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Megan Reeves History 1302- 8:00 am T&R 1 Mar 2011 Linda Graham

Bariatric Nursing In todays constantly rising and declining job market, the outlook for some careers is much greater than for others. Nursing, as an umbrella idea, is one of those that is constantly growing and changing with the advancement in technology and the creation of different nursing positions. Have you ever wondered what it would be like if you went to the doctor and there were no nurses? Many people overlook the fact that nurses are a very important group of individuals in the healthcare industry and a lot of them have different specialty areas that they enjoy. Having family members struggle with obesity and some undergo weight loss surgery, a type of nursing that has always interested me is bariatric nursing. The ideas of helping overweight people get their problems with food and exercise under control while potentially extending their lifespan is an appealing thought. To struggle and try to make someones life richer and getting them to fall out of love with food seems like an impossible feat, but bariatric nurses help and succeed with this every day with patients that have undergone weight loss surgery. Although this is a field of nursing that has always captured my own fascination, one may need to know and get all of the facts that this field is about. Jumping into any career is a bad decision and getting involved in one can be destructive to a persons finance and possibly even their mental health. A person may hear about the demand for nurses and that it is a wonderful career to join and try it out and find that is something that they cannot handle or do not enjoy, so I will look at the past, present, and future of bariatric nursing in both preoperative

and postoperative weight loss surgeries and hope that it will help me in choosing if it is the right career choice for myself. General nursing has been around for many years, but bariatric nursing is something that has just recently started making headlines. Before explaining the nurses responsibilities, its important to first understand and get the history of what bariatric surgery is to determine the job description for these nurses. Bariatric surgery, [] involves surgically reducing stomach capacity, [and] is indicated for dangerously obese patients who havent been able to reduce weight with medically supervised diets, exercise, and behavior modification (Gallagher 59). According to Gallagher, the first form of this weight loss surgery was introduced in the early 1950s (60). It would seem obvious that during this time there was no such thing as a specific bariatric nurse since the procedure was new and mostly experimental. The nurses that wouldve been involved with these surgeries would have been general nurses or even surgical nurses. Because the procedure was new, there would have been minimal duties for nurses other than the general jobs such as watching over patients during recovery and checking vital signs. During this time, registered nurses could start getting more and more involved with bariatrics and integrate what they learned in their general practice with what they learned from their experiences with the surgical procedure. This would be the beginning of a new type of nursing, bariatric nursing. Although this was a slowly emerging new nurse specialty, there are no records of any major bariatric nurses during these early procedures. The articles state no early bariatric nurses or mention the jobs, but it is a foregone conclusion that if there was a type of surgery that there would have been a nurse for it, just as there are cardiology nurses or any other specific type. The first official record of bariatric nurses according to the National Association of Bariatric Nurses

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website would be in 2004, when this association was developed to expand and produce research for those nurses who want to understand obesity and the growing field. The National Association of Bariatric Nurses was formed in 2004 out of a recognized need for the nursing profession to dedicate resources, knowledge, and research towards improving the life and nursing care of people suffering from obesity, proving that even though there had been a number of previous years of bariatric surgery, it wasnt until the 21st century that people started recognizing bariatrics as its own field and joining the field in order to help others(National Nurses). Today, weight loss surgery is more common and a much easier option for many who are trying to lose a copious amount of weight. Harvard Women's Health Watch states that Surgeons have been doing bariatric surgery for more than 50 years, but the number of people undergoing the procedure (most of whom are women) has soared recentlyfrom 36,700 in 2000 to 171,000 in 2005 (6). From this article, one can see that the weight loss surgery field is expanding which means that the need for bariatric nurses increases. Before you become a bariatric nurse you must first be a registered nurse like with any other special field and then take a special exam. To become a Certified Bariatric Nurse you have to successfully complete the Certified Bariatric Nurse examination. Each candidate must demonstrate competence in all technical aspects of bariatric nursing commensurate with the standards established by the American Society for Bariatric Surgery for effective and safe patient care (Best Medical Jobs ). This exam comes as no surprise, because one would not want a person who doesnt fully understand what bariatrics involves helping them with his/her weight and medical problems. An exam like this would measure how well the individual knows and can put into action the basics

of weight loss surgery. This might involve something as small as taking a patients blood
pressure to something a little more difficult such as gathering and determining a patients mental health stability before and after the surgery. When it comes to the exam, there are guidelines and handbooks that may help with studying and getting ready for it. The ASMBS has developed this Candidate Handbook to describe all aspects of the credentialing process and assist you in preparing for the examination. This handbook contains an overview of the examination, the admission policies, and rules for the examination, and other pertinent facts you should know about the administrative policies governing the examination. It also describes the content and procedures for all parts of the examination. Sample questions are provided to help you become more familiar with the types of questions appearing on the comprehensive multiple-choice examination (American Society for Metabolic and Bariatric Surgery). After taking this exam and hopefully passing a bariatric nurse can look forward to their new duties in the weight loss field of medicine. Because these nurses are basically registered nurses, their pay would average around the same that general registered nurses make. In the Occupational Outlook Handbook Median annual wages of registered nurses were $62,450 in May 2008. The middle 50 percent earned between $51,640 and $76,570. The lowest 10 percent earned less than $43,410, and the highest 10 percent earned more than $92,240. These are old figures, but it seems likely that the pay in 2011 and beyond would be the same if not more than in 2008.

