As a holistic health nurse, I am so passionate about patient education and partaking in healthy lifestyle habits to obtain optimal levels of mind, body and spiritual wellness. A major factor in creating a healthy lifestyle is also maintaining a healthy weight and Body Mass Index (BMI) for your specific body type. As nurses, it is an essential part of our patient-care role to provide the proper education for patients when it comes to implementing healthy lifestyle changes.
Today I wanted to mention one of many examples in which this is completely disregarded and leads to worsening levels of health and well-being, as well as being equally frustrating for any nurse or healthcare professional. In order to comply with the Health Insurance Portability and Accountability Act (HIPAA), I have withheld the name of the patient, nurse, facility and any involved members; however, I will provide a brief synopsis of a situation which occurred several weeks ago:
A patient was admitted to an intensive cardiac care unit with a multi-vessel coronary artery disease and 90% clogged arteries. The patient’s BMI was at the highest end of the obese category and was admitted to the hospital for a complex and risky open-heart surgery.
Late one night, the patient asked her nurse for 2 sandwich meals and 2 pudding desserts. The nurse appropriately ordered the sandwiches and gave them to the patient, while also gently educating the patient that it is not a good idea to have a dessert that is so high in sugar and fat content so late at night before bed. The nurse also let the patient know that she would be happy to order the requested desserts should the patient still feel hungry after the sandwiches.
What happened next was shocking: the patient angrily bursted out,
“I’m not here to talk to you about my diet, I’m only here for the clogged arteries!”
The patient submitted a complaint that the nurse talked to her about weight, and rather than the nursing management handling the situation neutrally, they immediately took the patient’s side, directly prioritizing patient satisfaction over patient health.
The nurse was then reprimanded for discussing the “sensitive” topic of weight, which the manager stated must only be discussed by a professional clincial dietician.
Keep in mind that the dietician is rarely present on the unit, and primarily responsible for speaking to all malnourished patients throughout the entire hospital. Also, the nurse did not speak to the patient in a condescending matter, mention the patient’s weight or tell the patient to not eat; in fact, she did end up giving the patient the double serving of dessert along with the double meal of sandwiches. She simply also informed the patient that consuming such foods at late-night hours is not conducive to overall health.
If you are involved in any healthcare or related profession, you will immediately understand where the frustration lies. It is both the duty and the responsibility of a nurse to educate his or her patient’s on their basic health care, especially while they are admitted into the hospital. In this case, the patient’s dietary habits were both the cause of the primary diagnosis, and a vital aspect of the treatment and prevention of the patient’s disease.
In fact, because the patient’s weight management was not previously addressed, and because the patient was not properly educated throughout her life of healthy dietary decision-making or alternative nutrition options, the patient ended up in the worst-case scenario.
The patient now continues to remain unaware that her clogged arteries that led to such high cholesterol levels, eventually requiring a life-threatening open-heart surgery, was directly caused by these continued unhealthy eating habits and the avoidance of discussing this “sensitive” issue.
Not only is this a frustrating situation for the nurse, but it also serves as an ethical issue: should the nurse comply with the management’s request and allow the patient to ignorantly consume food that can (and will) inevitably lead to an eventual decline in the patient’s health? Or should the nurse speak up and push the issue forward, bringing light to the dangers of completely ruling out diet education from the nursing role?
In this case, the nurse attempted to move forward with the issue, but no changes were made. Unfortunately, this is only one of many such cases in which the patient’s request and satisfaction overpowers the priority concerns and health needs for the patient’s overall well-being.
What would you do if you were in this situation? Have you ever encountered anything similar? Can you think of ways through which this situation could have been better handled, resulting in both patient and nurse satisfaction while promoting the best health practices for the patient as well?