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Can fat nurses be good nurses?

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If the role of a nurse is to teach patients and the public about healthy lifestyles, is it possible for an overweight or obese nurse to be an effective nurse?

We know all too well that many of the chronic health issues seen today in the United States, including type 2 diabetes and hypertension, are related to diet and lifestyle. We’re taught in nursing school to encourage healthy lifestyles and teach patients and the public how to stay healthy.

And yet we’re guilty of not walking the walk.

A study published in May 2008 in the Journal of American Academy of Nurse Practitioners found that more than half of 760 nurses surveyed in six states were overweight or obese. When asked about issues with losing weight, 53 percent of the nurses in the overweight/obese group stated that although they recognized they should lose weight, they didn’t have the motivation to do so.

Why Nurses Aren’t Motivated
It’s not always easy to get motivated to do something you know you should do. Losing weight is generally on that list. For a nurse, undertaking a lifestyle change required to lose weight may take more work and effort than it might for someone who works regular hours and in a less stressful environment.

Irregular hours mean irregular eating times and perhaps difficulty squeezing in adequate amounts of exercise. If you haven’t planned ahead for meals and snacks, the only food available may not be what a dietitian would recommend for weight loss and health.

Since extra weight can contribute to illness and perhaps lost workdays, could the workplace, which gives nurses the erratic schedules and high stress levels, be responsible for a nurse’s lack of health?

Does Obesity Mean Incompetence?
Undoubtedly, a nurse’s skills have nothing to do with her body size. No matter who she is, her knowledge depends on three pounds, the average weight of a human brain. Retaining, assessing and processing information are no different between a nurse who weighs 120 pounds and one who weighs 180 pounds.

But what of the physical work? Nurses who are mildly to moderately overweight may not have difficulty with the physical aspect of nursing, but the heavier or obese nurses may not be so lucky. That is a generalization, of course, but usually, the larger the person, the more effort it takes to perform a physical task like running up the stairs to answer a cardiac arrest code. When a nurse is out of shape, she is also more prone to injury.

Patients and family members may not consciously be aware of it, but when they see the nurses who care for them, they make observations about the nurses’ behavior and appearance. If a doctor recommends a calorie-reduced diet or other restrictive diet, the nurse is the one who generally must answer questions and be available for patient teaching if the dietitian isn’t. To be honest, it’s not that different from the days when a doctor, smoking a cigarette in his office, would tell his patient that he should stop smoking because it wasn’t good for him.

In the study mentioned above, 93 percent of overweight nurses recognized when a patient was struggling with obesity, However, only 24 percent of those nurses pursued the topic of obesity with those patients. This is a striking finding considering nurses are the frontline in healthcare. The people whom patients often turn to for advice and help are nurses.

Change Is Possible
Nurses everywhere are making lifestyle changes. For example, Rosemarie Hernandez Jeanpierre, a Los Angeles–area LPN, became a spokesperson for healthy living, telling her story to major magazines and newspapers about how she dropped 110 pounds. Rosemarie, now a regular marathoner, undoubtedly started her weight loss journey with small goals—the kind that any nurse or patient can apply to his or her lifestyle.

Do you think a nurse’s weight can have a negative effect on her work?

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Marijke Durning

Marijke is a professional writer who began her working career as a registered nurse over 25 years ago. After working in clinical areas ranging from rehab to intensive care, as a floor nurse to a supervisor, she found she could combine her extensive health knowledge with her love of writing. Although she has been published in a wide variety of publications for professionals and the general public, her passion is writing for the every day person to promote health literacy.
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38 Responses to Can fat nurses be good nurses?

  1. Sean Dent Scrubs Blogger

    We as nurses have developed the attitude -‘do as I say, not as I do’. As well as viewing our own health as not in our control. “It’s not my fault, it’s my bad knees, or bad back, or too old, etc, etc”.
    If we viewed and tackled our own health they way we view our job, responsibilities, and how we care for our patients – we’d all be that much healthier.
    Yes- a nurse’s weight does have a negative effect on ‘their’ work.

  2. Steph

    A NP & I one day were talking after “lecturing” our pts about annual exams, monthly breast exams, healthy eating and exercise….when we asked eachother if we do the same. Of course the answer was “no”.

    I thought to myself, how can I ask my pts to do so, if in fact I’m not practicing what I preach….6 yrs later I’m on a healthy streak and going to compete in my 1st fitness/figure competition this coming year!!

    I had an elderly lady ask me at the gym one day what I did for a living and I told her I was a nurse. Her response was “you’re a great role model for us, because I hate it when fat nurses tell me I need to lose weight and they’re fatter than me”. She made my day!!

