has kept the weight off. She no longer has high blood pressure, and her glucose is within normal limits. She has become more active, and enjoys gardening, and walking. I invited four of my colleagues to lunch, to discuss their perception of obese patients, and barriers in caring for them. Each person interviewed shared negative perceptions of obese patients, sighting the physical demands. They said it takes twice as long to do most of the care for an obese patient, and so many cannot do anything to help with their care. They are at risk for falls, pressure ulcers, and the staff is then deemed responsible, and must deal with the consequences of hospital acquired injuries. The high acuity of an obese patient is not considered in making staffing assignments, even though their care is often more time consuming. They also felt our safety was in jeopardy, and know of many who have suffered back and neck injuries caring for obese patients. Many of the obese patients have longer hospital stays, due to the co-morbidities, and the risk of hospital acquired infections is greater. Often, the nursing care can be excellent, but it may still be difficult to prevent hospital acquired injuries. I also spent the day in cardiac rehab, with the nurse Marla, and the exercise physiologist, Whitney. Patients are referred to cardiac rehab after a cardiac event,
ADULT OBESITY IN TARRANT COUNTY, TEXAS 22 such as a Myocardial Infarction, Cardiac Intervention, (stent placement), or Open Heart Surgery. I shadowed both employees for a different perspective. Marla acknowledged, over 50% of her patients, men and women combined were overweight, and almost 30% were considered obese. Many patients did not have an exercise routine, and most admit to an unhealthy diet. Marla stated the population of patient in this area, were not suffering from food insecurities, but ate fast food on a regular basis, and often ate at restaurants. Many in this community have careers, and busy lifestyles, making cooking at home difficult. Marla conducted a complete history and physical exam, including medication lists for each new patient. Whitney, E.P., would then see the patient and discuss the exercise program. This 26 -36 session program guides patients through exercise while monitoring heart rate, blood pressure and pre and post glucose for diabetic patients. Clients start the program with light exercise, and increase the intensity throughout the program. Patients also have educational classes from a pharmacist, nutritional classes from their outpatient dietician. They are educated on reading labels and identifying high fat, sodium, and sugar contents in food. They are educated on making healthier choices when visiting restaurants.
ADULT OBESITY IN TARRANT COUNTY, TEXAS 23 From these interviews, it was very clear that the obesity crisis here in Tarrant County is quite challenging. There are many barriers; both behavioral and environmental issues present. People with busy lifestyles often eat away from home, and are tempted with tasty, but high calorie fast-foods, with large portions.
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- Spring '16
- TARRANT COUNTY, Fort Worth, Texas, adult obesity