‘Internalizing Worthiness’: A Study of Obese Nurses Managing Their Weight

Abstract

Introduction: A significant number of nurses are overweight and obese, which poses a risk to their health and wellbeing. This study uncovered a theory illustrating how nurses who are obese manage their weight and how the process was influenced by personal, contextual, situational, and conditional factors. Method: The researcher employed a qualitative research method using face-to-face, semi-structured interviews with registered nurses who were currently obese or had a history of obesity and subsequent weight loss. Proprietary software was used for data management and qualitative data analysis. Three levels of coding were employed to uncover the underlying process of how obese nurses manage their weight in the context of the demanding contemporary workplace. The associated personal, contextual, situational, and conditional factors that act as barriers and facilitators to this process were identified. Results: The narratives revealed the nurses wanted to lose weight and implement eating behaviors but failed to balance their own self-care needs against patient care demands. This may be linked to the long history of self-sacrifice in nursing. The nurses described cues to action helped them initiate weight loss and balance their own health against workplace demands. When the nurses struggled with their weight, they recalled being reluctant or avoiding engaging patients in weight loss counseling; however, when they started to lose weight, they felt empowered to provide weight loss counseling to patients. Implications: The findings from this study have implications for practice, education, and research. Nurse leaders and managers may consider creative work redesigns to support the nurses in implementing self-care practices at work. Nurse educators may incorporate activities to allow students to develop and practice personal self-care skills before graduation. Researchers could explore the interrelatedness of self-worthiness, self-sacrifice, and negative outcomes for nurses managing their weight and design and test weight loss interventions, specifically addressing the unique barriers that nurses face. This thesis examined the relationships between nurse characteristics, organizational factors, and recovery of medical errors among medical-surgical nurses in hospitals. Research has focused on error causation rather than error recovery that consists of identifying, interrupting, and correcting errors before patient harm occurs. Greater understanding of factors that influence error recovery can aid in the development of strategies to reduce negative patient outcomes. A descriptive cross-sectional, correlational study was conducted using a convenience sample of 184 medical-surgical nurses across the country. Each medical-surgical nurse recovered, on average, 22 medical errors in a three-month period. Regression analysis using a negative binomial model revealed that three factors were significantly associated with medical error recovery; education (p = .001), expertise (p = .003), and hospital size (p = .016). Findings suggest that expert medical-surgical nurses with advanced education were better able to recover medical errors. Factors such as education and expertise should be considered when staffing units to reduce negative consequences and improve patient safety.