Several years ago, I entered an operating room to assist with prepping a cardiac patient, only to find another nurse, “Joe” standing at the feet of my intubated and anesthetized patient.  “I can’t believe she’s painted her toenails”, he said, shaking his head in disgust.  “Why would someone like this, someone this hugely fat, even bother to paint her toenails?”  I looked at my patient, who was visibly overweight.  She had perfectly painted toenails, a bright and cheerful red.   I still remember her little bright red toes peeking out of the bath blanket covering her legs. 

Not long after that experience, I provided a lunch break to a nurse working in a “CABG” room.  This patient was having an elective coronary artery bypass grafting for a blocked coronary artery.  The surgical team was in the process of sewing the bypass grafts.  The music that the surgeon had selected was a recording of humpback whale songs.  The surgeon, usually an aficionado of classic hard rock, had never played this particular CD before.  The patient was morbidly obese.   The surgeon stated he thought the music was “appropriate” given that the patient was “fat” and also “a whale”.

In our profession, we all know that obesity leads to some significant health concerns.  Every one of us understands that the obese patient presents very real nursing care challenges.  It can be very challenging to find the appropriate sized equipment to provide safe patient care.  Turning and repositioning and transferring an obese patient can be difficult and can present challenges, both to the patient as well as to the staff who are trying to move the patient without sustaining injury to themselves. 

Studies support that many of us are prejudiced against the obese.  Even those who specialize in bariatric care evidence biases against the obese that they are not even aware that they have.   Some argue that “fat bias” is the last socially acceptable prejudice as society continues (rightfully so) to be intolerant of gender, racial and sexual orientation biases.

Yet where are nurses, the “conscience” of healthcare and the advocate for the patient when disparaging comments are made against overweight and obese patients?  Do we abdicate our role as patient advocate in light of significant evidence that the overweight and obese are at risk for significant health conditions?  Is it our impatience with the additional accommodations required by the obese?  Do we not stand up for our patients because we are as intolerant as the rest of society?   

It is ironic, isn’t it; given the fact that many nurses and health care professionals are overweight or obese too.   In point of fact – both “Joe” and the cardiac surgeon mentioned above were significantly overweight, if not obese.   Nurses can thwart societal norms by tempering epidemiologic understandings of the risks of obesity with the compassion and caring that is integral to our profession. Let’s replace the “f-word” along with its shameful connotations with words of compassion, caring and hope. 

Jayme Nelson Bio