Fat Nurses Need Not Apply

A Texas hospital has declared war on the scourge of obese nurses:

A Victoria [Texas]  hospital already embroiled in a discrimination lawsuit filed by doctors of Indian descent has instituted a highly unusual hiring policy: It bans job applicants from employment for being too overweight. 

The Citizens Medical Center policy, instituted a little more than a year ago, requires potential employees to have a body mass index of less than 35 — which is 210 pounds for someone who is 5-foot-5, and 245 pounds for someone who is 5-foot-10. It states that an employee’s physique “should fit with a representational image or specific mental projection of the job of a healthcare professional,” including an appearance “free from distraction” for hospital patients.

“The majority of our patients are over 65, and they have expectations that cannot be ignored in terms of personal appearance,” hospital chief executive David Brown said in an interview. “We have the ability as an employer to characterize our process and to have a policy that says what’s best for our business and for our patients.”

It all sounds so, well, high-schoolish, and I don’t think the CEO is seventeen, though he’s acting like it. I mean, can you get any more shallow? Since when does physical appearance have anything to do with competence or worth or dignity of any health care professional?

Or maybe David Brown doesn’t really believe nurses actually have skills — we just stand around as decoration, lookin’ pretty.

And fitting the  “representational image” of hospital employees to meet patient “expectations?” What the hell does that mean, anyway? If  patients expect this (and this is a pretty common “representation”)

A representational image of a nurse

then hiring practices should make sure all nurses are boobalicious? What if the patients want all-white nurses? Or all females? Or no Muslims?

The man is a bit of a dink, obviously. I can only imagine how valued overweight nurses employed by this hospital must feel.

The article goes on to note that this David Brown, CEO of Citizens Medical Center, has some issues. In 2007  he wrote memo about some foreign-born physicians in which he  stated: “I feel a sense of disgust but am more concerned with what this means to the future of the hospital as more of our Middle-Eastern-born physicians demand leadership roles and demand influence.”  He continued, “It will change the entire complexion of the hospital and create a level of fear among our employees.”

Needless to say, there is a discrimination lawsuit over that.

So let’s summarize what the leadership at Citizens Medical Center believes: scary scary fat nurses scaring patients. Scary scary dark-skinned physicians scaring employees and patients.

Clearly a place where I would want to work. Or be treated.

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  1. #1 by Knot Telling on Tuesday 27 March 2012 - 1236

    How can this be legal in the US?

    • #2 by torontoemerg on Tuesday 27 March 2012 - 1237

      Apparently in Texas it is.

      • #3 by Knot Telling on Tuesday 27 March 2012 - 1443


      • #4 by student paramed on Thursday 29 March 2012 - 0551

        From my understanding (read: according to all Texans I have talked to), Texas really is its own country :P

  2. #5 by gregmercer601 on Tuesday 27 March 2012 - 1837

    When will people figure out that things leak? To the public? Amazing.

  3. #6 by torontoemerg on Tuesday 27 March 2012 - 1842

    Social media has changed everything — and every institution is under scrutiny. Most haven’t quite figured it out yet, or think Twitter and Facebook are trivial nuisances. Guess what?

  4. #7 by mog on Tuesday 27 March 2012 - 1944

    He’s obviously a bigoted idiotic plonker. So his racist leanings aside however…he does voice what many people think. I’ve read many articles on interviewers making up their minds in the first few seconds, about tall people being more likely to get a job than a short one, good looking vs plain, smart vs scruffy, fat vs thin, etc etc. Fatism is the latest and most acceptable bias. So if one is a chubster then one is more than like to fail that interview.

    I know that it’s wrong, but, but, there’s a GP in my local practice who is well into grossly obese and I would not like him treating me. Oh no.

    • #8 by The Nerdy Nurse on Tuesday 27 March 2012 - 1947

      Here’s the thing about overweight individuals in healthcare, just because they don’t practice what they preach does not make them any less competent of a provider.

      It’s really unfortunate that you would judge a persons ability to provide you with competent medical care based upon their appearance.
      Really? Are we really going there?

      • #9 by mog on Wednesday 28 March 2012 - 2303

        I never said that it was a good thing that I felt that way now did I?? Reread my post and you will see that I know it’s wrong.

        However it exists. We all judge people by appearances, perhaps some of us are more enlightened than others. I try but it’s hard to be perfect.

