Tuesday, 24 June 2014

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.


  1. This is really great Marina! It's really interesting and helpful to hear what patients who have an ED need from someone who has actually been an inpatient. You are going to be an incredible nurse :)

  2. Thanks for this compassionate blog.
    As you said clients with ED need lots of care but validation of their feelings, respect their choices,ideas,belief and treat them with respect and dignity all are very important for their wellbeing


  3. I am also as RN and CDE I completely agree with you.
    I know many of my colleague easily get frustrated from overload of work and so not able to treat clients with dignity and respect and then blame patients for their failure(nurses) to accommodate those who suffer and needs care.
    Yes Marina you are lucky because now as a nurse you know how patients feel and what they expect from a nurse or a doctor.

    CJ(RN and CDE)

  4. All public expecting nurses and doctors to give better supportive care.
    Sorry for your poor care you were given by inpatient treating nurses.


  5. You are really the best patient 'advocate.


  6. This is true those who matter never judge and those who judge do not matter.
    I wish people resect and care for each other especially nurses


  7. The benefit of complete recovery is to invest your experiences in changing course.
    You suffered ,treated badly and blamed for nothing wrong you have done .
    Now you will be an excellent person to understand people feelings, dignity and respect in addition to their disease and people will love you more.
    See how God allowed this suffering to teach you how to be a good nurse and a caring loving person.


  8. It will not cost us any thing if We look at others with smile and good tone of voice but it may make life stress easier for them .


  9. All patients especially ED victims need better care and support.


  10. I can not believe nurses were harsh with you .
    You are an angel, how dare they
    This will help you to feel patient pain more than any other nurse who never experienced this.


  11. How the person supposed to show care and sympathy turn into monster.
    I think these kind of nurses should not be working in our country.

    Sandra D

  12. As you may recall I went through many treatment programs before my complete recovery. I hope I forget and forgive those nurses and doctors who treated me without respect and who were harsh and callous. I will not forget those who were pleasant and nice.
    I am sure Marina you will forgive them and you will learn from this experience how to feel others 'feelings and support them.
    I am sure God put you into this suffering for same good reasons.


    Recovered ED for 7 years without relapse

  13. People who matter never judge ,always respect and support.
    Smile does not cost any thing but make a big difference.


  14. I heard lots about how hospital staff treat clients harshly and I am wondering when this will stop.
    I am sure you will set an example of how clients and families should be treated.


  15. I appreciate your kindness and support to patient.
    You really a good nurse.


  16. Some people including nurse never felt the impact of soft words and nice smile and unfortunately some of them graduate from medicine or nursing schools.


  17. For this reason many people do not like go to Hospital .


  18. Your compassion is more than a GEM


  19. This post tells us how Marina is (caring,loving,supportive and understanding for human being need of respect and love)
    We love you Marina

    Mays and Iraqi community

  20. Hi my friend
    I read this post and I am amazed how great a person you are.
    You care about others and I hope others treat you with care and respect too.
    I am trying to continue reading all previous posts.



  21. Now Razan a head of me reading this wonderful blog.
    I would like to command Marina for putting much emphasis on people's feeling and dignity as well as physical illness.


  22. Thank you for this caring post.


  23. I appreciate this blog.


  24. Thank you for this post, Marina. That's what makes us so special. We have seen both ends (being patient and nurse), thus know to listen to patients and be compassionate. We are better nurses because of our experiences. You are amazing and I'm so proud of you!
    What is the name of the article in your post? I'm going to search it on my school database, since I don't have a McMaster account. Thanks!


    1. Cat, your words are so kind! I am very thankful for your wise and true words. They mean a lot to me. I have edited the blog to include the title and authors of the article so that you can search for it without having a libaccess account!

    2. Let iterate what Cat has said.
      As a medical student I saw both sides. Mostly We are lucky having excellent caring nurses and doctors .Only very rarely We see some of us as harsh and tough and disrespectful to those who are ill and just wanting more listening.
      This is a learning experience for me to be same as caring and supportive to my clients as Marina and Cat among others.

      Med student

    3. You're welcome, Marina. It amazes me how much good you've done. You're an inspiration for all battling an eating disorder. Keep it up, hun. Thank you for article info.
      Penny, I'm glad this was insightful for you. As a healthcare professional, I always remember that I'm treating and caring for the person first.


  25. A caring nurse makes a big difference and leaves long term impression on patients and their loved ones.


  26. I sweer you will be the best nurse.
    Sorry you treated harshly by harsh people nurses or doctors or clerks can be harsh .I have same bad expereice when my mom was sick.


  27. I am sure the roughness of you own experience will make you a compassionate caring person and you are .


  28. I experienced this more with doctors than nurses. Thank you for caring about patients dignity.


  29. This attitude from doctors and nurses would not be tolerated .
    We need to clone Marina .


  30. You matter and you care and respect your readers and We really hoping We can clone you.


  31. Wonderful post stands for sick people vising doctors. When this comes from a nurse it means a lot.


  32. I will not expect nurses to be as caring and knowledgeable as you.
    I hope your experience with harsh nurses and this post and blog motive nurses and doctors to treat people with dignity.


  33. I heard this from many of friends who had been to hospitals.
    My heart with you and every body who has to be in similar situation.
    The positive side We have many many good people like you Marina


  34. Having one good person can make a differnce .
    We are sure you are the one who can make a differnce in showing care and smile.


  35. I look at positive and I hope We have more and more of Marina's style of nursing.


  36. Every time I read this blog I feel amazed,hopful and optimistic and wonder how could be your success in complete recovery and maintaing your school.


  37. Caring person like you make a big difference.
    Rude people go to hell


  38. This is excellent discussion led by caring author.


  39. You matter and so you do not judge.
    Well done.



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