Dude, you're killing me!

I've been having some increased discomfort in the tolerance region of my brain.  It all started with the moving of gastric bypass patients to the unit I was working on some years ago.  It was like trying to put the same poles of a magnet close together; impossible.

**** I will allow that 0.00000000001% of the population genuinely has some physiologic reason why they are morbidly obese*****************

That said.

If you won't take care of yourself before you get to me, why the hell am I obligated to take care of you in a way that will injure myself and/or my coworkers?  If you can't put the damn cheeseburger down, why should I pick up my compassion card?

I've been watching this show called "Obsessed" where people with OCD are given exposures to the ideas or things they fear most.  It's not for lack of exposure that my obsessively negative thoughts are nurtured.  We have a couple of superfat nurses on the unit along with the odd assortment of chubby, middle aged spread, or post baby nurses.  One superfat nurse is loud, abrasive, and has no regard or respect for others.  The other is loud, abrasive, has no regard or respect for others AND is pregnant AND wears skin tight clothes in lieu of scrubs.  Always has.  I'm not sure why management allows this to continue.

I do not want to see your mooseknuckle.  Ever.

Then the mooseknuckle option is removed because now they're in the bed.  Nekkid.  And I have to push the rolls of fat over, up, under, around to get the ECG electrodes on.  Hold the arm up to get a BP cuff on.  Fat people, you may never have seen the numbers the scale brings up, but let me give you something to chew on (pun intended).  I have to stretch before and after lifting your dead weight arm up just to put a cuff on it.  I has to weigh 50lbs.  Watching your face go purple as you're having the fat that's normally supported by your thighs/knees now actually on your abdomen as I try to get a foley in is absolutely not one of the highlights of my shift.  FINDING the place the foley goes through the abdominal and thigh fat requires an extra two people and a minimum of one flashlight.

I just read that in Kansas (I think) an ambulance company is going to increase the costs for caring for and transporting those over 350lbs.  I found myself startled initially reading it, not because I had any opinion either way, but because I'm so freaking inundated with those >400lbs that 350lbs seemed a pittance!  I reframed my thinking and found myself cheering!  What if nursing did the same thing?

1. Q2h turns requiring > 3 people: $50/person/turn
2. Bathing >  qshift r/t offensive diaphoresis or odor: $50/person required to assist/bath
3.  Foley placement: $100/person required to place
4. Isolation: $5/hr more for the nurse assigned, $10/hour more if airborne and the nurse has to wear the hood.