        Now this particular CEO does sound very strange indeed but is there a tiny valid point in there somewhere? At what stage does morbid obesity become a disability and/or a health and safety hazard? Is there a stage when patient care is compromised by the doctor being 400lbs and barely able to stand for long enough to examine the patient? So instead of making adjustments he cuts corners. For how long can he perform CPR, can he still bend to intubate or it that compromised?

        It’s not all about appearances. However If people don’t judge by appearances then why do we bother trying to look professional at work?? We want our patients to have confidence in us. In my basic training we were told; look and be clean, no extremes of appearances, nothing overly offensive. It’s a fine line.

  5. #10 by The Nerdy Nurse on Tuesday 27 March 2012 - 1944

    This is beyond disturbing.

  6. #11 by Wander on Tuesday 27 March 2012 - 2043

    You can’t make this stuff up. The justification for not hiring over a certain body mass was ageist (patients over 65 have “expectations”) as well as stupid and incoherent, but the inadvertent racism (in addition to the overt racism) of “changing the entire COMPLEXION” of the hospital and creating “fear among our employees” (dark people = Bin Laden) is just hilarious.

    Also, passing the prejudice buck to “our employees” is an added outrage. Don’t wear a hoodie near that hospital; the CEO might shoot you.

    • #12 by xraytech in VIRGINIA on Wednesday 28 March 2012 - 1123

      I think the CEO’s internal justifications are more than aesthetic. There’s a hidden message. Employee health costs, sick days, injuries are all a part of that CEO’s thinking.
      I’m sure he has a hunch based on bad statistics and is trying to save a buck. It’s a poor attempt at reducing costs. Welcome to Dink Hospital.

      • #13 by torontoemerg on Wednesday 28 March 2012 - 1837

        Yes there’s that, I suppose, though the CEO was pretty clear it was all about appearance.

        Frankly I don’t know which rationale is uglier.Or meaner.

  7. #14 by T on Wednesday 28 March 2012 - 2342

    Maybe if those asshole hospital CEOs stopped forcing nurses to work roatating shifts, which destroys their health and makes them eat at all hours, maybe the nurses could get back in shape.

    No thanks to this rule.

  8. #15 by Anonymous on Thursday 29 March 2012 - 1455

    OH Boy, I can hardly wait till the discussion gets around to Smokers…………..

    • #16 by torontoemerg on Thursday 29 March 2012 - 1958

      Oh that has already happened in some places.

    • #17 by GrannyRN on Thursday 30 May 2013 - 0104

      That is already happening. There is a hospital group in Southwest Georgia which forbids the use of ANY kind of tobacco product…(includes smokeless products as well).
      Personal privacy is under attack like never before in Amerika…

  9. #18 by Bradford & Bradford, Attorneys at Law on Friday 06 April 2012 - 1009

    Reblogged this on Bradford & Bradford, Attorneys at Law – The Blog and commented:
    I think this hospital better consider hiring a new CEO or it will have to spend all of its profits defending lawsuits.

  10. #19 by Granny RN on Saturday 07 April 2012 - 1020

    No one who uses any kind of LEGAL tobacco products, no nurses over age 50, no FAT people, etc. etc. Big Brother doesn’t have enough experienced RNs so he can afford to discriminate so blatantly?
    And in a place called the ‘Citizens Medical Center’. (Ever notice how such institutions-even governments-go by something like that name?) People’s Republic, Democratic Republic, etc.
    This kind of discrimination SCREAMS fascism As in Nazi Germany, Bosnia, Cambodia and countless others. WE only want a certain ‘type’ of individual working HERE. So what’s next? No Jews, Mexicans, Catholics, redheads, short people, veterans with artificial limbs, …(fill in the blanks).
    Does this place ban the presence of vending machines? Do they cook fried foods and desserts in the cafeteria? Are the ‘diet police’ on patrol in the units with portable scales? Is ‘morning PT’ required each day before work, as in the Army?
    Individual freedom is under attack in this country like never before. And most of it is coming from the private sector. We must defend our liberties and not give up our Civil Rights just to get a job!

  11. #20 by Beenthere! on Saturday 07 April 2012 - 2201

    Hey it is in the State of Texas! A Right to Work State. A very strong Right Wing Republican State. They do what they want to do to the “help” Nurses are nothing more than the “help.” The do not have the best of track records for patients to begin with. The care for psychiatric patients ranks at the bottom if not the last for the country. The treatment for the homeless the veterans in general is pitiful. Once again, it is a Right to Work State, Right Wing Republican State, yeah sure they still happen to be in the USA. They hate what they peceive to be “social” type programs. Nurses, teachers, laborers are just low level worksers. We are seeing the evaporation of the middle class. We will have the rich, the ultra rich and then the working class and the poverty level. Nurses, teachers are becoming just a member of the working class. Bye bye middle class. What does Texas and Arizona have in common? A lot. How they treat people they consider “labor”, in general.

