Do I Have the Right NOT to Be Weighed? - page 4

Hi everyone... Was at the doctor for a routine gyn recently and of course the tech was doing all the pre-lims like BP and stuff. She wanted me to get on the scale, which I always defer when I've... Read More

  1. by   truern
    I often refuse to be weighed for a routine office visit. I think Meerkat has every right to refuse especially if it's not relevant to the reason she's seeing the doctor. And really...just how many routine medications are weight-based??

    Edited per instructions
    Last edit by truern on Oct 30, '06
  2. by   BSNtobe2009
    Quote from truern
    I often refuse to be weighed for a routine office visit. I think Meerkat has every right to refuse especially if it's not relevant to the reason she's seeing the doctor. And really...just how many routine medications are weight-based??

    BSNtobe2009, I think you are out of line suggesting therapy for Meerkat.
    I don't think that was out of line...she said she was in recovery from an eating disorder. Eating disorders are psychological disorders. If she is in recovery, part of recovery is returning to a normal life. Eating disorders are unique versus other types of recoveries because you can stay away from drugs and alcohol, but you can't stay away from food, you need it to survive.

    If she is still having anxiety that is so extreme thats he cannot step on a scale in a routine healthcare visit, even if she doesn't see the weight, or it written on the chart...my fear FOR her is that her recovery is still, too close to the edge, and therapy can either help her with this hurdle, or keep her from slipping back.

    I would never, ever, ever use "therapy" thrown out in a sentence casually or as an insult to anyone on this board. Eating disorders are very difficult to recover from, but as I said above, part of "recovery" is returning to a normal life.
  3. by   Multicollinearity
    Quote from BSNtobe2009
    I don't think that was out of line...she said she was in recovery from an eating disorder. Eating disorders are psychological disorders. If she is in recovery, part of recovery is returning to a normal life. Eating disorders are unique versus other types of recoveries because you can stay away from drugs and alcohol, but you can't stay away from food, you need it to survive.

    If she is still having anxiety that is so extreme thats he cannot step on a scale in a routine healthcare visit, even if she doesn't see the weight, or it written on the chart...my fear FOR her is that her recovery is still, too close to the edge, and therapy can either help her with this hurdle, or keep her from slipping back.

    I would never, ever, ever use "therapy" thrown out in a sentence casually or as an insult to anyone on this board. Eating disorders are very difficult to recover from, but as I said above, part of "recovery" is returning to a normal life.
    Boundaries! The issue at hand here is a patient's right to decline something - autonomy - and the implications/consequences.
  4. by   Meerkat
    Let me say...Getting on a scalle is NOT the 'first step' in recovery. Indeed, many treatment centers recommend ditching the scale altogether. Secondly, I have been in recovery for almost ten year with no relapse. Very rare for eating disorders, but it's true. Getting weighed is my last 'chain' . I can eat normally and I do. My clothing size is apprpriate for my build. I don't need to be advised to get therapy~~I've had tons of it and my recovery is strong and stable. I just don't want to get weighed. That's all.

    Thanks for the support!
  5. by   gauge14iv
    I do want to point this out...

    A patient who had declined to be weighed for years came in to discuss bariatric surgery. Well guess what? The insurance company wouldn't even consider authorizing a consultation to a surgeon because there were not at least 3 years of recorded and documented weights on the chart.

    I consider Height, weight, and BMI vital signs just like blood pressure, pulse or temperature. I NEED them to help a patient weigh the best options for their treatment. But I'm also willing to take the time to explain that. Part of the service I offer to patients is advice and counseling about diet and exercise, goals for weight loss, trending of blood pressure, glucose and other things that might indicate they are heading for chronic disease - and weight is a VERY important piece of that.

    Part of an effective disease prevention plan might include consultation to a nutritionist, PT for exercise and conditioning, and yes - sometimes counseling - I can't justify any of that without weights.

    I don't want to cause patients unecessary anxiety, but I do want to provide complete and comprehensive healthcare.
    Last edit by gauge14iv on Oct 29, '06
  6. by   Meerkat
    Quote from gauge14iv
    I do want to point this out...

    A patient who had declined to be weighed for years came in to discuss bariatric surgery. Well guess what? The insurance company wouldn't even consider authorizing a consultation to a surgeon because there were not at least 3 years of recorded and documented weights on the chart.

