This is the Weight and Healthcare newsletter! If you appreciate the content here, please consider supporting the newsletter by subscribing and/or sharing! Today I want to dig into a scoping review that looks at nursing care for the highest-weight people - The Nursing Care of People with Class III Ob*sity* in an Acute Care Setting: A Scoping Review by Ewens et al. 2020
Love this quote: "If the only way for a hospital to maintain their budget is to utterly fail to provide adequate care to some of their patients, then they should re-think their budget, perhaps starting with their executive’s compensation model." The cascading levels of failure to adequately care for all inpatients is egregious, with those with the most marginalized identities experiencing the greatest degree of failure. And the change has to start with how administrations are rewarded for providing the least care possible. Non-profits that operate like for-profits should have their tax status threatened by the federal government, and if they do not change their practices, their non-profit tax status should be revoked. Lobbying The Joint Commission to evaluate inpatient facilities based on their ability and knowledge to accommodate all patients could also bear fruit--if you regulate it, research dollars will follow.
Somewhere in the three years I was in and out of hospitals for multiple stays, I was told that I was required to use a "bariatric hospital bed," because I weighed too much for a regular bed and would break it. (This had not yet happened in any previous hospital stay, nor afterwards, and yet.)
The bed was literally a one-size-fits-all approach. To get "in" the bed, a motor tilted the bed until it was completely vertical. Then the patient has to step *backwards* on to a ledge, at which point the motor folded the bed so that, in theory, a part bent at the back of the knees and the bed went horizontal, with elevation for head and knees.
The bed was designed assuming that everyone is at least 5'8" tall. At 5'3" (on a good day), things didn't go as planned. Due to a semi-functional leg - the root cause of all these hospital stays - stepping backwards and upwards was almost impossible without lots of assistance, meaning I could not get in or out of bed without help. And then it happened - my third time getting into the bed, after managing the step up, the bend-at-the-knees hit far higher and shoved me on to the floor.
I told them that I didn't care how sick I was - get me a regular bed or I'm going home. They got a regular bed - which, of course, did not break.
That was 20 years ago I and I doubt things are any better today.
If I wait to respond until I've stopped crying, it'll be a long while. Decades of being treated like I'm the problem have exploded in my heart, and I'm becoming increasing apprehensive about my next medical appointment in 3 weeks. My feet are stimming like mad and I can barely breathe.
I'm so incredibly sorry that you've had to deal with this. If there is anything that I can do to help, please don't hesitate to reach out (WeightAndHealthcare@substack.com)
"This is a serious issue when it comes to healthcare because the higher someone’s weight, the less likely that they will be to face discrimination in accommodation in everything from chairs, gowns, and blood pressure cuffs to surgical tools and hospital beds and more due to structural weight stigma."
It's fixed, thanks! (Was between writing "more likely to face discrimination" and "less likely to be accommodated" and ended up with this mess instead!) Thanks for letting me know!
Great article. And I, like another commenter, was not aware that person-first language can be stigmatizing; I'll have to educate myself on that. Regarding typos, I believe this sentence contains two or three:
. . . there is a severe plack of high quality evidence the inform any healthcare for higher-weight people . . .
Love this quote: "If the only way for a hospital to maintain their budget is to utterly fail to provide adequate care to some of their patients, then they should re-think their budget, perhaps starting with their executive’s compensation model." The cascading levels of failure to adequately care for all inpatients is egregious, with those with the most marginalized identities experiencing the greatest degree of failure. And the change has to start with how administrations are rewarded for providing the least care possible. Non-profits that operate like for-profits should have their tax status threatened by the federal government, and if they do not change their practices, their non-profit tax status should be revoked. Lobbying The Joint Commission to evaluate inpatient facilities based on their ability and knowledge to accommodate all patients could also bear fruit--if you regulate it, research dollars will follow.
Somewhere in the three years I was in and out of hospitals for multiple stays, I was told that I was required to use a "bariatric hospital bed," because I weighed too much for a regular bed and would break it. (This had not yet happened in any previous hospital stay, nor afterwards, and yet.)
The bed was literally a one-size-fits-all approach. To get "in" the bed, a motor tilted the bed until it was completely vertical. Then the patient has to step *backwards* on to a ledge, at which point the motor folded the bed so that, in theory, a part bent at the back of the knees and the bed went horizontal, with elevation for head and knees.
The bed was designed assuming that everyone is at least 5'8" tall. At 5'3" (on a good day), things didn't go as planned. Due to a semi-functional leg - the root cause of all these hospital stays - stepping backwards and upwards was almost impossible without lots of assistance, meaning I could not get in or out of bed without help. And then it happened - my third time getting into the bed, after managing the step up, the bend-at-the-knees hit far higher and shoved me on to the floor.
I told them that I didn't care how sick I was - get me a regular bed or I'm going home. They got a regular bed - which, of course, did not break.
That was 20 years ago I and I doubt things are any better today.
If I wait to respond until I've stopped crying, it'll be a long while. Decades of being treated like I'm the problem have exploded in my heart, and I'm becoming increasing apprehensive about my next medical appointment in 3 weeks. My feet are stimming like mad and I can barely breathe.
I'm so incredibly sorry that you've had to deal with this. If there is anything that I can do to help, please don't hesitate to reach out (WeightAndHealthcare@substack.com)
I hadn't encountered the idea that person-first language can be stigmatizing. Thanks for including that.
Thank you.
"This is a serious issue when it comes to healthcare because the higher someone’s weight, the less likely that they will be to face discrimination in accommodation in everything from chairs, gowns, and blood pressure cuffs to surgical tools and hospital beds and more due to structural weight stigma."
Are you sure you mean -less- likely???
It's fixed, thanks! (Was between writing "more likely to face discrimination" and "less likely to be accommodated" and ended up with this mess instead!) Thanks for letting me know!
Great article. And I, like another commenter, was not aware that person-first language can be stigmatizing; I'll have to educate myself on that. Regarding typos, I believe this sentence contains two or three:
. . . there is a severe plack of high quality evidence the inform any healthcare for higher-weight people . . .