The conversation with Jane

Jane was a young adolescent aged 15 who I was looking after and once came up to me and revealed that she had low self-esteem, felt lonely and depressed because of her weight. This conversation took place between me and her at her place while her parents were away leaving only the two of us in the house. The conversation took place for about an hour during which she divulged that she was huge from her childhood and this is a genetic disorder in her family. It wasn’t such a bother till she was 10 and one of her classmates  called her a “fat ass” and that was the onset of her low self-esteem  She stated that she was bullied and harassed  at school by both her schoolmates and teachers, had no friends and was often very lonely and as result she had sank into depression. She was quite worried that no one would ask her out because of the fact that she was obese and called herself ugly. She disclosed that she highly blamed her parents for not helping her regulate her diet and not encouraging her to take part in physical activities. Instead they didn’t let her play with other children and that left her with an only choice of staying indoors and playing with her toys. She was also bitter with her parents because they never assured her of her beauty thus making her believe what her peers told her. .Moreover, she said that she dreaded going back to school after the summer. I told her that I had gone through the same situation and we could craft a diet plan that could help her.

During this conversation and during   the time i took care of her, I had a series of feelings. When she opened up to me I felt sympathetic because I had had a similar experience while I was in highschool.Like her, I had suffered from obesity from the age of 12 to 20 and therefore I could relate with her situation. I also regretted not encouraging her to open up prior to her speaking up. There was a sense of fulfillment since she thought of me as a person she could confide in .I was also very proud of her since she  took a very brave step of coming to me and opening up because most teenagers suffering from obesity shy away from talking about it. I felt accomplished due to the fact that I was able to convince her to let me help her come up with a diet plan that would go a long way into helping her lose weight since I had used the same diet plan on myself as a teenager. However I felt inferior since I wasn’t able to tell her parents that she needed their support

Personal feelings during and after the conversation

On evaluation, the event had both negative and positive contribution to my career and my personal life. Firstly we were able to come up with a diet plan that highly helped her to lose weight throughout my period of caring for her and gathered the courage to ask for support from her parents (Champagne, et al., 2011). It went a long way into assuring me that I was in the right career since I was able to help her. It greatly contributed to my experience with adolescents suffering from low self-esteem due to obesity. I had not handled anything related to this since the onset of my nursing course and this particular event aroused my interest in dealing with this group of people and therefore I did an intensive research on the impact of obesity on teenagers and the remedies for this problem. Zeller, Reiter?Purtill, Jenkins and Ratcliff (2013) discovered that there is close association between being overweight and suicidal ideation even in adolescents. Teenagers have a certain pressure to have a specific body shape. Failure to conform to this patterns leads to suicidal thoughts (Reeves, Postolache & Snitker, (2008). I therefore felt that I had failed to address this issue simply because she had  not brought it up .I however felt that I should have had this information before having this conversation so as to find out if she had experienced any suicidal thoughts. This period was also very challenging since I couldn’t face her parents and point out the contribution they had made in the low self-esteem their child was suffering from since they were my employees.

On contemplation, I drew a conclusion that the patient opening up to me was a very brave and positive move because she had an option of keeping it to herself (Karlsson, Rydström, Enskär, & Englund, 2014).. The fact that I assured her that she could confide in me resulted in her giving me accurate historical and personal information about what she was undergoing. Sacks and Westwood (2003).in their article state “that without clarifying the limits of confidentiality while handling teenagers a nurse can get incorrect or incomplete information during history taking”. On reflection, I figured out that the fact that I had gone through bullying and low self-esteem due to obesity in my teenage hood really played a role in handling this situation. I assured her that what she was going through could be solved  and was able to inform her  of the steps I took to overcome obesity.Moreover,I involved her in making of her diet and physical exercise plan. Johnson and Mollborn (2009) argue that adolescents always want to have feelings of maturity and independence in their own personal activities. They go through some psychological issues that require to be dependent on themselves when handling them. My ability to relate with the patient prepared me and assured me that I could deal with this situation if it comes up in another scenario. However, I failed to bring up the fact that she might have experienced suicidal thoughts due to depression since I wasn’t aware of it at the time of the conversation. Depression is popular among adolescents but often go unnoticed (Thapar A, Collishaw, Pine & Thapar K, 2012). Lack of knowledge on this matter made me feel that I had not handled the situation adequately and that I needed to conduct intense and further research on this particular matter in order to cover this matter extensively in the future (Fox, Gross, Rudser, Foy, & Kelly, 2016). Furthermore, I failed to confront her parents on their lack of support for their daughter and this made me question my career choice.

