Do I Have the Right NOT to Be Weighed? - page 5

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   caroladybelle
    Quote from Meerkat
    Come on, there are ways of knowing besides the numbers on the scale whether or not my weight is appropriate. Clothing size being one. I'm 5'5" and wear either a 6 or an 8 in jeans, depending on the brand. That gives a decent estimation is where my weight is, without focusing on the numbers of the scale.
    Sorry, while you have the right not to be weighed, I think that the MD has also got to have the right not to treat you, due to legal issues if they are so inclined.

    Height and jeans size do not mean a hill of beans when it comes to nutritional status, and accurate assessment of a patient's health. There are many drugs/meds that MUST have an accurate weight to titrate them safely. I have also personally known size 4s that are 5'5"s that are muscular and weigh 160, and others that weigh 110. For an MD to guesstimate can be very dangerous to your health and life. Especially given a history of an eating disorder. Potential alterations in electrolytes from this issue could also adversely affect how drugs work in the system (think Terri Schiavo's potassium imbalance and the family suing/winning a settlement, on lack of assessment - I believe it was her gyn that got sued, but could be wrong).

    As an onco/hemo nurse - my patients have to be weighed every visit, or in the hospital, once or twice per day. We use both weight/height to determine BSA. We also have to determine "dry" weight and ideal body weight to calculate dosing. A few pounds difference, change in electrolyte status, and fluid retention, may make a big difference in toxicity, and mean life or death.

    No one likes to be weighed, but given the current legal climate and toxicity of many common medicines, one has to understand the need for this basic assessment. It is not "blackmail" for a MD to require this, given that they can potentially be charged with negligence, if they prescribe meds and something goes wrong. By the same token, you are perfectly free to find an MD that permits this.

    Your best bet is to have one regular MD, not a group. I see an Internist for my gyn and medical needs.

    (I personally have an male MD that deferred PAPs to a female practitioner in his office - I had "issues" for several years with not wanting a PAP from a male - I have since gotten over my "issues" and he has garnered my trust.)
    Last edit by caroladybelle on Oct 30, '06
  2. by   JessicRN
    You have a right to do anything you want and it has to be respected by law if you are an adult and of sane mind. It falls under the act of refusal of treatment. As long as the person doing the treatment informs you of the risks for not doing the treatment (weighing in this case) all she has to do is document this in your chart.
  3. by   gauge14iv
    Quote from caroladybelle
    Sorry, while you have the right not to be weighed, I think that the MD has also got to have the right not to treat you, due to legal issues if they are so inclined.

    Height and jeans size do not mean a hill of beans when it comes to nutritional status, and accurate assessment of a patient's health. There are many drugs/meds that MUST have an accurate weight to titrate them safely. I have also personally known size 4s that are 5'5"s that are muscular and weigh 160, and others that weigh 110. For an MD to guesstimate can be very dangerous to your health and life. Especially given a history of an eating disorder. Potential alterations in electrolytes from this issue could also adversely affect how drugs work in the system (think Terri Schiavo's potassium imbalance and the family suing/winning a settlement, on lack of assessment - I believe it was her gyn that got sued, but could be wrong).

    As an onco/hemo nurse - my patients have to be weighed every visit, or in the hospital, once or twice per day. We use both weight/height to determine BSA. We also have to determine "dry" weight and ideal body weight to calculate dosing. A few pounds difference, change in electrolyte status, and fluid retention, may make a big difference in toxicity, and mean life or death.

    No one likes to be weighed, but given the current legal climate and toxicity of many common medicines, one has to understand the need for this basic assessment. It is not "blackmail" for a MD to require this, given that they can potentially be charged with negligence, if they prescribe meds and something goes wrong. By the same token, you are perfectly free to find an MD that permits this.

    Your best bet is to have one regular MD, not a group. I see an Internist for my gyn and medical needs.

    (I personally have an male MD that deferred PAPs to a female practitioner in his office - I had "issues" for several years with not wanting a PAP from a male - I have since gotten over my "issues" and he has garnered my trust.)
    A patient CAN be discharged from a practice for refusal to comply with treatment.

    So yes you have the right to refuse to be weighed, but the provider also has the right to decline to be your provider.

    I agree - eyeball weights don't cut it.
  4. by   aka_steven
    I would have no idea what that office's policies are... but as far as I know a pt has the right to refuse ANYTHING, but there may be conciquences.
    I personaly let a Pt refuse & note it, Then If the Dr wants the wieght, They can discuss it w/ them.
    Last edit by aka_steven on Oct 30, '06
  5. by   CoffeeRTC
    Wow.....I can't beleive this has been discussed for 6 pages. The op mentioned that this was a routine gyne check up. Eyeballing her build and wt would seem to be enough. Now if she was in for a sick visit, med check follow up etc, then yeah maybe a wt would be needed.
    We all have the right to refuse tx, tests etc. As long as the pro's and con's are spelled out...it should be okay.

    Someone metioned...recovery vs in recovery. As far as I understand...no one is ever fully recovered from eating disorders, addictions etc. It is a daily struggle. Some days easier than others. It kills me to hear of alcoholics who say they are recovered. Being recovered means that there is never a chance of it happening agiain or a relapse. Not true.