    Yes, we as nurses are role models!!

  3. Shawnee LPN

    Great article! Thank you for your thoughts.

  4. Shawnee LPN

    Great article! Thank you for your thoughts.

  5. I’M FAT BEEN FAT AND MAY DIE FAT AND YES IT DOES AFFECT MY PERFORMANCE YET OTHER SLIM TRIM NURSES MAY NOT HAVE THE GREAT JOLLINESS I HAVE ,I HAD TO SAY THAT BUT REALLY I HAVE SEEN SEVERAL SLIM NURSE WITH WONDERFUL BESIDE MANNERS PEOPLE TEND TO STEROTYPE, I HAVE FELL ON A PATIENT BEFORE WITH A EXTERNAL FIXATURE IN HER ARM AND A CAST ON HER LEG I WAS ALL OVER HER LIKE A CHEAP SUIT AND THE CO-WORKER HOLLERED UP THE HALL MY NAME STATING THAT I FELL AND INJURED A PATIENT WHICH THE PATIENT WASN’T INJURED BUT THAT WAS SO RUDE . I HEAR PATIENTS SAY LOOK AT HER SHE IS SO BIG HOW CAN SHE WALK AND AT THIS POINT MY KNEES HURT SO BAD I DON’T THINK I CAN DO THIS MUCH LONGER THE THING IS AS LONG AS I AM MOVING I AM OK ONCE I SIT THAT’S IT ,AND REALLY I DON’T PREPARE MYSELF MEALS TO EAT IF I WOULD I WOULD BE BETTER OFF SO YES WE HAVE A HARD TIME WITH OUR JOB

  6. R. Davis

    It’s simple.
    1. Irregular, Unbalanced and Skipped Meals : There are many things in the profession that take priority over “meal time”. Most nurses eat when and IF they can. Meals are often skipped… Or we have to eat so fast we don’t realize how much we ingest, much less have time to enjoy the meal or digest properly.
    2. Stress : Juggling home and work. Always pressed for time to get everything done. Worrying about the family, patients, coworkers, management, legal aspects of the job etc etc
    3. Irregular and or Lack of Sleep : Due to long hours at work and home. Staying up too long just to have some “personal down time”. Trying to sleep, but everything keeps going through the mind about what happened today, what needs to be done tomorrow, what did I forget to do.. etc
    4. Attire : Not being as aware of extra pounds due to wearing loose, comfortable scrubs most of the time.

    Life and circumstances are different for everyone. Over all, I am certain I have barely scratched the surface on what could definitely be taken further into discussion..
    But……
    The Bottom Line: The metabolism is affected by both the physical and emotional lifestyle.

    I will be the first to say, YES, we as nurses need to think of ourselves more often and take time to care for our physical and emotional needs.
    But in reality, the majority of nurses are giving, caring people, who spend the biggest part of their time and energy dedicated to taking care of others….Which often leaves little or no time and energy to properly care for themselves.
    Health and looks are very important, but sometimes the time dedicated to others has been more important to a Nurse. So, the next time you see a good nurse who does not fit in the correct range on the weight chart.. stop to think about the big picture instead of the big nurse.

    • TriciaJ RN

      Really, nursing is not very conducive to caring for oneself. The constant missed breaks means being ravenous after work. Also slows metabolism. The fatigue level makes exercise next to impossible. The chronic cortisol production: increased appetite and fat storage. Poor sleep from stressing about work: the “satiety” hormones don’t kick in.

      I think if I hadn’t left med/surg when I did, I would have a major weight problem by now. Middle age is hard enough by itself.

  7. fofo

    does the obesity of nurses effect in nurses performance

  8. Deborah Trammel

    Its not the size that determines a good nurse. The factor that determines a good nurse is her dedication to help others. I have been a nurse 21 years. I have seen great nurses of all sizes and I have seen lazy nurses that wore size small.

    • barbmak08

      Thank you! I am “plus sized” and I rock as a nurse! I work on a bariatric unit and I’ve had so many patients tell me I’m happy I’m their nurse because I can relate to them. Take that you skinny little nurses!