Positive and negative contributions to career and personal life

Conclusion

Looking back, there are things that I should have done differently. Firstly,I should have done intense research on the effects obesity has on teenagers since I was looking after someone with such a condition. This way, I would have found out about suicide being one of the significant results of obesity and thus would have brought it up. I also would have increased her involvement in making her diet plan because research by Sacks and Westwood (2003) shows that adolescents often want to be involved in matters  pertaining their health. In retrospect, I think advising her to see a therapist would have been a great idea since Gilbertson (2016) argues that self-esteem comes from the input of therapy in creating an experience of acceptance.

In future there are some elements that I will include in my action plan. Firstly, I will ensure that parents need to know they play a big role in their children’s health. Galati (2018) suggests that“ Parents are not paying attention to what they feed their children” and thus this leads to children suffering from obesity. Parents are therefore encouraged to support and ensure their obese children have a diet plan and encouraged to take part in physical activities so as to hasten the recovery process. I will also conduct extensive research on problems associated with teenage obesity in order to handle such situations effectively. I also plan to ensure my patient is ensured of confidentiality by introducing confidentiality forms since teenagers require trust from the nurse before they open up.

References

Champagne, C. M., Broyles, S. T., Moran, L. D., Cash, K. C., Levy, E. J., Lin, P. H., … & Loria, C. (2011). Dietary intakes associated with successful weight loss and maintenance during the Weight Loss Maintenance trial. Journal of the American Dietetic Association, 111(12), 1826-1835. doi: 10.1016/j.jada.2011.09.014

Fox, C. K., Gross, A. C., Rudser, K. D., Foy, A. M., & Kelly, A. S. (2016). Depression, anxiety, and severity of obesity in adolescents: is emotional eating the link?. Clinical pediatrics, 55(12), 1120-1125. doi:  [10.1177/0009922815615825]

Gilbertson, T. (2016) Does Therapy for Low Self-Esteem Really Work? GoodTherapy.org Therapy Blog. Retrieved 25 October 2018, from https://www.goodtherapy.org/blog/does-therapy-for-low-self-esteem-really-work-0520164

Johnson, M. K., & Mollborn, S. (2009). Growing up faster, feeling older: Hardship in childhood and adolescence. Social psychology quarterly, 72(1), 39-60. doi:  [10.1177/019027250907200105]

Karlsson, K., Rydström, I., Enskär, K., & Dalheim Englund, A. C. (2014). Nurses’ perspectives on supporting children during needle-related medical procedures. International journal of qualitative studies on health and well-being, 9(1), 23063. doi:  [10.3402/qhw.v9.23063]

Reeves, G. M., Postolache, T. T., & Snitker, S. (2008). Childhood obesity and depression: connection between these growing problems in growing children. International journal of child health and human development: IJCHD, 1(2), 103. Retrieved 25^th October 2018 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2568994/

Sacks, D., & Westwood, M. (2003). An approach to interviewing adolescents. Paediatrics & child health, 8(9), 554-556. Retrieved 25^th October 2018 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2794315/

Thapar, A., Collishaw, S., Pine, D. S., & Thapar, A. K. (2012). Depression in adolescence. The Lancet, 379(9820), 1056-1067. doi:  [10.1016/S0140-6736(11)60871-4]

Zeller, M. H., Reiter?Purtill, J., Jenkins, T. M., & Ratcliff, M. B. (2013). Adolescent suicidal behavior across the excess weight status spectrum. Obesity, 21(5), 1039-1045. doi:  [10.1002/oby.20084