    A post above questioned if they ban vending machines? Depends, do they get a profit from them?

  12. #21 by Beenthere! on Saturday 07 April 2012 - 2209

    As far as the post on lawsuits. Right to work states generally have a form one must sign in order to maintain employment. I know in Arizona, we had to sign it that stated we knew we could NOT sue our employer. You lose your liberties in these types of states. Smokers have to sign and some places tested for nicotine (if the hospital was totally non smoking) and yes hospitals can choose to hire only NON smokers. Generally they give the smokers awhile to get off the cigs and the (stuff) to help them get off. Some places charge them higher insurance premiums and yes do some sort of testing. If they state they quit. Not sure exactly what it is called as I am not a smoker. Private hospitals and facilities have been doing this for years!

  13. #22 by Granny RN on Sunday 08 April 2012 - 0036

    These privately-owned/operated hospitals may have been ‘doing it this way for years’ but it is high time that the same system which operates under the U.S. Constitution makes itself known to them. After all, I have NO doubt that this and most other hospitals receive MEDICARE as a payor source. And, as we all know, Medicare consists of Federal Tax Dollars and is administered by the Social Security Administration. One HUGE reason for passing what used to be called the Joint Commission’s survey for accreditation was so that a facility could GET those Medicare Dollars!
    MediCAID on the other hand is part Federal and part State but still TAX DOLLARS at work.
    Let us not forget that the fastest way to LOSE your rights is to sit back and let someone take them away.
    So, to all who would violate the Rights of the Individual just so that one can work for you, it is past time for the lawsuits to be filed fast and furious. Nurses have a perfect opportunity to band together if they only would in order to fight this kind of discrimination.

  14. #23 by Linda on Monday 09 April 2012 - 0945

    As a native born Texan, I am saddened that you should take your bigoted paint brush to all of us. Should I say that all Californians are self involved plastic surgery addicts, or that all New Yorkers are arrogant, no manners asses? We are professionals here folks……I am assuming…..we should fight against the arrogant, stupid, clueless administrators that run our hospitals, is he really that much different than most others out there. Hospitals and health care began to suffer most when we stopped thinking about caring for sick people and started trying to improve the profit margins. Hospitals becoming corporations was the worse thing to happen to health care. Let us not digress into harping at one another……we the nurses have more power than we know or use…..but instead we would rather eat our young, bite each other and blame, blame, blame……

    • #24 by torontoemerg on Monday 09 April 2012 - 1004

      I don’t think anyone was making assumptions about Texans, just that the State of Texas does have labour policies which are unfriendly to average workers and tend to favour employers… conditions which, as you correctly point out, are not unusual in the U.S.

    • #25 by Granny RN on Monday 09 April 2012 - 1652

      You are correct. It is not fair to ‘blame’ the whole state on the actions of a few. However, with social media and ‘news in a flash’ these days it doesn’t take long before just one bad apple makes the whole bunch look bad, as in the Arizona case involving Amanda Trujillo.
      Nurses have a perfect opportunity NOW to stand up as a united group against all kinds of discrimination, if only we WOULD!

  15. #26 by Beenthere! on Tuesday 10 April 2012 - 1113

    I wasn’t trying to insult your state. I was just attempting to point out the big picture. The ramifications that our government can have with the Right to Work states can do a real number on people. I pointed out some things about Texas because I too live in a Right to Work State called Arizona. I personally am not proud of Arizona. However, I must face the facts. Arizona is also at the bottom with it’s care for the mentally ill people when compared to the rest of the country. Am I insulted when the stats point this out? No, because it is a fact. I see it every day./Am I in the minority when I try to speak up for the patients or nurses (or other healthcare worker) at my jobs? YES! Do I find other nurses speaking up? NO! We cannot change what we fail to acknowledge. I am ashamed of my own state due to the majority of nurses that merely do whatever they are told. They accept things as is. They are Stepford Nurses. They become very apathetic. They will not speak out for their patients or their fellow nurses. There are obese people everywhere no just Texas. All I was attempting to get across in my prior post was: abuses like that can be done much more likely in Right to Work States. I know they can because I live in a Right to Work State. We need to quit taking things personal and just deal with how they really are.

