I'm of two minds on this very subject, which is often hotly debated on my unit (and many of your own units, I imagine). I work in MICU and CVICU, and I deal with a lot of morbidly obese patients these days. A LOT. While inside my rational brain and my empathetic gut I know that no one could possibly enjoy living this way, and that not a one of us is perfect and will surely be on the other side of the bed rails at some point...I also take home an aching, screaming back from turning, lifting, and tugging these people. And, to be honest, many of these patients aren't the least bit grateful for any of my care.
Just last month I had a 600 pound man who obviously hadn't bathed in many months, yet expected a head-to-toe bath and linen change every day, along with pillow-fluffing and constant item-fetching, all with nary a "please" or "thank you." Now, I'm a smart gal. I realize that some people are just jerks, be they skinny or fat, and that one doesn't necessarily have anything to do with the other. However, my back starts back up with that familiar ache, that deep-down sting, and it gradually begins to override my good will. Yes, I do feel resentful and a little ticked off when I am expected to literally put my body and my livelihood at risk just to pull someone up in bed. Yes, I do think it's ridiculous that someone can cross the 400 pound threshold and not take ownership in order to make a change. And yes, I do think (at least in the patient population that I am personally serving) there is a serious lack of accountability on the part of these people. However, I try never to let my feelings interfere with my care. I do the best I can to be a good nurse, but I'm only human. Don't I deserve a little empathy as well?