  9. Lisa Fuxx

    This is one time physical size does not matter. Are nurses as role models then preaching eating disorder amongst other impossible methods of weight control. I am not insinuating couch potatoe lifestyle here. .A host of the so called slim nurses have one disorder or the other not to mention obsessions with looks, add the stereotype of I am better than others generally associated with being slim. Actually, so called slim nurses are intimidating to their patients and discourages patients from reaching out or listening to their preaching, because it brings about inferiority complex since slim nurses look down on their patients in a way that says how did you get this way? I once had a nurse said to me “dont you think you need to loose some weight, because you’re overweight. Of course I know my size before I went to the Dr’s office I am a size 16

  10. Jeanie

    Yes being obese is a problem. I have been a nurse for 36 yrs. I was nearly 300 pounds, working in ICU and ER. My size did affect my physical performance of the job. I did not move as fast, bend as low or fit in tight spots.I left the ER due to the amount of running,and went to the ICU with less walking. I would be dyspnic on arrival to a code,but the most knowledgable, my brain was not affected by my size!

    I did however have life saving weight loss surgery, two years ago and my health has improved 100%. I can run to codes, stand longer and have so much more energy.
    Prior to my weight loss I had hypertension, insulin dependant diabetes and horrible hip pain, requiring 28 pills a day and 4 injections of insulin.Currently I only take calcium, vitamins and thyroid medication.
    I feel like I can keep working for many more years.

    • angiedeborja

      What a great success story Jeanie. Congrats on your accomlishment.

  11. D'Vorah

    Of course fat nurses can be good nurses! Not every nurse is on the code team, so not every nurse needs to be able to run up flights of stairs. Beyond which, there are plenty of thin appearing people who are in lousy shape. Frankly, I have less respect for the skinny NP who told me I needed to lose weight (really?! such a surprise to me!) than for the heavier one who could relate to the challenges inherent in tackling the whole diet and exercise thing — especially working 12-hour night shifts. So, yeah, I’m a fat nurse, but I think you’ll find that my patients think I’m a good nurse and that they don’t spend too much time thinking about my body habitus.

    • afrodditte1

      I really like your comment. I myself am a fat nurse and my patients love me. I remember my patient telling me that yes the other nurse is skinny and cute, but I was pretty and nicer. My weight does not affect my brain function and my ability to care and be humane. Yes I would like to lose some weight, however, we cannot all be super models. Yes I am fat but I can run and take care of my patients just like the other skinny nurses. This article is a good article, however, it could foster a division and a superiority/inferiority complex among nurses based on appearance. And no, I am not an advocate for being overweight, and yes it would be ideal if when discussing weight loss to our patients we ourselves are not overweight; but we do not live in a perfect world, and being overweight does not mean that you are less healthy than than the skinnier nurse with a heart problem. This topic will lend itself to opening a whole new can of worms.

      • judontmesswithme

        I am chubby, and unfortunately, I think there has already been an issue at my hospital regarding size, etc. But there is a new issue every single week anyway. One day they were going on about “longer hair is better” and at the time I had shorter hair. Then they decided to do a “Biggest Loser” competition and everyone got pedometers. That lasted about 3 weeks and everyone got too busy to log everything. The skinny nurses continued to talk about the fatter nurses on the floor behind their backs, and the fatter nurses talk about how the skinny nurses have trouble moving patients.

        No matter what, there will always be something dramatic to worry about at work. The can over worms has been opened and has been sitting on the table for quite some time, but you’re right – its a ridiculous topic.

    • barbmak08

      “like”

  12. Your name

    I am an RN and have seen all sizes of nurses but as a whole they are all glad that I am on the night shift with them. We do not have any PCT at night so any patient care including moving them falls to the few nurses on the floor. I was raised in the country and can take one side of a patient while it takes 3 thin ones on the other side. I do not think it is so much the size and the condition. I have and will continue to be able to keep up with the average .. maybe even about average nurse.

  13. joanne

    I have was very thin at the beginning 36 years ago, young, and inexperienced probably not the best RN, I got heaver with my 3 children and my skills got better, I got thin 88 lbs after my births and my ability to function as a pretty good nurse improved as my experience grew. I got cancer still worked as a Nursing Supervisor, nurse educator, ICU RN, stress test RN, and Nursing Instructor . I don’t think my size had anything to do with my ability. I am short (5 ft) am I less a RN because of my height.
    This is a silly biased discussion. Get real, talk about important issues please and don’t waste time putting thoughts into managements heads that they should get rid of RN;s based on appearance rather than skill.