  16. #27 by DB, RN on Tuesday 24 July 2012 - 1212

    OK, I’ll say it.

    I for one am glad this is being addressed. The truth hurts.

    Fat, unhealthy nurses are the elephant in the room that nobody talks about, and we’ve been ignoring it too long. Or worse yet we make excuses.

    Healthcare providers should also be providing a good example of health. Lets face it, we have a lot of fat patients too. We know they need to lose weight. Someone should tell them. But if the nurse is fat, they really can’t give that advice, can they? They’d be a hypocrite.

    No patient is going to listen to a hypocrite.

    And discriminate? Really? If you went to a gym and hired a personal trainer, would you hire the fit one or the fat one? Come on, don’t “discriminate” now…

    And yeah, fat doctors. That needs to be addressed too. But docs bring $$ to hospitals. Nurses are on the payroll. So nobody is going to tell the docs what to do. You don’t want to upset your cash cows…

    So yeah, Nurses will scream “discrimination” and file lawsuits to defend the right to be obese.

    Meanwhile, that pesky obesity epidemic will continue costing this country billions in diabetes, back problems, joint problems and heart disease to name a few.

    Yes. I am an RN. One who goes to great lengths to eat only “real food” and stay fit. And be that example.

    • #28 by joljenni on Monday 12 January 2015 - 1518

      I get your analogy about trainers but it is flawed….trainers are paid to be fit and make you fit….nurses are paid to be knowledgeable about health sciences…not to be skinny. And last I checked everyone’s brain weighs roughly 3 Lbs.

  17. #29 by L on Monday 20 August 2012 - 0134

    You know I respect the nurse considering my wife is an RN. I look at the nurses like how I did the chain of command when I was in the Army. The enlisted to all the crappy jobs, hours, schedules, and etc. While Officers whom are essential doctors in this case, dodge duties, sit out back in Iraq and smoke Cigars,( had a bunch of enlistees build a gazebo to smoke them as well, F**** BS!) sorry that’s a side track! lol. I mean the nurses are the line-units in hospitals. I mean big effing whoop mr. Doctor man you went to school and theorized in class for 5 years till you even touched a patient while nurses on the other hand have that ‘battle-experience’. Yes they can’t preform major surgery, but I’m sure given the time they could.

    Any who, on to my original point but that was just to show my concern for status of nurses and how they’re treated sometimes. Sorry to say I’m falling a exercise science and fitness major, and I utterly hate overweightness. I understand the stress and crazy hours, but heck there are ways to combat things like that, trust me I’ve been in high pressure situations. It sickens me a little to see health care providers not really care for themselves you know? I think that’s the major issue on here, is appearance of healthy up keeping not just in your job but your life. It doesn’t send a very good message to the patient, well at least to me anyways.


    • #30 by Granny RN on Monday 20 August 2012 - 1228

      First, let me Thank You for Serving! My son-in-law is about to deploy to the Sandbox for the 2nd time next year and God Bless all U.S. Service men and women who have kept the fight away from our shores since 2001.
      I know that your wife would tell you this so I will too: We NEED people like you who are into the physical training/therapy side of things! So if I may suggest, take a step back and reassess whether your current course of study is REALLY where you need to be right now. As you know, Results-Not Effort! are what really count and you cannot help anyone if you are on the bench. Also, more info is coming to light about the push for advanced college degrees as Higher Education has become Big Business vs. Vo-Tech programs which can open doors to high paying jobs and experience that is unparalleled. Personally I ‘tried on’ Nursing by going to a Nursing Assistant program at the local vo-tech school BEFORE I enrolled in a 2 year RN program.
      I always want to see our veterans succeed when they rotate back to the ‘World’, and once had a Navy Captain who compared Nurses in hospitals to NCOs in the Military-they are the ones who actually RUN the place and get things done, as you know from experience.
      All the Best to you in your studies and future endeavours!

  18. #31 by ash on Sunday 03 February 2013 - 1810

    guess what – i dont want a 400 lb nurse taking care of me, or lifting my elderly mother and falling on her? or giving out advice they dont take themselves. nursing is a physical Job and no woman over 200 lbs is healthy enough to do so.. it isnt discrimination – do you see 400 lb people at the olympics?

