Bush vetoed the bill on July 19, 2006.
The House of Representatives then failed to override the veto (235 to 193) on July 19, 2006. In a second trial The bill passed the Senate on April 11, 2007 by a vote of 63-34, then passed the House on June 7, 2007 by a vote of 247-176. President Bush vetoed the bill on June 19, 2007,[2] and an override was not attempted..

Intervention 2

The second intervention is for nurses to educate the public about obesity through creation of the right perception about obesity and factors that can be employed to reduce it.

Disadvantage 1
As a result of the well known fact about nursing shortage, this phenomenon has affected nursing educators too. Andrea (2007) in her article states, “Of the 2900 nursing doctoral students who enroll each year, only 440 graduate. The average age of a new doctoral graduate in nursing was 45.7 years and 6.5% of the graduates were 55 years or older.” She goes on to say that this demographic has done little to improve the situation of the nursing scholarly culture. In return there is a shortage of faculty that is supposed to teach new nurses and the public in general. The few nurses that graduate from nursing school are hence siphoned to more critical healthcare system like the hospitals. This means that community based care that is meant to be the primary mode of prevention has been left with no educators creating a whole new challenge for public education on issues such as obesity.

Disadvantage 2
Unavailability of health care centers, information coupled with public illiteracy has been a major disadvantage for wellness promotion through community education. Nurses who teach on the community level greatly depend on this resource for their service as educators to be effective. Lack of this resource has lead to an increase in health care cost through Emergency department response and chronic diseases such as diabetes and hypertension. Parker( 2005) states, “Widespread problems with health literacy significantly limit effective dissemination and understanding of relevant health information in society, especially among many vulnerable populations where health literacy challenges are especially pervasive” she goes on to explain that an improvement in community healthcare will reduce disparities, cost and quality of care. Therefore a well furnished community health care center can greatly reduce the cost of health care in the long run (Parker, 2005)


















Bibliography

Andrea L. Smesny, P. J. (2007). Barriers to Scholarship in Dentistry, Medicine, Nursing, and Pharmacy Practice Faculty. American Journal of pharmaceutical education , 5 (71), 91.
Espo, D. (2007, April 12). Stem Cell Research Enhancement Act. Retrieved Feb 5, 2008, from Wikipedia: http://en.wikipedia.org/wiki/Wikipedia:Text_of_the_GNU_Free_Documentation_License
Mosti M, D. G. (2007, nov 27th). Calculating Surgical Costs: How Accurate and Predictable is the Cost of a Laparoscopic Roux-en-Y Gastric Bypass? Obesity surgery , 1555-7.
Parker, L. G. (2005). Library outreach: overcoming health literacy challenges. Journal of the medical library association , 4 Suppl (93), S81- S85.