Overweight & Under Pressure : Is Nurse Fighting Textbook Case of Discrimination?

NEWPORT, R.I. —  Always a chubby child, Sharon Russell was put on her first diet at age 5, just about the time she decided to someday be a nurse.

But 15 years later, her plans were nearly thwarted when she did battle with the nursing staff at Salve Regina College here.

Catherine Graziano, dean of the nursing school at Salve Regina, said that Russell flunked a clinical training class required for graduation and that her weight was “never an issue.” But Russell, who is 5 feet, 6 inches tall and weighed 328 pounds while at Salve Regina, said she was “invited not to return” for her senior year in 1985 “because I am fat, and because they said I don’t fit the image of a nurse.”

Their legal dispute centers on a contract that Russell signed in 1984, during her junior year, after she was informed that she had flunked the clinical training course. In the contract, Russell agreed to attend Weight Watchers classes and to lose at least two pounds per week. The school says Russell drafted the contract; Russell said she was “coerced” into signing it.

A federal court ruled in April, 1989, that Salve Regina had wrongfully dismissed Russell. That decision was upheld by a federal appeals court, which awarded Russell $44,000 in damages.

Salve Regina, located in a mansion overlooking the ocean on Cliff Walk here, has appealed what is invariably known as the “fat nurse case” to the U.S. Supreme Court. Arguments were heard Nov. 27, and a decision is expected this term.

Russell, 26, finished her nursing program at St. Joseph’s College in West Hartford, Conn. For the past three years, she has worked as a pediatric nurse at All Children’s Hospital in St. Petersburg, Fla. She said her weight fluctuates between about 285 and 300 pounds, “the same as it was in high school.”

Her supervisor, Karen Shepard, said she was “never aware of any problems (Russell) had in performance because of her weight.” Russell recently received a promotion, and “the issue (of her weight) didn’t even come up” in considering her for the new job, Shepard said.

But at Salve Regina College, Graziano said Russell’s weight first became a potential impediment to her career during clinical training, when she and her classmates began studying cardio-pulmonary resuscitation.

“In the practice session, Sharon was unable to perform,” Graziano said. Russell fell on top of the mannequin she was working on, Graziano said.

Graziano added that the school had trouble finding scrub gowns and other clothing to fit Russell. She said the Salve Regina nursing staff felt that Russell “couldn’t perform in a clinical setting”--that, for example, “she couldn’t teach patients about diet and nutrition.”

She charged, moreover, that Russell “is trying to make a career out of saying it was the fat” that caused her leave Salve Regina.

Russell said she has been heavy her whole life. She bristles when people ask her how she can be a good role model for the health profession because “there are so many things that go into the image of a nurse that it shouldn’t be based solely on how she looks.”

She has “always had such wonderful interactions with my patients and their parents,” Russell said. “No one has ever said anything about my weight.”

Russell’s lawyer, Edward T. Hogan of East Providence, R.I., said his client’s troubles began halfway through her junior year, when “the professors were constantly harassing her.” He said they used her “as an example of how to administer a needle to a fat person,” and, while showing how to make a bed for an obese person, an instructor called out: “Sharon, lie down.”

The school contends no harassment took place. Salve Regina has had many overweight nursing students, Graziano said.

Graziano said that when Russell was informed she was flunking her clinical course, the student “came into my office, begging to be allowed to continue.” Hogan said his client did not initiate the meeting, but “was invited” to the dean’s office.

That meeting, in late 1984, resulted in the contract in which Russell promised to lose weight and to have her weight-loss effort monitored by a faculty member.

Graziano said the contract was Russell’s idea. She said Russell wrote out the agreement before Graziano’s secretary typed it.

“She said, ‘I’ll do anything you tell me, as long as you let me continue,’ ” Graziano said.

Asked if she had been coerced into signing the contract, Russell said, “Oh boy! That’s an understatement.”

Hogan said Russell “did lose some weight, she did go to Weight Watchers and she did report to her faculty monitor.” But the school said that she failed to meet her weight-loss goals and that she did not attend the Weight Watchers meetings each week.

After classes ended in the spring of 1985, the school wrote Russell a letter reminding her of the “agreement to voluntarily withdraw” from the nursing program if she failed to live up to her weight-loss agreement. “They said she could go to another program” at Salve Regina, Hogan said. “But she wanted to be a nurse, not a teacher, or an accountant.”

Rather than transfer to another program at Salve Regina, Russell finished her nursing training at St. Joseph’s. Christopher Kiernan, Salve Regina’s academic dean, said that Russell chose not to return to Salve Regina and that she was never dismissed from the school.

Russell said the experience upset her so much that she gained 65 pounds after leaving Salve Regina. In an attempt to lose that weight, she later underwent a stomach-stapling operation.

Despite her weight, Russell describes herself as a healthy and active person.

“Our society today is so gung-ho on being thin, thin, thin,” Russell said. “But I ride my bicycle about 10 miles, three times a week. I love to swim, and I do some workout tapes, although I think they’re stupid.

“I enjoy physical things,” Russell said. “I’m not a sedate person. People don’t believe that about fat people. The stereotype is fat, lazy and sloppy.”

Some people even say that fat people are less intelligent, Russell said. “What does your weight have to do with your intelligence?” she asked.

At All Children’s Hospital, Russell said she has the same health insurance policy as other staff nurses. She said she is seldom sick, and boasts, “my blood pressure is good, my cholesterol is good.”

Graziano called Russell’s legal efforts overblown. “If you claim fat discrimination, that sells magazines and newspapers,” she said.

Kiernan said the five years of legal fighting had been difficult for the school because “we’ve been slaughtered by the media.”

For her part, Russell said she was eager to have the case behind her.

“I’d like to get it over with, and just stop talking about it,” she said.