Fat Nurses Need Not Apply Revisited

More on the Texas hospital, Citizens Medical Center, which banned fat people from being hired. Citizens Medical Center, you might remember, made it policy to exclude new hires with a body mass index >35, and explicitly stated employees appearance should “fit with a representational image or specific mental projection of the job of a healthcare professional . . . free from distraction” for patients. Medscape has a video (sorry, couldn’t figure out how to embed) from a medical ethicist named Art Caplan with another point of view. Partial transcript:

Look, I’m all for trying to set a good example and I think there are plenty of businesses where being thin and being in shape really do matter. I guess if you run a modeling agency it is very important. But I’m not convinced, really, that putting in weight restrictions is the best idea in terms of sending out the right message or a necessary message to patients. Patients, I think, can work with their doctors to try to overcome common problems. Doctors see all kinds of patients with all kinds of habits and all kinds of lifestyles. I think patients can deal with seeing all kinds of healthcare workers with all kinds of habits and all kinds of lifestyles. If they want a thin one, they should be able to pick one, but I don’t think the hospital necessarily should have to say that only the thin ones can work here. [Emphasis mine.]

Really? That last bit sounds needlessly, well, stupid. Does he really think patients should be allowed to choose their health care providers on the basis of their appearance?  “Let’s see. . . ” one can imagine patients musing, “that nurse is too fat. Tht nurse is too old. That nurse is too. . . dark. That nurse is too male. That nurse is too Muslim. That nurse is too gay.” And so on. Apart from fostering bigotry and discrimination, and demeaning and devaluing staff, in practical terms, you’d soon run out of nurses. I mean, not every nurse looks is thin, white, young and female.

One more thing. I understand there is a role for hospital policies regulating appearance: hygiene, facial hair, tattoos, uniforms and jewellery are usually targeted. Fair enough. I also understand the need for an ethicist to weigh (so to speak) both sides of the issue, but isn’t there some point where, after all is said and done, you have to say evaluating people of the basis of their body characteristics  in general is just wrong? I don’t think that medical ethicist Art Caplan exactly said it was wrong. Making a value judgement, that employers treating nurses and physicians as human beings with inherent dignity and worth, is important. It might even be a good place to start.

[UPDATE] Also, too, these thoughts from a writer named Susan Pape at Policymic.com:

When I am in need of hospital care, I want the staff to be the best, hardest working, most talented, most caring available. I do not care if they are overweight. Employing health care providers on the basis of their competence is a matter of life or death …to me.


Obesity is not a choice, and it is not immoral.

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  1. #1 by jenjilks on Monday 14 May 2012 - 1141

    Playing Devil’s Advocate, isn’t there a certain amount of stamina involved?
    Many work situations involved being able to manage the physical demands of a job. Do you do a fair amount of lifting patients, as I see in my volunteer work?
    I have two clients over 200 lbs. and I am having a hard time pushing the wheelchair, and I chop wood, and work out 30 minutes per day. Not that I am slim, by any means, but I find there are physical demands that an obese person may not be able to handle.
    That said, there is a difference between BMIs and being fit. Thoughtful post.

  2. #2 by LC on Monday 14 May 2012 - 1340

    Great post – I’m surprised this issue hasn’t made it into large media headlines. You list some appearance related criteria hospitals have policies around that are ‘fair enough’. I get facial hair (N95 sealing effectively, jewellery et cetera) but why tattoos? Assuming they are not racist tattoos or some other offensive material what is fair enough in that?

  3. #3 by Thin and competent on Monday 14 May 2012 - 1901

    What if thin nurses are just as (if not more) competent than overweight nurses? Let’s say, as a hospital admin in charge of hiring, there are 30spots available…and there are 40 thin nurses and 40 overweight nurses applying, all of whom are clinically sound. Why not hire 30 of the thin, healthy, works-out-regularly, eats-well nurses? It makes sense to encourage and promote healthy lifestyles in a healthcare setting.

    • #4 by LC on Monday 14 May 2012 - 2102

      Yeah but there is a difference between making a choice as an individual manager when faced with multiple qualified candidates versus creating an organization-wide discriminatory hiring policy….

      • #5 by Kill Fatpeople on Sunday 09 February 2014 - 1409

        It’s not discrimination to exclude employees that don’t fit the profile. You have an obese heart patient with an obese nurse. Why do the surgery anyway?
        England considered that already. If you’re too fat, you don’t quality for a knee replacement. Go lose the weight first.
        This should also stand true for heart surgery and even more so. BUT, you can wait a while to lose weight to have your knee fixed. If your heart is shot, the wait may be very short until you’re shot.
        Have fat people tithe to their future surgery. Overweight by a hundred? Put 20 thousand bucks away to pay for your fat ass to be repaired so our insurance plans won’t have to pay for your bad choices in life.
        And spay and neuter PEOPLE too.

  4. #6 by evil is evil on Monday 14 May 2012 - 2348

    So, can I expect that overweight doctors will not be credentialed?

  5. #7 by jeanhill on Tuesday 15 May 2012 - 1135

    If a picture of health is what they are “aiming” for what about those who smoke cigarettes for example? People of all sizes, colours, backgrounds, etc take part in that unhealthy habit.

  6. #8 by Abdur Razzak on Wednesday 16 May 2012 - 0131

    Great Canadian classified website!
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  7. #9 by aaxkxopuf@gmail.com on Saturday 03 May 2014 - 1259

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  1. Fat Nurses Need Not Apply Revisited, Jay Doe, RN, 5/14/12, Those Emergency Blues, @torontoemerg, @nurseup #nursefriendly | Nurse Up!
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