  14. I work with several examples of the ‘Jeep Cherokee’ obesity butt class nurses who ‘clear an aisle’ when they’re at work and mostly all of them exercise their buttocks on seats rather than patient care as much as they can and carry their large attitudes around to share with others who obviously can see what they themselves know about their laziness and selfish slothfulness. Lunchtime is often a pizza party and getting these mountains of flesh to help you is an effort yet they routinely expound the virtues of a strong male to assist them with their patients until you’re done moving their equally obese patients. After of course its back to the ‘bad male’ this and the ‘bad male’ that syndrome and all the things that men have done since creation began to them to keep them in their place! LOL I am not lying or stereotyping. Its true really true! I sometimes wonder where they find scrubs to fit their extra extra extra large derrieres! I watch them often with their little get togethers during work laughing and joking and then you ask one of them something about some procedure and they get downright mean like some old hog possessing her little piece of heaven! I don’t feel sorry for them. I work twelve hours and I keep in shape. Its called exercising the mouth mostly and that means keeping it flexed shut once the body says its got enough food. Its getting up and moving a little to do your work. Its bringing good food from home so you don’t have to eat the crap and rip off stuff from the vending machine thieves. Its called not smoking and not drinking and the other things we tell our patients and applying them to ourselves. Patient heal thyself is as much true to nurses heal thyselves! If this seems harsh and cruel than think of all the harshness and cruelty that you incur with hypocritical teaching that is laughed off when obese nurses tell a patient about lifestyle changes. Think of all the harshness and cruelty that have happened in injuries incurring others because these human monstrosities couldn’t do the work at their jobs and the patient got a bedsour for not getting turned or died because like someone commented the nurse couldn’t get to the code on time! Reality check!

    • mamajo RN

      WOW, you seem to have some sort of inferiority complex to be attacking other nurses like you did in your post. I can not believe you would call anyone, let alone peers “human monstrosities”. Nursing is about caring for people, all people, including your peers. You need to go back to Nursing 101 or even before that…you need to learn compassion and caring as you have none now. Why would you even become a nurse with your malevolent thoughts???? Just my 35 years of job experience talking, but I guess you have more and consider yourself better…you are a sad little person.

    • write4recovery Student

      The fact that you need to attack and judge other people so harshly just says to me that you feel incredibly insecure about yourself. If you have such hatred of overweight people and their inability to control themselves (which is what you seem to perceive is the problem with obesity) my guess is that you are terrified that you will spin out of control yourself. You’re projecting your issues with food and power onto other people so that you don’t have to look within. Try taking a look in the mirror (and not just to check out your ass) and figure out why you need to hate on other people to feel good about yourself. Because really, if you felt good about yourself to begin with, you wouldn’t need to attack other people.

    • barbmak08

      Maybe it’s your piss poor attitude that make others not want to help you. Wow – the vitriol that spilled from you post is amazing! I am a big girl and I can run circles around many of the other nurses. I am on the go all 12 hours and my ass seldom hits a chair during that time. It’s not a beauty contest or popularity contest, it’s all about great care for the patients. Big or small, just do it all.

  15. OhioPsychNP APN

    Yes, a nurse’s weight can have a negative effect on a nurse’s work. Some of the comments left, however, are less than sensitive to the plight of the obese nurse. C’mon, nurses. We need to be kinder to each other and supportive on one another. Stop eating your young!

    Editors: Referring to all nurses as SHE has deleterious effects on men in nursing, the public’s view of nurses and nursing, and the nursing profession. NOT ALL NURSES ARE WOMEN! Sentences such as the last line of this article — “Do you think a nurse’s weight can have a negative effect on HER work?” — are sexist.

  16. Fat nurses CAN be good nurses but the fat might be keeping them from being better nurses.

    The word nursing comes from the root nourish.

    Just as a nursing mother can provide better nourishment for her child if she nourishes herself first, a nurse who takes better care of herself can be a better caregiver.

    I speak at hospitals and nursing associations about being the MVP – Most Valuable Patient. I’ve been encouraged with how much interest there has been on this topic.

    http://www.NurseMVP.com

  17. mookie Fan

    I think they absolutely can and should have no one giving them any guff about it!

  18. dlacombern

    I am currently writing a concept analysis of fitness and nursing. Weight and health does matter for a nurse. Not only does it matter for the nurse themselves but for the patients and people they teach… The reduction in injuries and improvement from Moral is important for the nurse. obesity is an epidemic and as a nurse being a role model is very important right now. I am not saying you need to be at the gym 5 days a week and be able to run a marathon. I am saying as an organization we are pretty sad. It is pathetic when my elderly neighbors always make jokes about the nurses they see on cruises etc and how obese they all are. The article form 2008 is actually very good about the obesity in nursing. We need to take care of ourselves before we can take care of others. As nurses our credibility does rely on our ability to follow our own advice. I am a skinny nurse but I work really really hard at making sure I do something every day to maintain my health. I don’t want to catch NURSES ASS…. as it has been joked for years in my family that nurses have big butts. My husband and I are both nurses with two children. WE on our crazy schedule make it work, so can everyone else.

