SherwoodForest

Hospitals and geriatric care facilities increasingly have to care for very heavy and severely overweight people – a task with multiple challenges for both occupational health and safety and humane nursing and medical care. The decisive factor here is good preparation of the facilities before a shooting situation occurs.

Hardly any hospital is prepared for the emergency care of heavy patients. The first hurdles are already encountered in the emergency room: there is often a lack of resilient patient stretchers and chairs, blood pressure monitors and nursing materials in the appropriate sizes. The functional units for diagnostics, such as radiology, the cardiac catheter measuring station and sonography, are often not designed for heavy people with their corresponding body dimensions. If an operation is necessary, there may be. only operating tables are available which do not meet the requirements for safe working loads and also have a much too narrow lying surface. But even transferring patients to the operating table is a challenge, as the sluice tables are often only designed for patients weighing up to 160 kg.

Overweight and obesity in numbers

• Whether someone is overweight is usually determined on the basis of the body mass index (BMI). This is calculated according to the following formula: BMI = weight / height 2 . The weight in kilograms and the size in meters are taken into account here.
• According to the World Health Organization’s classification, overweight begins at a BMI of 25, and at a BMI of 30 or more, it is called severe overweight or obesity.
• According to a study by the Robert Koch Institute, 53.0 percent of women and 67.1 percent of men in Germany are currently overweight. The proportion of obese people has increased in recent years. It is currently 23.9 percent of women and 23.3 percent of men.
• However, the extent to which a person’s weight poses special challenges for nursing and medical care does not depend on BMI alone.

• Example 1: A non-ambulatory patient is 1.60 meters tall and weighs 80 kilograms. She has a BMI of 31.2 and is therefore severely overweight. The round body shape makes it difficult to move this patient, but the regular aids and other equipment of the hospital are perfectly sufficient in this case.
• Example 2: A patient who is also unable to walk measures 2.05 meters and weighs 115 kilograms. He has a BMI of 27.4 and is therefore not yet considered obese. Nevertheless, due to his weight, he can only be moved with aids. At the same time, pay attention to the load-bearing capacity of equipment and materials here.

Stresses on the musculoskeletal system of employees

Even caring for "normal-weight" people (80 kg) places (too) great a demand on the musculoskeletal system, as shown by laboratory studies conducted by the BGW together with the Leibniz Institute for Occupational Research at the Technical University of Dortmund. Many transfer, positioning and mobilization situations here are far above the recommended values.

Everyone has narcissistic traits, but that doesn’t make him a narcissist. Narcissism expert Chris Oeuvray explains the four characteristics that make up a narcissist, what a toxic relationship looks like, and why such unions need a clean break.

Melanie is 35 and is in the middle of life. She meets Ronald and falls in love with him. He embodies everything she has ever wanted: he is great looking, eloquent, charming, confident and successful. Within a short time they marry and become parents. Soon Ronald shows his other face. He is choleric, cheats on Melanie, makes her responsible for everything bad. At first Melanie defends herself and the situation escalates more and more often – more and more. She gives in for the sake of harmony and resigns. Her self-confidence crumbles and she falls step by step into his narcissistic trap until she is at his mercy. Her marriage becomes hell. Melanie recognizes this and wants to separate. To prevent this from happening, Ronald pulls out all the stops. He spoils her, in the next moment he tortures her, he finishes her off. He accuses her of being a failure, stalks her until she almost goes crazy. On top of all this, he threatens to harm the children. He knows her vulnerabilities and exploits them shamelessly. She is devastated.

How such a relationship with a narcissist arises and develops, I describe in the thriller "Fatally in love", which deals with the fictitious love affair between Ronald and Melanie. Ronald binds Melanie to him, manipulates her, makes her dependent on him, abuses her emotionally. For those affected and their relatives, it is often inexplicable how someone gets into such a toxic relationship. For the person affected, on the other hand, it is often difficult to leave the narcissist.