What would you say to this shocking patient statement?

[aboucherrn]

Obese female in her forties admitted from the ED for asthma, allergy list a mile long, takes medication for anxiety, depression, fibromyalgia, migraines, chronic back pain, etc. Has packed her comfy jammies, memory foam pillow, iPad, laptop, and cell phone, and before she has even entered the room she needs the facility WiFi password and a pass to the cafeteria because she hasn't eaten all day.

This is just me venting and trying not to sound too judgmental. This actually happens all the time and I am used to "professional patients". I just wanted to paint a metal image for what this patient said while I was admitting her.

I learned she had recently been admitted to a nearby facility for the same diagnosis but left AMA. I asked why she had left AMA and she said she didn't like her doctor. I said sometimes that is the case and she could have requested a new doctor. She said she did that, and didn't like the new doctor either. I asked why and she said "They had brown skin and heavy Indian accents. I am an American, and if I go to a hospital in America, I demand to have an American doctor".

I had no idea how to respond, so I just said "It is your right to be comfortable with your doctor", then finished the admission assessment. I have been a floor nurse long enough that very little shocks me, but WOW.

How would you have responded to that statement? What other shocking things have patients said that you didn't know how to respond?

[Asystole RN]

I never say anything to bigots. I given them what my children call "the look." It is a dead stare with a slight frown and a raised eyebrow. I am very, very good at it and can keep it going for as long as necessary. It makes my displeasure clear without ever saying anything anyone can turn around and complain about. What are they going to say? "I complained about my brown doctor and the Blue Devil looked at me all funny!" I dare them, lol.

You should review the term bigot and reexamine your own views.

Tolerance is not only for those whom you agree with.

[CherylRNBSN]

You handled that situation beautifully, OP.

As much as we hate to admit it, we're not going to turn a bigot into an open-minded, tolerant individual in the course of a hospital stay. Whatever makes someone that way, we don't know and we can't fix it. I do like Blue Devil's approach, and have been known to give good glare when stupid, insensitive, judgmental comments come out of patients' mouths. But again, I have neither the time nor the temperament to try to 'educate' these fools, so I just fix 'em with a bad look, mutter "I'm sorry you feel that way" and go right on doing my job.

Viva,

Love the "good glare" comment...I'm stealing it!

[edmia, BSN, RN]

A patient once asked me, "Is your husband black too?". I said, "No, darling, he's white, but he turned out nice." She laughed and I just kept on going with my work of caring for her...

People will have opinions about all kinds of things, but at work, you keep it professional. No religion, race, sexual orientation, or politics discussed with patients. Ever.

[eatmysoxRN, ASN, RN]

Crazy stuff. The primary reason I hear complaints about foreign doctors is because patients have a hard time understanding them sometimes (I'm from the south where there isn't much cultural diversity). I felt bad for a doc once because he tried so hard but wasn't very understandable unless he yelled and spoke very slowly. He was an amazing teacher and a doc I'd let care for me anyday.

[Castymiss]

I will not say only an uneducated person would say such a thing.I could care less what color a doctor is, but I would prefer American educated

[Novo]

I would have shoved a sock in her mouth.

[sissiesmama, ASN, RN]

Viva,

Love the "good glare" comment...I'm stealing it!

Bahaha! I unfortunately have a pretty good "stink face" that I forget to try to conceal at times. This patient ould have gotten it I am sure.

Anne, RNC

[AZMOMO2]

I wouldn't have said anything because you can't fix stupid... but I would have made sure her doctor was exactly as described and continued to be so... so she would leave AMA from my department as well.

[caroladybelle, BSN, RN]

I will not say only an uneducated person would say such a thing. I could care less what color a doctor is, but I would prefer American educated .

Why, the irony.......The facility for which I work, is virtually always listed as a top hospital on major polls for best care - both nationally and internationally. It has pioneered many lifesaving drugs, pieces of medical equipment, and procedures, used throughout the world. And the many, if not most of the brilliant minds that I work with, as MDs (attendings/interns/residents) are not American.They are Indian, Japanese, Chinese, Korean(north and south), Malaysian, Russian, German, Jordanian, Israeli, South African, Sudanese, Haitian, Peruvian, Canadian, Argentinian, Moroccan, Greek, Italian, Scottish, Irish, Welsh, French, etc. Most took their basic medical education outside the US, before coming. They also interestingly enough speak much much better English that those of us born here. My dept's former clinical specialist occasionally had us correct her grammar to become more proficient. Given that she spoke and wrote in 5 major languages fluently, we cut her slack on a few misplaced letters and adverbs.

[Guest343211]

My response--redirection. OK, you are here to be seen and treated for thing following. . . . Let's see how we can help meet your medical needs to the best of our ability. If she ever brought it back to an issue of bigotry, I would try to re-direct back to the essential points/needs for which she is seeking care.

You are not necessarily going to change bigotry. This is something that runs deeper in the individual, and they need find their way, if ever, to inner growth and reprogramming their own thinking.

To me, this in some ways isn't any different than some folks asking for female physicians or female nurses. There is a mindset that the person has, for whatever reason/s. There's no time in an ED or in an acute or critical care setting to try to make the person have an epiphany about this. For a small set of such folks, it might be possible, but not usually.

So just focus on the admission priorities, and don't be taken aback by ignorance or faulty reasoning from patients. You can only do so much. The key is to stay focused on the priority issue at hand.

[SweetPEI]

I can see you're point OP in regard to this patient's comment. However like mentioned before, you are much like this patient in terms of how you described her. What in the world does her weight, need for wifi, and a meal pass have anything to do with the actual comment? It makes me feel as if you wanted us to have some sort of pre-thought about her to make your actual point much more valid. In other words, it seems as if you were judgmental of her from what you SAW way before what you heard. In fact even listing her illnesses was quite unnecessary. She was admitted to a previous hospital., but left AMA. She was then admitted to your hospital and during your assessment she explained why she left the previous hospital... You could have started there. I am a mixed person, and have encountered, overheard and seen bigotry in action numerous times, however as a healthcare professional my judgments have to be put away and I have to focus on the patient. That does not mean I punk out, but it does mean I am professional. I would however say to her that I have worked with many excellent doctors from all over and their nationality does not determine their skill. I would also let her know that we will do the best we can, but we cannot make any promises as to where her doctor is from.

[JZ_RN]

I would have called her on her racism, frankly. I would have said, well, doesn't matter the color of their skin or how they talk, a doctor is a doctor. Sounds petty and racist to me. I don't care for racist people in real life, and I wouldn't care for a racist patient. I am white but I am not "American" so it offends me when people are racist, very deeply.

I would have said, well., don't be so quick to judge a book by it's cover and then left the room.

In my head I'd be thinking, "stupid racist hog."

**** Edit- I don't think this is the same as demanding a female doctor or whatever. That's a personal comfort issue, not a personal dislike of the doctor for senseless reason. If I am going to be "exposed" I prefer a female doctor. Nothing against the male doctors, I'm sure they would do a good job but that;s outside my personal body comfort zone. It's not because I hate male doctors or think they are somehow "not as good" just because they're male.