Bariatric Specialist Nurse
Observing Change
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Teamwork – the key to successful weight loss surgery
This time last year, all eyes were on the Beijing Olympians. The first gold medal for Great Britain went to cyclist Nicole Cooke who sprinted across the line and as she did, marked the pinnacle of an eight year international career. Cooke, an outstanding individual athlete, paid fulsome tribute to her support group after receiving her medal. ‘Team Cooke’ as she described them contained her coach, performance manager and family members, all of whom had the goal of getting Nicole to the Olympics, and allowing her to perform to her full potential when she was there. ‘It’s a team effort ‘she explained.
But what relevance does the achievement of an elite athlete have for a person considering weight loss surgery? The answer may surprise you - plenty. Weight loss surgery can and should be a life changing event. Many patients describe their operations as a ‘second chance’. For them it’s a massive life event and a chance at last to gain control of their weight problem. A truly Olympian challenge, if you have struggled with obesity for years or decades.
To fulfil the potential that weight loss surgery offers, everyone needs their own version of ‘Team Cooke’. So, if you are considering weight loss surgery, who do you need on your squad? Well, the first thing to say is, you are the boss,- which means for this project you call the shots – so if you don’t like or have a bad feeling about anyone at all – they’re off the team. Everyone has to have your best interests at heart.
Who is first pick? Well, you might not want to broadcast the fact that you are considering surgery, but you should see their specialist with your partner or a close relative alongside. They can provide support, and it’s always easier to talk about what you learned from the consultation with the specialist with somebody who was there. Which brings us to the surgeon, It goes without saying that he or she should be highly experienced and technically expert, but they must also be able to provide, in person, the coaching and guidance for as long as needed after the operation to get the right results. A specialist nurse in obesity surgery is a must to provide advice and support, and explain new symptoms that can occur after surgery and provide reassurance. The best obesity surgery services now provide 24 hour access to this specialist advice. An experienced specialist dietician is an absolute necessity – he or she will be the bedrock of the new eating regime that leads to results. Finally the hospital itself – is it clean and safe, close and convenient with follow up clinic times that suit your lifestyle? Are they truly committed to the needs of patients undergoing obesity surgery – when you walk in, do you feel as though you are among friends?
So if it seems to you that there is a lot to think about when considering obesity surgery, you’d be right. But the best news is, with the right team behind you, you have every chance of achieving your own, personal Gold Medal.
An appeal for a return to ‘etiqutte-based medicine’
Robert Macadam comments on a provocative article in the leading medical journal The New England Journal of Medicine.
It’s fair to say that US psychiatrist Michael W Kahn MD hit a nerve with his leading article in the New England Journal of Medicine published on 8 May 2008. In his view, modern medical teaching of the skills of empathy and compassion may have been emphasised at the expense of the older attribute of good manners. He wrote ‘I may or may not be able to teach students or residents .to see things through the patient’s eyes... I think I can, however, train them to shake a patients hand, sit down during a conversation, and pay attention’.. His own (European–born) surgeon impressed him with behaviour in ‘dress, manners, body-language [and] eye contact’ that he described as ‘impeccable’. ‘I found myself thinking’ he went on’ “What a professional” and even (unexpectedly), “What a gentleman”’. His appeal for a return to previous standards of etiquette suggests that it would ‘put professionalism and patient satisfaction at the centre of the clinical encounter’.
His points are well made, though I would hope that on this side of the Atlantic, standards of behaviour have been preserved somewhat better. However, we also have to deal with changes in social norms, and the way doctors
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