The Challenges of Caring for Young Patients with Eating Disorders

Article Categories: Diseases and Conditions & Nurse On the Job

About 8 million Americans have eating disorders. Ninety-five percent (95%) of those people are aged 12 to 25. Ten percent (10%) start to experience eating disorders at ten years old or younger. There is a 119% increase in hospitalizations in children younger than 12 years of age from 1999 to 2006, due to eating disorders. These numbers are alarming, and over time, nurses find themselves caring for more young patients who struggle with eating.

For starters, nurses in primary care spot red flags of the possibility of a child with these conditions. Weight loss or failure to gain weight expected of a child's height and fluctuations in weight are the hallmarks of disordered eating. During a more detailed physical examination and history-taking, nurses may also possibly note dental caries and gum diseases, dull hair, fine body hair, or alopecia. Other warning signs include amenorrhea in teen girls, claims of being “fat” even if underweight, and reports of heavy exercise, anxiety, depression, and unusual eating patterns by either the patient or the family.

Now, let’s look at a few more numbers in order to better understand how nurses come into the picture to address the challenges of treatment:

One in every five people, or 20%, with severe eating disorders will die without treatment. With treatment, that number drops to 2-3%. However, only about 60% of those treated ever recover.

You see, the role of nurses in decreasing the number of affected children and adolescents is critical. Yet, nurses are faced with the challenges of providing proper care, some of which we have compiled below:

1. THE SECRETIVE NATURE OF PATIENTS CAN BE OVERWHELMING.

Nurses unknowingly or inadvertently play detective when caring for people with eating disorders because they have to look for telltale signs of purging, concealing or throwing out food, or any other means of reducing weight in secret. If they miss the signs, nurses can feel guilty and inadequate.

2. NURSES FEEL FRUSTRATED ABOUT DIFFICULT AND UNCOOPERATIVE PATIENTS BEING RESISTANT TO TREATMENT.

The resistance is difficult to deal with, using just therapeutic words. For example, nurses might encounter a patient with anorexia nervosa, who became unconscious and is receiving treatment. Once some strength is regained, the patient repeatedly pulls out their nasogastric tube.

3. NURSES FEEL THAT PATIENTS KNOW MORE ABOUT THEIR DISORDER THAN THEM, which is the case most of the time in adolescent patients. Power struggles happen because they lose control of the patient and the treatment.

4. THE NURSE CANNOT TRULY COMPREHEND WHY A PATIENT WOULD STARVE THEMSELVES AND NOT EAT.

With anorexia nervosa, for instance, although the condition is well-discussed in nursing books, encountering these patients in the real world brings out questions about how someone can override a very natural instinct for survival, that is, eating.

5. IT ALSO IMPACTS THE NURSE’S OWN BODY IMAGE ISSUES.

Nurses themselves may be battling body image concerns, and feel that they are ineffective providers of care to these patients.

6. NURSES CAN GET DISCOURAGED BY THE FLUCTUATIONS OF PROGRESS IN TREATMENT.

Nurses have goals they set with patients. And often, just when everything is falling into place and objectives are about to be met, the patient backslides and nurses find themselves back at square one. The sudden reversal can breed frustration and resentment in nurses.

7. A NURSE MAY LACK EDUCATION AND TRAINING IN THE CARE OF PATIENTS WITH EATING DISORDERS.

The treatment for anorexia nervosa and other similar conditions is very complicated. As a result, nurses feel that they lack adequate knowledge and training to make treatment successful. They do not feel confident and engaged to meet recovery goals with the patient.

The road to addressing the challenges of caring for young patients with eating disorders may be a long and bumpy one, but the future is hopeful if you focus your attention on finding solutions.

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