Posted on 03/31/2006 1:51:43 PM PST by austinite
ST. LOUIS - Going to the hospital is rarely fun. If you weigh over 300 pounds like Beth Henk, it can be embarrassing. "I've flipped an exam table — I sat on the end of it and it just flipped up," said Henk, whose weight peaked at 745.
When her son was born three years ago, "I had to sit in the hospital bed the whole time — the hospital's rocker wouldn't fit my butt."
Today Henk helps Barnes-Jewish Hospital in St. Louis find better ways to deal with the growing number of very obese patients, an issue for many U.S. hospitals. Barnes-Jewish is replacing beds and wheelchairs with bigger models, widening doorways, buying larger CT scan machines, even replacing slippers and gowns.
Last year, patient care director Colleen Becker decided to check the numbers. She looked at a daily hospital census — about one-third of the 900 patients weighed 350 pounds or more.
Startled, Becker checked another date, then another. The numbers were consistent. On some days, half the patients were obese. Some weighed 500 pounds or more.
"We ran the data again to make sure we weren't hallucinating," Becker said. "We weren't. So we had to somehow figure out the appropriate supplies, equipment, training and care for the patients we're dealing with."
The answer was a "bariatric care team," which Henk serves on, to address the challenges posed by obese patients. Those challenges are many.
Hospitals around the nation are working with equipment suppliers to accommodate larger patients, said Elizabeth Lietz, a spokeswoman for the American Hospital Association. And it's not just for the patients.
ATF Healthcare, a union representing 70,000 nurses and other workers at hospitals in 18 states, last week called for new laws forcing hospitals to buy equipment such as portable hoists to prevent worker injuries.
A union-commissioned survey of more than 900 nurses and X-ray technicians found the majority have chronic pain or have suffered injuries from lifting and moving patients.
At Barnes-Jewish, lift machines help some patients get in and out of bed. Chairs have been made stronger and wider. Lights have been added at floor level because the bodies of extremely obese people can cast a shadow that makes it hard to see the floor.
The hospital is replacing many of its beds — built to handle people weighing up to 350 pounds — with beds for 500-pound patients.
"Three-hundred-fifty pounds is nowhere near what we need for beds now," said Art Kidrow, a nurse manager at Barnes-Jewish. "We've had some 650-pounders up here."
Some wings of Barnes-Jewish are replacing 36-inch-wide doorways with those that are 48 or 52 inches wide. The bathrooms are being fitted with floor-mounted commodes that can't be pulled out of the wall, and rooms reconfigured so patients can essentially get out of bed and step into the bathroom.
Gowns are bigger. Wheelchairs are wider. Even hospital-issued slippers come in extra-large sizes because the standard-issued footies were cutting off circulation for some patients.
Issues extend beyond the patient's room. Operating tables have been widened because the girth of some patients was lapping over the table, in some cases all the way to the floor, Becker said. CT scan machines weren't wide enough. Syringes with the longest available needles — 4 1/2 inches — couldn't penetrate the fat.
Along with doctors and nurses, the hospital's 30-member bariatric care team includes former patients like Henk and people from the hospital's engineering and housekeeping units.
Henk, 41, represents both patients and those who try to help the obese — she is program manager for Washington University's weight management program.
She's been heavy for as long as she can remember — she was in Weight Watchers by age 5. "Everybody in my family is at least 100 pounds overweight," she said.
Gastric bypass surgery seven years ago helped her shed some weight, but she's dropped to 315 pounds mostly through better eating and exercise.
Still, she knows what larger people go through at the hospital.
"I believe in dignity for whomever you are," Henk said. "It can be scary, too. If people are trying to lift you up and somebody doesn't have the strength, it's very scary."
Based on recommendations from the team, Barnes-Jewish has developed a protocol for lifting heavy patients.
The hospital is also working with suppliers. Manufacturers now offer more than 1,000 items specifically for obese patients, said Sandy Wise, of Novation LLC, a Texas-based company that provides contracting services between hospitals and manufacturers.
"It's been a trend probably for the last four or five years," Wise said. "Hospitals are continuing to see an increase in obese patients, and it affects every department. You have to think of the patient from head to toe, everything they do in the hospital until they walk out the door or they die."
In fact, Barnes-Jewish is striving to make even the end more dignified. Becker said the law requires a leak-proof body bag. Some patients were so large they wouldn't fit in them. The hospital is working with a vendor to develop a wider bag.
hmmmm if such a high percentage of patients is in the
350-500+ lb range im thinking that bigger beds and
wide doorways are the least of our country's problem ...
Got a brother-in-law in this category and he is highly indignant about any reaction to his girth.....drove a folding chair leg into a hardwood floor, broke the frame on my sofa and doesn't have an ounce of remorse.
When people criticize American health care and say Europeans live longer (slightly), my answer is that Europeans don't have as many fat people as we do. Even the greatest medical system in the world can't make a 500-pound person live to see 70.
At what point should insurance companies start charging by the pound?
about one-third of the 900 patients weighed 350 pounds or more
Holy crap! Is this hospital on Jupiter?
It wasn't until recently that there were scales that went much above 300 pounds. Now they're SOP in most hospitals. And it would make sense that the morbidly obese would make a higher % of hospital admits.
The relative I mentioned above WORKS in health care....and was routinely weighed in the kitchen, where there was a scale to weigh in bulk food deliveries of some sort.
Exactly!
I can remember many times the patient being wheeled down to the back loading dock to be weighed. Personally, I think that is wrong from about 10 different directions from dignity to safety to sanitation and hygiene.
I'm glad they finally have the right kind of scales in patient care areas.
A union-commissioned survey of more than 900 nurses and X-ray technicians found the majority have chronic pain or have suffered injuries from lifting and moving patients.
Frankly, I'm not interested in subsidizing special treatment for huge numbers of the morbidly obese. Neither do I wish the taxpayer to make massive workman's comp payouts for the hospital staff who care for them.
Nope, just down the road a piece from me.
"Henk, 41, represents both patients and those who try to help the obese — she is program manager for Washington University's weight management program.
She's been heavy for as long as she can remember — she was in Weight Watchers by age 5. "Everybody in my family is at least 100 pounds overweight," she said.
Gastric bypass surgery seven years ago helped her shed some weight, but she's dropped to 315 pounds mostly through better eating and exercise."
Hhmmmm ... a little math shows that following Weight Waters from age 5 to age 34 left her hundreds of pounds overweight.
Wouldn't make a great commercial...
Almost everybody costs the system in the last years of their lives, I remember reading that five out of every six dollars spent on medical care in this country are during the last six months of life. In the case of the morbidly obese, they are generally not drawing down ten or fifteen years worth of Social Security payments on the way out, in addition.
The advances in gastric bypass surgery should start to, pardon the expression, "thin" out their numbers. But, they're all going to die someday, and are pretty much guaranteed to sap the healthcare system at that time, like almost everybody else.
I'll bet you got a lot of potholes.
Ain't that the truth? The costs on all sides are huge...almost as huge as these patients. I can't help but wonder at what point you say, gee, I haven't seen my feet in 5 years....wonder if I should drop a few pounds?
I think she has that back-assward.
He'd get a bill from me, or a threat to his life if he ever came back to my house if he didn't pay.
...and are pretty much guaranteed to sap the healthcare system at that time, like almost everybody else.
We all sap the healthcare system at some time, but not all of us incur illness through extremes of destructive behavior.
There's already a cheap, established and effective treatment for obesity---a healthy diet and a $25 pair of walking shoes. I'd be happy to see taxpayer funding for trips to the dietitian.
just damn! Never heard that one before.
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