Hospitals groan under weight of heavy patients

The hospital is replacing many of its beds — built to handle people weighing up to 350 pounds — with beds for 500-pound patients.

"Three-hundred-fifty pounds is nowhere near what we need for beds now," said Art Kidrow, a nurse manager at Barnes-Jewish. "We've had some 650-pounders up here."

Some wings of Barnes-Jewish are replacing 36-inch-wide doorways with those that are 48 or 52 inches wide. The bathrooms are being fitted with floor-mounted commodes that can't be pulled out of the wall, and rooms reconfigured so patients can essentially get out of bed and step into the bathroom.

Extra-large gowns and slippers
Gowns are bigger. Wheelchairs are wider. Even hospital-issued slippers come in extra-large sizes because the standard-issued footies were cutting off circulation for some patients.

Issues extend beyond the patient's room. Operating tables have been widened because the girth of some patients was lapping over the table, in some cases all the way to the floor, Becker said. CT scan machines weren't wide enough. Syringes with the longest available needles — 4 1/2 inches — couldn't penetrate the fat.

Along with doctors and nurses, the hospital's 30-member bariatric care team includes former patients like Henk and people from the hospital's engineering and housekeeping units.

Henk, 41, represents both patients and those who try to help the obese — she is program manager for Washington University's weight management program.

She's been heavy for as long as she can remember — she was in Weight Watchers by age 5. "Everybody in my family is at least 100 pounds overweight," she said.

Gastric bypass surgery seven years ago helped her shed some weight, but she's dropped to 315 pounds mostly through better eating and exercise.

Still, she knows what larger people go through at the hospital.

"I believe in dignity for whomever you are," Henk said. "It can be scary, too. If people are trying to lift you up and somebody doesn't have the strength, it's very scary."

Based on recommendations from the team, Barnes-Jewish has developed a protocol for lifting heavy patients.

The hospital is also working with suppliers. Manufacturers now offer more than 1,000 items specifically for obese patients, said Sandy Wise, of Novation LLC, a Texas-based company that provides contracting services between hospitals and manufacturers.

"It's been a trend probably for the last four or five years," Wise said. "Hospitals are continuing to see an increase in obese patients, and it affects every department. You have to think of the patient from head to toe, everything they do in the hospital until they walk out the door or they die."

In fact, Barnes-Jewish is striving to make even the end more dignified. Becker said the law requires a leak-proof body bag. Some patients were so large they wouldn't fit in them. The hospital is working with a vendor to develop a wider bag.

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