First Impressions Matter, B**ch!!!!

  1. Yanno, I always try to make a good first impression with patients and their families. It freakin' matters. It sets the whole tone, and it really makes a difference in what kind of rapport you can develop with your patients.

    I had a special consult today in my recent quest re: possible ttc. The office nurse, the ONLY nurse btw, was a total rude, snotty little twit. This was a visit regarding which antidepressants I can and can't take during pregnancy. It was a one time consult, damn it. It had nothing to do with my physical health, no meds were going to be prescribed, NOTHING. MERELY A CONSULT OF THIS PARTICULAR DOC'S MEDICAL OPINION. NOTHING ELSE.

    Office b**ch tells me as a part of her duties, each pt. gets BP/P/R and WEIGHT............................................ ...........

    Folks, my DOG doesn't even know my weight, okay? I don't weigh for ANYBODY. I DON'T CARE WHO YOU ARE. UNLESS MY MEDICATION IS WEIGHT BASED, YOU WILL NOT KNOW MY WEIGHT. PERIOD. END OF STORY. So I politely tell her I will decline weighing, and she looks at me, up and down, pursed lips, and says, "well, we do have women who just don't look, you know."

    I wanted to smack her. I am immediately on the defensive. I have weight issues, okay, and I don't effing need her crap about "there are women who don't look." I wanted to say, "I'm sorry, B**CH, WHAT PART OF NO DON'T YOU UNDERSTAND????!!??" I told her NO again, and she proceeded with my vs. I was sooooooooooooooooooooooooooooooooooooooooooooooooo oooo put off by her. I was just clawing at my purse, thinking a million different ugly things about her. When searching through my purse for my insurance card, I MADE SURE TO WHIP OUT MY NURSING LICENSE WHILE "SHUFFLING" THROUGH MY THINGS IN MY WALLET in hopes she'd see and know that she was not only being a snot to a patient she didn't know from ADAM, but to a FELLOW NURSE.

    REFUSAL OF TREATMENT INCLUDES BEING ABLE TO REFUSE CERTAIN PROCEDURES, AND BEING WEIGHED IS ONE OF THEM. WHY IS IT SO HARD FOR ALL THE OFFICE NURSES OUT THERE TO UNDERSTAND THIS????? I RESPECT MY PATIENTS' BOUNDARIES, WHY DO THESE PEOPLE GET SO PISSY WHEN I REFUSE TO WEIGH??? IT IS NONE OF YOUR FREAKIN' BUSINESS WHY OR WHY NOT I WEIGH, I SAID NO, NOW BACK THE F OFF.

    Look, people. All you students and new nurses especially........PLEASE REMEMBER..........your patient can refuse whatever he/she wishes unless their is a COURT ORDER stating they are incompetent, and there is someone acting in their stead, OKAY??? Do not get all rude and snotty if someone refuses treatment. I had a patient yesterday that signed out AMA for familial reasons. Was I rude to her? NO. Did I disagree with her decision? YES. Did I reflect that in my treatment of her? NO. I told her, respectfully and politely, the risks of leaving, and encouraged her to return to the hospital if she has any further problems. Part of nursing is learning how to CONTROL YOUR OUTWARD APPEARANCE. You can be frustrated or put off. You can not like what someone is doing. But damn it, they teach you in nursing school (at least they taught MY class) how to *******' watch your body language and facial expressions so as not to MAKE YOUR PATIENT FEEL UNCOMFORTABLE.

    Please be aware of how you're coming off. It MATTERS. It MAKES A DIFFERENCE. BODY LANGUAGE, FACIAL EXPRESSIONS, AND TONE OF VOICE SAY A LOT MORE THAN THE WORDS COMING OUT OF YOUR MOUTH. Please, people. Remember this.
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  2. 98 Comments

  3. by   OBNURSEHEATHER
    LMAO! You know what shay..... you are such a freakin riot!

    OK. So I have similar issues. It's was actually suggested to me by a shrink that I remove all scales from my home and never, ever again in my life should I know what I weigh.

    So I'm accomodating for certain things. I go to my OB for almost everything anyways, and I'll get on the scale for them once a year. But I stand backwards, and I make it known that I do not, under any circumstances, want to know what it says. I also ask them to take special care to zero the scale back out before I step off and catch a glimpse. You know, the formerly eating disordered tend to get all caught up in "the numbers."

    So this one time, the nurse just says to me, "but you have to stand the other way."



    I said, kindly and gently, "um, no I don't. Studies have shown that most people weight the same backwards as they do forwards, so I choose to stand backwards."

    But she was obviously flustered and perturbed by this, and fumbled through the rest of her part of the appointment with much attitude. Funny actually.

    It's like, that poor nurse is stuck as the only nurse in that office all day, and weighing people is her little power trip. You ruined it for her, and threw off her entire routine!

    I feel for ya honey! Some nurses are not good at controlling their outward dislike for certain things.

    Heather
  4. by   NurseDianne
    Hey my friend......glad your not mad or anything.....:roll
    Ok, i'm pickin' but I do understand. When I'm admitted to the hospital I refused to be weighed on a daily basis. It's none of the anyone's business, especially those with whom I work with. And your right, they don't have to like it!
    Did you complain to the office manager or doctor? I would, loud and clear!!
  5. by   Sleepyeyes
    wow, shay! they gave you a hassle over THAT????!!! lemme sic my kitty on 'er.
    He wants to know how much SHE weighs...