    • janine RN

      You happen to be skinny. I am of average weight. But, we both probably have some bad habit. To judge an obese person is insenitive to their struggle. Of course we should be the best possible role model but, some nurses smoke, some have bad relationships, we get sick, we die. We are human. We can provide good care and not be perfect.

  19. Abby Student

    When I was a cna, my unit manager told me that someone as “small as me would never be able to move patients”. At that time I was actually over 150 lbs (I have the blessing of always looking smaller than I am). I’m only 5’2″. I’ve been all the way to 185 and worked my way to lose. This manager told me to stop worrying about my looks and “start worrying about patient care”. As far as I know it is unsafe for anyone, but especially a new aide, to operate a hoyer lift by them self. (which is why she was lecturing me to begin with)

  20. mbluestone

    This is an excellent subject. I am not a nurse but as a child of a nurse I would frequent the hospital and noticed that nearly every nurse is obese. As a personal trainer this is baffling considering nurses (good ones) are among the hardest workers in the work force. The typical nurse is on their feet 12 hours a day, constantly moving.

    This constant activity inhibits a tremendous caloric burn.

    I would love to write a guest post discussing this topic in greater detail accompanied by solutions.

    my blog is http://stlweightlossclub.com/

  21. janine RN

    Nurses are people. People have bad habits. I have seen homely plastic surgeons, dermatologists with acne, hair dressers with bad hair, landscapers in unkempt homes, carpenters in shacks, neurotic psychiatrists. Yes, you can be fat and be a good nurse.

  22. nishki LVN

    It doesn’t matter if you’re fat or thin, it just matters that you care about your patients and are willing to take good care of them. I agree with the person that says that juggling work and home,skipped meals, etc-(R Davis)Gee whiz, sometimes we can’t even go to the bathroom because our patients have to go first- or we have to help them with breastfeeding, or a diaper change or a million other excuses, or even worse, someone elses patients are calling, you can’t find that nurse, so you go and answer their lights so the patient doesn’t have to wait- definitely don’t care for the article-is this person even a nurse?

  23. write4recovery Student

    This is horrifying. Do you realize that eating disorders among women over 30 are up 42% in the last 10 years? Do you understand that it is exactly this kind of language that has an influence on those statistics? There is such a phobia and so many assumptions are made about overweight and obese women– they are lazy, sloppy, and a number of other pejoratives– that women fear for their jobs if they gain weight. Articles like this do not help the stigma attached to weight, they just add to it. Whoever allowed this to be published needs to get a clue.

  24. vickyjackson11

    I don’t think a nurse’s weight has a negative effect on her work. I believe that if she is committed and driven to provide the best quality care, she will, no matter what her weight is. It’s the brains and heart that matter!

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  26. angiedeborja

    I empathize with nurses who work 12+ hour shifts. Scheduling in exercise is very challenging on the work days, but it still needs to happen because it becomes a matter of injury prevention. Overweight nurses can still be excellent nurses and deserve just as much recognition for their talents and expertise. http://goo.gl/lNSXb

  27. judontmesswithme

    This was recently published: http://jama.jamanetwork.com/article.aspx?articleid=1555137#qundefined

    The author of this article should take a look at this link. Weight has been scrutinized much more recently, because people with low BMIs and people with a BMI of over 35 are considered to be unhealthy now. Those with a BMI of between 25 and 30, although seen as “overweight” are actually starting to be proven is fairly healthy.

    However, I do agree that nurses definitely do not practice what they preach. I can’t tell you how many times I’ve heard a coworker teach about smoking cessation, and less than 10 minutes later, she’s outside blackening her lungs.

    It’s also been my experience that a lot of nurses have trouble discussing weight with patients, not just overweight or obese nurses. The skinny nurses don’t like to go their either, because weight is an uncomfortable discussion. Obese patients often don’t want to discuss the subject at all. In fact, at my office, many patients won’t even step on the scale and refuse to even talk about it with the doctor. Is it good for nurses not to talk about it with patients? No, but I don’t think it’s always just because the nurse feels too guilty to talk about it.

  28. bensontm

    I’ve worked with many overweight nurses. In general, weight makes no difference in performance. In practice, it does matter in some areas.
    I work in ICU. There have been nurses who were not allowed on the code team because they “took up too much room” and the doctors complained. Most of the flak is stereotypical bs excluding the obvious health risks.
    If our places of employment were truly interested in improving the overall health of their employees, we would see more fitness programs geared toward night shifters, as well as healthier food options instead of the usual fried special (aka quick stuff or leftovers from lunch).