    I consider Height, weight, and BMI vital signs just like blood pressure, pulse or temperature. I NEED them to help a patient weigh the best options for their treatment. But I'm also willing to take the time to explain that. Part of the service I offer to patients is advice and counseling about diet and exercise, goals for weight loss, trending of blood pressure, glucose and other things that might indicate they are heading for chronic disease - and weight is a VERY important piece of that.

    Part of an effective disease prevention plan might include consultation to a nutritionist, PT for exercise and conditioning, and yes - sometimes counseling - I can't justify any of that without weights.

    I don't want to cause patients unecessary anxiety, but I do want to provide complete and comprehensive healthcare.
    I understand that. But if you eyeballed me, you would see that I look absolutely undeniably average. Not overweight, not underweight. Blood pressure isn't something you can eyeball. Our pts can be sitting in front of us non symptomatic, with a BP that's way out of range. I completely see why BP and other vitals are important too measure. But let's look at the WHOLE clinical picture...an average looking person with normal vitals...I don't see the reason to get caught up in the numbers on the scale. Clinically, as long as there is no gross anomolie, it just shouldn't be that important, and certainly not important enough to refuse treatment/routine visits to a pt who refuses. In fact, demanding to know my exact weight (on a scale that probably has not been calibrated in God knows how long)is practically as obssessive minded as the eating disordered pt might have been at one time!
  7. by   P_RN
    I wonder if it would be beneficial to try for a primary medical provider who always sees you. The group where every doctor is at square one with you isn't really continuity of care.

    I usually don't avoid the weight, but I do have a neuropathy in my left arm, and request no BP in that arm---really painful. A new nurse (RN) in my PMDs office and I almost came to a shouting match over that. I won that round.

    I take a couple of meds (ca channel blockers) that can put pounds on me in no time flat. I've changed as much as 8# in a month....all fluid.

    When you get ot my age you have "schtuff" like that to worry about. Talk with your doctor and explain......
  8. by   gauge14iv
    I would never demand it - it's your weight - but I definately strongly encourage it.

    It could present a complainace issue in some cases, although not necessarily in yours.

    If you really have issues about getting on a scale, I would encourage you to explore that with your provider.

    For instance - I like having a patients usual weight on the chart in the instance when they present 2 weeks later with gastroenteritis. It is good to be able to trend the weight from year to year, particularly in families where there is a family history of diabetes or other conditions. just a few examples I can think of.

    Honestly - having your weight recorded for your medical record is very very useful to your provider - even if you aren't really aware of it and are rather certain your weight is normal.

    I would never force somebody or argue with them about being weighed - but it's certainly a missing piece when I am reviewing a chart without the patient in front of me. How can I calculate certain values without a weight?
  9. by   gauge14iv
    Yup - calcium channel blockers, diuretics and a whole host of other medications would be another reason to be weighed...
  10. by   TazziRN
    Being weighed during an acute illness is one thing, very necessary, but for a routine visit....I don't see why it can't be refused. I have, when I just haven't felt like it.
  11. by   gauge14iv
    The thing is - I have no way to predict that 6 mos from now your weight won't be important. What if weight loss were the only sign of cancer you had and we hadn't weighed you? What if the fact that there was no weight trended meant that we delayed a diagnosis or treatment? It's just one of the things that helps to put all of the pieces together - and it really does matter more than you think it does.

    Routine weights may be even more important than weights during acute illness.

    Sure you have the right to refuse - just like any patient has the right to refuse anything they don't want.
    Last edit by gauge14iv on Oct 29, '06
  12. by   cardiacRN2006
    Quote from BSNtobe2009
    I don't think that was out of line...she said she was in recovery from an eating disorder. Eating disorders are psychological disorders. If she is in recovery, part of recovery is returning to a normal life.
    She said she was in recovery-not recovered. I have a feeling that this will always cause anxiety. No need for a set back because the tech/MA needed to fill in all the lines on the paperwork.

    If a Dr can't eyeball a pt and tell if they have an appropriate weight for their height, then they aren't a very good Dr.

    It's certainly not life threatening to get this weight-especially during a Gyn visit!
  13. by   pmakeuprn
    I say if you do not want to be weighed, do not do it. I would have told that medical assistant you would discuss the matter with your doc. She probably
    has sent patients into the exam room with missing info before so she was just covering her backside... you know that problem will go away with electronic records. All the repetitive BS will go away. If you had seen a doc earlier that day and was weighed, then they can go into the record and retreive the VS and everything else they need and not have to ask you for it again. It will speed up things considerably.

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