Bariatric Patients Sew Success with Inspirational Quilt

by Linda Trainor, RN, BSN

Ms. Trainor is from Beth Israel Deaconess Medical Center, Boston, Massachusetts.Funding: No funding was provided.
Disclosures: The author reports no conflicts of interest relevant to the content of this article.

Photos:
The “Now I Can” Quilt

Examples of “Now I Can” Quilt statements

Bariatric Times. 2013;10(5):14.

Stepping on the scale in the bariatric clinic at Beth Israel Deaconess Medical Center in Boston, Massachusetts, used to be an all-encompassing experience as patients nervously anticipated what the all-important number would register.
Sighs of relief, smiles of joy, self-deprecating comments, and giggles of happiness are only a few observations made during my seven years of working as a registered nurse in the bariatric clinic.

Witnessing the scale registering a significant 100-pound weight loss in eight months or four pounds in one week is not uncommon in the early stages following weight loss surgery.  Patients are most often very pleased with these results. But as patients’ eyes lower to the important number on the scale in the latter months, when weight loss is not as drastic, patients sometimes appear frightened, puzzled, or, at worst, discouraged.

The fact is that the use of the scale does provide an accurate body mass index (BMI) for clinics, but clearly does not have the capacity to speak to a patient’s real success. In fact, I have found that the scale can sometimes be inversely proportionate to a patient’s well-being. Even slight elevations in weight, or staying at the same weight, have bothered many patients, as their eyes are glued to that number—rather than on the prize of a better quality of life.
I specifically recall discussing quality of life changes with one puzzled patient who was visibly shaken that the number on the scale dared remain the same after she incorporated an exercise plan into her daily routine. She even asked if she could remove all of her clothing and put on a hospital gown to help register greater weight loss.
“How would your life change if the scale registered two pounds less today?” I asked her. The patient pondered the question for a moment and answered, “Quite frankly, it wouldn’t.”
It was a humbling moment for her as a patient and for me as her nurse.
“Scales are for fish and not a true indicator of success,” I explained. We both laughed.

The mood shifted as we concentrated on how her waistline was slimmer and her dress size went from 24 to 16 in a matter of months. Most heartwarming was when she shared that she had recently attended Parent Night at her child’s elementary school and was able to sit in her child’s chair. She shared how this moment spoke volumes to improving her quality of life compared to the number she just witnessed on the scale.

Shy of having the scale thank patients for their patronage and loyalty, our bariatric team designed a way to shift the focus away from a number at the time that weight is measured, to the quality of life the patient is experiencing.
Staff and patients collaborated as a team to create the “Now I Can” quilt. The idea, which originated from the multidisciplinary bariatric team, was to have patients showcase their success stories in a personal and profound way.
Patients were simply asked to submit on an index card a “Now I Can”—something specific that they could not do prior to having weight loss surgery. Patients were asked to include only their date of surgery and initials with their “Now I Can” statement.

One patient, a school teacher, shopped for colorful material to create the quilt squares. The finished measurement of the quilt would be 10 feet by 10 feet, with 4 x 4-inch squares. A larger square was placed in the center of the quilt with a clear and concise message: Now I Can. The border proudly repeats a ceremonious theme of endorsement: “I think I can. I know I can. Now I can.”

Another patient, an artist, volunteered to transcribe the many messages from the index cards to the squares of material, and then sew them all together.

Patients who helped the project along were happy to volunteer, saying that it was their way to thank the bariatric team for their continued support prior to, during, and after their respective weight loss surgeries.

The quilt not only fashions patients’ success stories, but also helps to create a clinic without walls.
Many new patients as well as postoperative patients are thrilled to read the written messages on the quilt that include such “Now I Can” statements as the following:
•    Have hope again
•    Fly on an airplane without an extension belt
•    Dance
•    Look in the mirror
•    Live my life without taking medications.

Our bariatric quilt was a collective effort that serves to inspire patients to change their perception. Our goal was to bring awareness to real changes, in real time, by real people.

The quilt hangs in the clinic right next to the scale. Now, when patients weigh in, they are squarely faced with their bari buddies’ living testimonials of their true measurements of success. The result is the best of both worlds because it cheerfully connects patients together while bringing awareness to individuals’ very own potential.
However, in addition to those many inspirational testimonials colorfully displayed on the front of the quilt, the most heartwarming message is really written on the back. It reads: “This quilt is dedicated to the brave men and women who have empowered themselves through the BIDMC weight loss program. Let this inspire change …”

“The “Now I Can” quilt, which was the brainchild of Linda Trainor, was an awesome idea that has rallied our patients together.”
-Dr. Dan Jones, Director of the BIDMC Bariatric Program

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