What would you say to this shocking patient statement? - page 3

by aboucherrn 14,740 Views | 93 Comments

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,... Read More


  1. 17
    Quote from 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 .
    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.
    Last edit by Esme12 on Sep 10, '12 : Reason: spacing
    jadelpn, Altra, simonemesina, and 14 others like this.
  2. 2
    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.
    tewdles and orthonurse55 like this.
  3. 8
    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.
    Last edit by SweetPEI on Sep 9, '12
    sckimrn, Ruby Vee, jadelpn, and 5 others like this.
  4. 2
    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.
    chaka_1709 and SCruzRN like this.
  5. 6
    QUOTE>>> 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.>>> QUOTE As others have posted you clearly revealed your own bigotry in your first paragraph. I will add that "professional patients" often know their bodies and how they will react to treatment very well.How many of us here on allnurses have presented to the ED ,asked for a certain med and been labeled a drug seeker? There are several threads about that.Maybe she has discovered that foreign born physicians are not as open to her particiption in her plan of care. Her requests are not that surprising-I am sure the meds she received in the ED stabilized her,she probably felt too sick to eat prior to coming in so upon arriving to the floor she was feeling better and wanted to eat.Given her history the internet is probably her lifeline. I take me own pillow ,face cloth,Nook and stuff when I go on vacay and will probably do so if I am ever hospitilized.Does any of this change your perspective of this patient? The term "professional patient" implies malingerer imho-is that what you mean? Anyone with a slew of chronic diseases if well used to acute care and I'm sure wants their creature comforts.Would you say the same thing about a 26 yr old man with metastatic cancer who arrives with his lap top,cd player amd such?
    tewdles, cienurse, FMF Corpsman, and 3 others like this.
  6. 2
    Quote 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.
    Same argument can be made about comfort level--English speaking, more familiar, etc. I know some people are sensitive about this, but at the end of the day, it comes down to some similar things and the point as to why one is seeking care in the first place. No doctor or nurse for that matter, male or female, gives a lick about the individual's body. To them, it's no different than pulling up the hood of a car and checking to see if things are in working order. Truly. To me, the sensitivity is problematic in thinking, b/c people are being overly sensitive about something they needn't be.

    Even if using an OBGYN, by biggest concerns are "Does he or she know what they are doing?

    How experienced are they?

    Can he or she be compassionate, while still being on top of their game in a crisis?

    Are they honest?

    Can I openly asked them questions?

    Do they listen?
    How adept are they if performing something like surgery?

    Are they likely to blow important things off?"

    These are the kinds of things that are important.

    Frankly, and this is just anecdotal experience, I have had more female OBGYNS and OB nurses hurt me during a pelvic exam then male doctors. I have no idea why that it. Just the random turn of things I guess. Although, I think some people don't know the different between carefully probing and palpating versus poking and being rough.

    Point is, I don't give a pig's ear what your gender, race, or whatever is. I want to know that you are experienced, qualified, and that you truly care. Everything else is utter BS.

    BTW, a woman physician or nurse can be just as critical or judgmental of someone's body (as noted in the original post) as any male physician or nurse can be. If a person is going to be an azz and judge your body (most don't care unless you are so grossly obese that it's an obvious problem), then they will be an azz whether they see your body exposed or not.

    It's fine whatever your rationale, and that you own it, but you do realize it isn't logical thinking, and 99.9% really could give a rat's tail about what your body looks like. I mean, if you are a nurse, does it roll that way for you? Do you really care if your patient is buff or not? You are not there to care about that kind of nonsense, and neither are other physicians and nurses.

    It's a different slice of the same thing though. The patient in the OP's situation has her biases against non-American physicians or physicians or different races. Her reasoning is off. In the same manner, so is the reasoning against giving preference to a male or female doc or nurse. I mean the really young teens that need pelvic exams, sure, you try and humor them, b/c they are young. At a certain point, however, you'd hope sound reasoning would kick in and people would get over it.

    I am not judging per se. I am simply stating the consistency in illogical thinking patterns.

    The docs of different races don't or at least shouldn't care what race you are any more than they care what gender you are, unless they are trying to rule out ectopic pregnancy. It just is of no consequence either way in terms of examination or general function as a physician or nurse. If it is OK to ask for a physician of another gender, logically, it should then be OK to ask for a physician of another race or of say only American origin.