  6. by   MollyJ
    Shay,

    I would suggest to you that you would, in the future, just tell the nurse that you hate weighing in public BUT that if it becomes necessary for the doctor to have a weight in order to make a clinical decision, you will gladly comply AT THAT TIME.

    I would tell you that serial weights CAN occasionally help doctors notice trends. I think weights are an important bit of routine health information that you request of people all of the time in your practice. Obviously, it is a loaded topic for you. Respectfully I would submit that the office nurse wasn't the only person with attitude in that examining room.
  7. by   Q.
    Shay darlin' you are a riot is right! :chuckle

    As an office nurse (currently) until I start my new job on the 30th, the MAs here hardly do vital signs at all, much less a weight! We had to battle this out for MONTHS before we got them to have the MAs take these at every visit!

    I hear ya, though, a patient can refuse whatever they wish so long as they are competent and informed, and a nurse has no business passing *active* judgement on that patient.

    Sure, it bothers me when a patient refuses a BP though that is the entire reason they are here, but they have that right. And we document that all over the chart. I will kindly offer why we need to take the BP, and if they still refuse? Fine. Whatever. It's your life.

    I have weight issues, but I do weigh myself every frickin day at the clinic. Call me the opposite extreme. If I fluctuate by 3 lbs for water weight or a BM for cripe's sake, I freak out.

    Oh well.

    Gotta love ya, Shay.:kiss
  8. by   shay
    Okayyyyyyyyyyyyy......trying soooooooooooo hard not to scream here.

    Molly, first second and third of all, don't you DARE tell me about MY attitude, honey. I was polite to her. VERY freakin' polite. And I TOLD her that if my weight was necessary to give me a prescription, I would allow them to weigh me at that time. And no freakin' duh weight can show trends.....................NEWSFLASH, I WENT TO NURSING SCHOOL TOO AND HAVE A FUNCTIONING BRAIN.

    Heather is correct, I have a hx of an eating disorder. And ftr, it was a PSYCHIATRIT'S OFFICE I was in...............................I HAVE NEVER IN MY LIFE BEEN ASKED TO WEIGH AT A PSYCHIATRIST'S OFFICE.

    So don't sit there and tell me about my attitude, tyvm. I've had it up to here with self-important nurses today. Good God. I can only hope that one day karma bites your sanctimonious butt and lets you be in the hotseat as the one getting talked down to and treated rudely, only to have someone tell you YOU must have had an attitude or else you wouldn't have been treated so shabbily.

    Thanks SOOOOOOOOOOOOOOOO much for your support........it means ever so much.

  9. by   LasVegasRN
    Well, good grief! All they had to do was write "pt refused/declined" in the weight section and leave it at that! No DRAMA necessary! Sheesh!

    If I would have been there, I would have held your purse for you!
  10. by   shay
    thanks Vegas. :kiss
  11. by   micro
    Thanks, SOOOOOOOOOOOOO much for your support. It means ever so much.

    Shay, you speak volumes in what you say.

    Weight or other issues, whatever happened to patient rights.........
    and just because a doc is a doc and a nurse is a nurse........
    doesn't mean they have permission to rule my life or my decisions.

    I went to nursing school and passed boards and have been successfully practicing myself.

    When did we forget the human in caring for humans in nursing?

    Shay,
    keep on postin'
    I admire you
    Micro
  12. by   shay
    thanks, Micro.....and Susy and Heather and everyone else..... :kiss
  13. by   researchrabbit
    Shay, what a nightmare!

    I work in research and ANY patient can refuse ANY procedure at ANY point for any (or even no) reason. Doesn't matter what it is, although of course if they decide they don't want to take the study med, of course we have to stop the study.

    I have to ask why if they wish to stop drug (to capture side effects) but otherwise I mostly don't -- people know what they want and what they don't. I explain consequences (if any) and then let it go; it would be unethical otherwise.

    The only downside is that then I document my a** off as to what didn't get done and why (but in this job, you document it off anyway!).

    Sometimes after someone has refused something and I say "OK" and let it go, s/he'll decide to do it after all...almost as though HAVING the power to refuse is really all that was wanted.

    Can't imagine why anyone would let their ego get involved in a patient's refusal! Not a good sign for a nurse to be so inflexible.
  14. by   nell
    Oh Shay, I feel for you. We all have those little things that other people just don't understand. And you're perfectly right to refuse any treatment/proceedure for any reason.

    Your post brought up somthing that has frequently been a topic in our unit - especially at Academy Awards time: Nurses have to be great actors/actresses.
    ...they teach you in nursing school (at least they taught MY class) how to *******' watch your body language and facial expressions so as not to MAKE YOUR PATIENT FEEL UNCOMFORTABLE.

    Please be aware of how you're coming off. It MATTERS. It MAKES A DIFFERENCE. BODY LANGUAGE, FACIAL EXPRESSIONS, AND TONE OF VOICE SAY A LOT MORE THAN THE WORDS COMING OUT OF YOUR MOUTH. Please, people. Remember this.
    Sometimes the acting is more exhausting than the patient care. Every family member must be made to feel that his/her little darlin' is the MOST darlin' of all... No, of course I don't mind...Is there anything else I can do for you, I have the time...

    One more reason we should get paid more - something a little closer to what actors get.

    That office nurse, however, should get kicked out of NAG (Nurses' Acting Guild).

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