    To the op...keep up your good work.
  6. by   BSNtobe2009
    Quote from cardiacRN2006
    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!
    I totally agree with you. That was why I suggested that having the conversation about her weight with the MA every time she goes into see the doctor, could be adding to the anxiety. If it were me, I wouldn't want to repeat the story of why every time I went in. She shouldn't have to, they should note that on her chart.
  7. by   nuangel1
    i would refuse.that is your right.if the dr dismisses you i would just find another dr .end of story .and i would see the same dr each time so i only had to explain myself once and it could be on the chart .
  8. by   Antikigirl
    You certainly have the right to decline as long as you know the consequences of declining as you seem to! It is informed concent actually even though it is a declination...like informed declination.

    As long as you know the risks of not doing it, you have the right!

    This is where the but, or however comes in now..LOL! (isn't their always one?). Okay...a MD if they wish to prove a point or really want that weight also has a right to declare you as declining appropriate treatments or assessment and decline treating you or declairing you as AMA (against medical advice) and your insurance will NOT pay. That can be a sticky situation, so find a MD that is understanding of this and will see and treat you regardless.

    Keep up the faith on staying healthy girl! I really appreciate that you know what your triggers are, and avoiding them! You know yourself...and that is a very wonderful and GOOD thing! Kudos to you!!!!!!!! I wouldn't weigh you there, but try to find other alternatives to finding out your weight if needed...and would be there for you 100% as a team player for your health!
  9. by   Nurse`Chief~Chickie
    Quote from multicollinarity
    i think i might have to call the office manager. i think i'd have to say something like: "i very much like being a client of dr. xyz at this office, and appreciate the care i have received. however, as dr. xyz's client, i chose not to not adhere to this request of weigh ins because i have an eating disorder and i find weigh ins distressing. could you please note this on my chart so there isn't confusion regarding weigh ins at future visits."

    this would telegraph to the office manager that you do appreciate the office and that you are cordial. by using the lingo of the day, client and adhere, rather than 'patient' and 'comply', you are reminding them of your ownership of your own darn body and right to decline. i think it's a gentle nudge to use the lingo that is associated with the shift in medicine to recognizing patient autonomy.

    oh this whole thing just makes me mad.



    this is just what i was looking for. maybe these words will work for us.
    my 16 y/o 'fiancees daughter' went to the gyn ( 1st visit)not long ago, and suddenly we were knee deep into a an relapse. we had no idea what triggered it. she was tightlipped, and then quick as it started, we find out the ma ignored her dads instructions ( per the orders from the inpatient tx drs. she was under for months) ( and as 'just a fiancee' i, even as a nurse don't count grrr...) not to weigh her, as it truly wasn't relative to the exam. they blatantly ignored instructions from him and don't see that they made a poor judgement related to her care. it's a struggle every day, for her and us. no amount of research i've done can bring me close to understanding the reality she lives in, but i understand the guidelines from her tx, and scales are a no-no. unless specific situations call for it. then it must be backwards and kept secret from her.
    congratulations on your success meerkat, keep up the good work.:icon_hug:
    Last edit by Nurse`Chief~Chickie on Nov 9, '06
  10. by   bethin
    I think some people are forgetting patient rights. The pt has the right to refuse if they are aware of the risks, which I'm sure the OP does. It isn't a check up for a nutrition appt, she isn't suffering from CHF, etc. I would think the tech and doctor would be more worried about her periods than her weight. Yes, weight is important but is getting her weight soooooo important for this gyn exam that it should risk sending her out of recovery? Put yourself in the tech's place: you push Meerkat to get weighed and two weeks later you find out she's in the hospital because of her dramatic weight loss. How would that make you feel? I can say that would make me feel pretty bad and I would feel guilty that I hurt someone.

    Recovering alcoholics don't go to bars because they know that their nemesis is there. Maybe some anorexics/bulemics shouldn't get weighed because the scale is the nemesis. If she says she's not ready, she's not ready. We shouldn't push people. Meerkat will get over this hurdle when she's ready.
  11. by   Altered
    Do we have to be weighed during the nursing program? You know, for practice or something?
  12. by   jolleygirl
    I have had pts refuse to get weighed and that is the end of the issue, but I do think it can be a necessary part of the medical history. I can't imagine the Dr not seeing you just for refusing to get weighed.
    I have seen pts insist that say they can not eat/vomit everytime they eat, etc. yet weight may be stable or up. I would think this might indicate a need for further testing, or pts who say they eat well yet continue with unexplained weight loss, also had a pt refuse to get weighed, she told me her "current weight" and the NP asked her to get on the scale and found it was considerable different.
    I have had pts get on scale backwards or close there eyes for the weight as well.
    Also as some one mentioned medication dosage can be based on weight.
  13. by   pagandeva2000
    I know this is an old thread, however, I think that sensitivity is in order here. Most times, I see CNAs or even nurses weigh people in groups (meaning that there are other people in the room) and then shouting out the weight.."300 pounds...WOW...what are you doing???" and that is total disrespect. I am not an overweight person, but, that offends me.

    Whenever I weighed someone (especially someone who is obese), I always had the door shut, and I asked if they wanted to know (most did) and I told them silently, or let them see what I wrote on the documentation.

    Weight is an important assessment piece; we need to know if the patient is retaining fluid, and if so, how to treat. But, it can be done with dignity and respect.

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