Care of a patient with ED

I was inpatient once for my eating disorder...and...well, let's just say that it wasn't my favourite experience. Why? Was the problem in me? Was it the staff there? Or both? How do nurses and doctors care for patients with ED?

There is a lot of evidence that is now focussing the relationship we have with patients with ED. When I say 'we', I mean healthcare providers. I am lucky because I got to see this from both ends: from being a patient, and now, as the nurse. I can tell you that one thing that I hated about inpatient (IP) was being treated like a baby or child. The staff made me feel like I was...inferior because I had an ED. I felt that despite being 18, I was not treated as such. In addition, I felt that no one there cared about me. Sure, the staff did their jobs. But in the end of the day. there is definitely room for improvement. What is interesting is that this advice can even go beyond how to treat someone with ED - it all comes down to understanding how we, as society, should treat anyone in general...especially those who are ill and need compassion and support.

As a nurse, I am aware of how my attitude and mannerisms can affect patients. If I am angry, this can make the patient feel sad or uncomfortable. If I am happy, I can do my best to comfort the patient. Helping patients with ED is not any different. Sure, nurses and doctors are simply 'doing their job', and I am not expecting every healthcare professional to love their patients. But I AM expecting that you treat them with respect and dignity. That, during your time at work, you for your best o help patients and to advocate for them.

I can see how doing this can be hard. Caring for a patient with ED means that you need to be careful with what you say and do. You need to take careful assessments of their body systems to recognize complications and to keep them safe. You need to understand that sometimes, the patient will not be able to understand how ill she or he is, despite being so thin and frail. As a nurse, I see this all the time with patients with ED. But because of my experiences as a patient. I also realize that this is not their fault. Patients CANNOT see that they are ill. They are sick, but they don't FEEL it. At the same time, patients may be smart, funny, or appear to be healthy. This is why caring for ED patients is so hard - you need to be mindful that looks can be deceiving, and that intellect is different from illness. ('Caring for the hospitalized patient with an eating disorder' (2003) by Gimby and Wolfe is a pretty good article about how to assess a patient with ED).

What I particularly want to point out is that as nurses, we need to be mindful that patients with ED need a lot of care. They don't just need to be fed, weighed, and monitored for exercise or self-harm. They need to feel cared for, and they need to learn how to care for themselves. They need to understand that you are doing your best to keep them healthy, even if they do not want this now. You need to tell them that despite their discomfort now, they will get better and recovery is possible. You know how hard they are working, and you realize that eating and gaining weight is the hardest thing that they will ever do in their lives. But you also know that this is worth it, and that they are strong enough to overcome this. You know that this is not their fault; that recovery is on its way and that it will take time. Mistakes happen, and they are human. Even with relapses or mistakes, you know that they can muster up the strength and devotion to continue on their way towards recovery. You know that they are more than their eating disorder - that the ED does not define them, nor does it say anything about their character, personality, manners, beliefs, etc.

Again, this is easier said than done. I was a patient with ED before, and I know how stubborn and firm I was. But again, I know that this wasn't my fault. I was ill, and I needed my nurses and doctors to understand this. instead of blaming me, I needed support and motivation. Instead of making me feel stupid for being sick, I needed someone to tell me that I was being strong. instead of treating me like nothing more than an eating disorder, I needed someone to make me feel that I was human and I had a life outside of this illness. The main point, in the end of the day, is to remember that all patients, with any illness, are not at fault for their disease. And regardless of what they are ill with, or how this came to be, they deserve to be treated with respect, love, care, and dignity. No blame, no shame.

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