    I am not saying this is right. I am only trying to look at the thing in a balanced, logical manner.
    Last edit by samadams8 on Sep 9, '12
    Pick01 and sharpeimom like this.
  7. 1
    Quote from ktwlpn
    QUOTE>>> 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.>>> QUOTE As others have posted you clearly revealed your own bigotry in your first paragraph. I will add that "professional patients" often know their bodies and how they will react to treatment very well.How many of us here on allnurses have presented to the ED ,asked for a certain med and been labeled a drug seeker? There are several threads about that.Maybe she has discovered that foreign born physicians are not as open to her particiption in her plan of care. Her requests are not that surprising-I am sure the meds she received in the ED stabilized her,she probably felt too sick to eat prior to coming in so upon arriving to the floor she was feeling better and wanted to eat.Given her history the internet is probably her lifeline. I take me own pillow ,face cloth,Nook and stuff when I go on vacay and will probably do so if I am ever hospitilized.Does any of this change your perspective of this patient? The term "professional patient" implies malingerer imho-is that what you mean? Anyone with a slew of chronic diseases if well used to acute care and I'm sure wants their creature comforts.Would you say the same thing about a 26 yr old man with metastatic cancer who arrives with his lap top,cd player amd such?

    I don't know that she is being purely biased by using the word "obese." This is a word used scientifically, just as moderately or morbidly obeses are scientific terms. Something you would definitely see in and H&P for heaven's sake. I get what she means by mental picture now. I don't know about the rest of it, as patients can be manipulative, or somethings, they are truly sick but they are, well, the way they are.

    Often enough asthma patients are frequent flyers; so they may well know the drill and want to be comfortable.

    And who knows why the woman thinks the way she does?

    I personally just think it is the quality of the caregiver that should be judged above all else.

    Dude, if the the best, most thorough doc there is a male or female from the Land of East MudFlappionia, is 65 or 75 years old, but is sharp as a knife and has agile skills, that's who I want caring for me. Everything is bull crap.

    To the OP's original point, if you are really sick, so long as you don't get a total quack, you just want treatment and relief. Darn, it's like when you are in truly major pain--like one of those unremitting migraines--no relief through vomitting--and the pain is so bad that your BP is 240/140. You could care less, so long as you get proper treatment and relief.

    But it is also a point that half of the ED admissions or more as such that can be dealt with in a physician's office or in an urgent care center. When you have to divide yourself between people coming in bleeding out or actively infarcting, plus children in respiratory distress or rape trauma, it is a pain in the butt to have to deal with so many non-urgent cases. The ED gets smacked with everything, and people don't get that. Even in the ICU, for the most part, you have to be able to justify giving the bed to someone--in terms of space and in terms of financial costs. But the ED, shoot, they just keep getting everything, while too often, also getting hits of a true emergent nature. It's part of what makes the ED a major pain in the butt.
    simonemesina likes this.
  8. 1
    wow..what a piece of ****!
    Novo likes this.
  9. 6
    Oh that's too bad you did not get the care you wanted over there.
    Well let's see who is rounding today,,,there Dr. (insert very difficult to pronounce Indian name here), then the attending is (Insert another foreign name here), residents are (even more foreign sounding names here). Charge nurse is (insert foreign sounding name here), and so on and so on...
    Then apologize to her royal highness for not having ANY non foreign Docs on all night.
    Excuse yourself and have one of your brown skinned accent having coworkers go in to see if she was comfortable or needed anything.
    Would have been fun just for laughs..

    Like someone said, you can not fix stupid, but you sure can have fun at stupid's expense.
    simonemesina, wooh, aboucherrn, and 3 others like this.
  10. 1
    After restraining myself of speaking my mind and knowing my face is free and clear of dirty looks (My face tends to have a mind of its own sometimes) I would have probably told her that she has the right to choose her doctor as well. I myself am brown in skin color but was born here in america. Initially I would be upset but then I have to think that people like that do not deserve to be even an afterthought. Its just sad that we are in this day and age where there is still that ignorant mentality.
    Last edit by yoshells on Sep 9, '12 : Reason: weird color typing
    Psychtrish39 likes this.


Top