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Obese patients put strain on hospital's resources

Specially designed beds to cope with larger patients at Darent Valley Hospital
Specially designed beds to cope with larger patients at Darent Valley Hospital

Patients who weigh as much as an adult polar bear or a Harley-Davidson motorbike are creating a strain on equipment, not to mention resources, in north Kent.

Obese admissions at Darent Valley Hospital, some of whom top the scales at more than 40 stone - 300kg - have to have specialist beds, seats, wheelchairs, hoists and even toilets at their disposal.

But the equipment, which costs thousands of pounds, and the staffing levels required to care for larger patients are stretching resources.

Bariatrics, the branch of medicine which deals with the causes, prevention, and treatment of obesity, has experienced a boom at the Darenth Wood Road hospital in recent years.

It now stocks wheelchairs capable of carrying up to 50 stone, heavy duty hoists to haul obese patients into beds, and one specially designed bed with a maximum load of 47 stone.

Heavy duty chairs, in three different widths, can accommodate patients weighing up to 50 stone, while most of the hospital’s standard beds - about 340 - are capable of accommodating loads of up to 36 stone.

The hospital has even recruited a specialist bariatric nurse trained in moving larger patients and giving advice on all aspects of care.

Emma Mulvihill, who is also a back care specialist, has been the hospital’s lead bariatric nurse for more than four years.

She has gradually increased the hospital’s range of equipment since staff were caught short when a 44-stone patient was admitted.

She said: “He came in saying he was 28 stone on his scales, but they only went up to 29 stone. When we weighed him he was 44 stone and we had to get a bed in from another company.

“That patient made us realise the need and the action was taken from there. I wrote a 3,000-word piece arguing why we needed equipment and each year I’ve put another bid in.”

The hospital would not say how much the equipment cost, but bariatric beds of a similar size can cost up to £3,000, with wheelchairs priced at about £2,500 and specialist hoists up to £2,000.

Mrs Mulvihill said: “None of it is cheap, and things like the bed have to have annual maintenance checks, but the costs are nothing compared to the dignity a patient receives.”

Mrs Mulvihill said some patients had come to her complaining that other hospitals had sent them to a weigh bridge designed for HGVs at the Dartford Crossing because their own scales were not big enough.

Darent Valley Hospital has its own walk-in or sit-on scales capabled of weighing up to 85 stone, about the same as a Formula 1 car.

Despite the wealth of equipment, Mrs Mulvihill said the scale of the national obesity problem means future purchases can never be ruled out.

“It’s definitely increasing - that’s a fact,” she said. “Now almost every NHS trust has bariatric problems. Surgery is on the increase more and more with things like gastric bands, but the most pressure is on staffing levels - that’s when the resources are used the most.

“When you have a larger patient on your ward you need more staff. Before I came it was just a case of how many staff you could find, but now I aim for five to six staff to move a patient.”


Understanding obesity

Perceptions of obesity are often misguided, according to the hospital’s lead bariatric nurse.

Not all obese patients are overweight because they eat too much, Mrs Mulvihill said. She added: “When someone’s larger and they put on weight it’s not necessarily going to go on one arm, it goes on all over. Sometimes it’s medical, sometimes psychological and sometimes physical.

“One of the biggest things is the psychological aspect. We’ve a very strong level of care here and I always spend a lot of time with my patients and their families because they need that support.”

And fat is not the only thing taken into consideration when assessing a bariatric patient, Mrs Mulvihill said. Because it is judged on a person’s body mass index (BMI), even muscular sporting figures can fit the bracket.

She said: “Every single member of an American football team and most of the England rugby team would be classed as bariatric. Most of it is muscle but their BMI would still be high.”

She said even super-fit Dartford strongman Terry Hollands, who weighs about 28 stone, would be classed in the same category.

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