    • #32 by GrannyRN on Sunday 03 February 2013 - 1942

      Actually there ARE Very Overweight People at the Olympics-in the Weight Lifting Events…

  19. #33 by GrannyRN on Saturday 09 February 2013 - 1130

    Christine: I do not mind your use of my ideas as I have posted them so long as you keep them in the context of what I have written. -Granny

  20. #34 by Monika on Thursday 21 February 2013 - 1130

    There may be some in the weight lifting but they are NOT in the cardio or any type of endurance. We have to face the facts. It is NOT healthy to be overweight, period. Just like it is not healthy to smoke or eat unhealthy.

    • #35 by GrannyRN on Thursday 21 February 2013 - 1231

      It is not healthy statistically to LIVE, period. To eat, smoke, drink alcohol, drive, cross a busy street, breathe the air in big cities, exercise too much and so forth.
      There are numerous incidents of Olympic-class athletes whose immune systems are so overwhelmed by that level of ‘fitness’ that they develop cancers, infections and even genetic changes at a higher rate than the ‘unhealthy’ general population (ScienceDaily, 2007).
      I am not advocating obesity any more than smoking, drinking or doing any other type of ‘legal’ activity which compromises health.
      But, it is important to acknowledge ‘extremes’ in ANYTHING as being ‘unhealthy practices’.
      It is also critical that we not allow our Right to Choose (how we live) to be taken away by employers, politicians or anyone else.
      NO ONE lives a perfectly healthy lifestyle unless they are in a Bubble. And THAT is anything BUT healthy!

  21. #36 by TheNerdyNurse on Sunday 17 November 2013 - 1612

    I think the issue that people are missing here on this one is that it isn’t just nurses who are overweight. In America, it’s a large portion of the population. However, Head Nurse points out that about 50% of the nursing workforce are considered overweight, which is a touch higher than the general population http://bit.ly/1bRQeUT .
    If I had to put my finger on the reason for this it’s probably stress. It will cause you to stay overweight even if by all calculations you are eating less calories than you are burning. I we could reduce the stress level for nurses, I believe that our BMIs would go down with it.

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  25. #40 by Susan on Wednesday 18 June 2014 - 0944

    Speaking as a patient, fat doctors and nurses inspire no confidence. And as for middle eastern or Indian-trained doctors, the cultural gap is significant, to say the least. Not my cup of tea, generally. Evaluations of fitness/competence should be based on objective criteria only, however. Being morbidly obese doesn’t bode well for being able to perform in patients’ best interests. Neither does graduating from an inferior school. But maybe being at the bottom of the class in an inferior school would be a good sign, since the ranking would be influenced by the opinions of inferior instructors.

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  28. #43 by Kay S on Sunday 15 May 2016 - 2209

    I agree that the nursing staff need to set an example of being well groomed, not smoking and of proper weight and propertion. The fatness is not healthy or appealing and out of control to the point of forcing people to think this is the norm! It’s not ok to present that image in healthcare at all. Slender or average, more proportioned staff with good hair, teeth and skin are not treated nicely by overweight women who are miserable…. Sadly, but reverse discrimination goes on in the workplace. Smoke, have a bunch of tattoes, piercings, be hateful, have no concern for your weight and body image, be 300 lbs literally and you will be so respected and the top nurse. This is the common scenario these days. I commend this doctor for speaking truth. Whatever happened to looking professional and setting examples? Also, tired of foreign staff I do not understand nor do patients… They need to speak clear English and not impose their customs on anyone.

    • #44 by Kay S on Sunday 15 May 2016 - 2225

      I agree that the nursing staff need to set an example of being well groomed, not smoking and of proper weight and proportion. The fatness is not healthy or appealing and out of control to the point of forcing people to think this is the norm! It’s not ok to present that image in healthcare at all. Slender or average, more proportioned staff with good hair, teeth and skin are not treated nicely by overweight women who are miserable…. Sadly, but reverse discrimination goes on in the workplace. Smoke, have a bunch of tattoes, piercings, be hateful, have no concern for your weight and body image, be 300 lbs literally and you will be so respected and the top nurse. This is the common scenario these days. So tired of the excuses people use to have football broad shoulders, gigantic bellies, no curves in right spots, bad posture, bad skin and hair…. So very gross. I walk the floor a 12 hour shift and lose weight and stay fit. Be a true lady in your manners and elegance as a woman. Looking manly and badly groomed is WRONG. God did not design you to let yourself go to come to work and throw your weight around. I’ve met very few overweight women in healthcare who were nice or truly more competent than someone not overweight and well groomed. So, no excuse in this field. I commend this doctor for speaking truth. Whatever happened to looking professional and setting examples? Also, tired of foreign staff I do not understand nor do patients… They need to speak clear English and not impose their customs on anyone.

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