Hospitals groan under weight of heavy patients

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Hospitals groan under weight of heavy patients

ST. LOUIS (AP) — Going to the hospital is rarely fun. If you weigh

over 300 pounds like Beth Henk, it can be embarrassing.

A hoist, rated for patients up to 750 pounds, is used to move

Marcus in St. Louis.

Tom Gannam, AP

" 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. " (Related: New

extra-large ambulances in Vegas)

Today Henk helps -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. -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.

By Tom Gannam, AP

A special chair for obese patients is large enough to accommodate

physical therapists Dawn Caplan, right and Natasha Miriani at -

Jewish Hospital in St. Louis.

" 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 Lietz, a spokeswoman for

the American Hospital Association. And it's not just for the

patients.

ATF health care, 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 -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 -Jewish. " We've had

some 650-pounders up here. "

Some wings of -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.

By Tom Gannam, AP

The slippers for obese patients are twice the size of " large "

slippers.

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 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, -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, -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.