The future outlook for bariatric nurses would seem to be growing. Due to the increasing amount of obesity in todays society amongst both adults and adolescents it looks like there will

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be many more bariatric surgeries to come which means more bariatric nurses will be needed to care for these patients. The role of the bariatric nurse would stay the same. They will have to monitor [A] patients blood pressure (BP) and pulmonary function should be optimized before surgery and any preoperative abnormalities in lab values corrected. If the patient smokes, encourage her to stop. If the patient is a woman of childbearing potential, tell her to use reliable birth control to avoid becoming pregnant before surgery and in the first postoperative year (Gallagher 60). They might also have to measure the patients mental stability and inform them of the lifetime commitment. These are all things that future and present bariatric nurses have to do before the actual surgery, but there are more responsibilities for after surgery patients. Postoperative or right when a patient comes out of surgery the nurse will need to check all vital signs, make sure no blood clots develop in the legs since there will be minimal movement, check for any bedsores, and move them so that the risk of bed sores does not increase. More importantly and more life threatening a bariatric nurse will need to look and stay focused on paying attention for any possible bariatric surgery complications. According to Gallagher any bariatric nurse that may Suspect an anastomotic leak, abdominal compartment syndrome, internal bleeding, or sepsis if the patients abdomen becomes rigid, hemoglobin and hematocrit fall, potassium rises, and the patient complains of nonincisional abdominal pain, or if her lab results indicate metabolic acidosis. Fever, tachycardia, and dehydration may point to sepsis related to a gastrointestinal leak. Notify the surgeon immediately if any of these changes occur (62). The most important thing that a bariatric nurse should do during this time is to make sure that the patient understands that the surgery went successful and that he or she is doing just fine. If there are complications the nurse should calmly tell the patient and try to reassure him/her that

everything will be all right. Most patients will be groggy after this procedure and will have a range of emotions. The bariatric nurse should be prepared for individuals who are grumpy and want more pain medication to those who wake up happy and are ready to leave the hospital. All in all the future of bariatric nursing resembles the present state with a lot of possible growth in the field. After researching the past, present, and future of bariatric nursing it seems to me that making the final decision to become one would be recommended and enjoyed by myself. There is a lot of work to be done to get into this field, but I find that the benefits and the ability to say that I helped someone become one less obesity statistic are very rewarding. Of course any type of nursing is rewarding for the people who enjoy and make it a career, but weight loss appeals to me because it has become a personal goal of myself to lose weight and to help my family become much more healthier. A number of things stated in my research are things that I have experienced before.A mother, a grandpa, and an uncle of mine have all undergone bariatric surgery because they had been struggling for years to lose weight. Their results are fantastic; together they have lost a total of 250 pounds and are still losing. Every time one of my family members goes to their bariatric doctors office, I try to join them. The bariatric nurses that they have are wonderful and inspiring. They keep encouraging their patients to lose weight even when the patient feels like they have come to a plateau and can lose no more, its incredible. With all of this, I can say that bariatric nursing seems like it would be the perfect career for me.

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Works Cited American Society for Metabolic and Bariatric Surgery. "Certified Bariatric Nurse Examination Candidate Handbook." American Society for Metabolic and Bariatric Surgery Fall 2009: 1-30. ASMBS. Web. 21 Feb. 2011. "Certified Bariatric Nurse | Best Medical Careers Top Medical Jobs." Best Medical Careers Top Medical Jobs. N.p., n.d. Web. 21 Feb. 2011. <http://medicalcareersite.com/2011/02/certified-bariatric-nurse.html>. Gallagher, Susan. "Taking the weight off with bariatric surgery." Nursing 1 Mar. 2004: 58-63. Print. "Improving the Nursing Care of the Morbidly Obese." National Association of Bariatric Nurses. N.p., n.d. Web. 21 Feb. 2011. <www.bariatricnurses.org/index.html>. Occupational Outlook Handbook, 2010-2011. 2010-11 ed. New York, N.Y.: Skyhorse Pub., 2010. Print. "Weight-loss surgery is an option for many.." Harvard Women's Health Watch. June 2006: 6-7. EBSCOhost. Web. 19 Feb. 2011.