What would you say to this shocking patient statement?

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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?

I bet you any amount of money that she left the hospital because she knew they has her pegged for drug seeking behavior. The whole " brown skinned doctor thing" was to throw you off so you would not ask so many questions. This is so classic I know " professional patients". Also sounds like to me she may have munchausen syndrome. I did a paper on it in nursing school....and in almost every case the Person would pack personal items like they were going in vacation. Things I would not even think to pack I I was in so much distress I had to go to the ER, just to get attention and they even go as far as going to a hospital out of state in order to advoid being detected... They are master manipulatirs ....sad but true..

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
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. :cool:

I'm with Viva.....someone once said on AN......."You can't fix stupid".

Where I come from we call that a positive Samsomite sign....:lol2:

You responded appropriately OP well done.

Patients did not always act like thisand for the most part, their behavior is to be blamed on theentire medical community.

Hard to reply but I'll try, judgement comes in all shapes and colors as does patients(obviously) Personally I think you may have engaged her way too much by even asking why she left another facility. We're all nurses here so the main reason was probably no matter what color the doctors skin was or his accent he/ she probably told her her condition/behavior was unacceptable, wouldn't fill her narc RX. I have had many professional patients thruout my career,I've also witnessed MD's who lay it on the line for patients, just know as nurses we may not be afforded the same luxury of speaking our mind as an MD is. I'm for the look myself trust me my eyes speak volumes about what my head says. Patients like this one are experts at manipulation and are a giant thorn in a nuses side. The underlying disease is mental more than physical. A good doc would not only speak his/her mind but make a mental health referal. If you are confident in your assessment involve the MD in a care confrence and make the suggestion. If not chalk it up to it takes all kinds and come to the forums where we all have our nightmare clients nobody will hold it against you for saying what we all think of these types of patients. she'll continue to make her rounds until someone confronts her and even then who knows......

Hi Blue Devil,

I believe that as nurses we are educators. This patient's attitude provides and excellent teaching opportunity. While you personally would not initially say anything verbally, your look of displeasure is a strong non-verbal communication. From the description of this patient I gather she would not remain quiet after receiving your non-verbal communication. No doubt she would have engaged you in a discussion. I am curious how you would have responded. Perhaps she would have said something like, "What is that look for?" What is your response?

I think your answer was perfect.

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

In my honest opinion, if a patient is obsessing about the racial-ethnic background or skin color of the healthcare providers, then (s)he is well enough to go home.

Frist of all you are there to tend to people, i suppose you have heard worse.

I am obese and not by choice and i have had to put up with nurses like you you.. My thyroid died many years ago not my choice but it happens. I dont abuse the medical system in anyway shape or form.the woman you were tending to is a bigot..... You can't change her mind but dont stick me in her group ...

Ok here it goes... The fact that the pt. is presenting with Asthma (although she had time to pack luxuries) is just her way of getting a "bed"... leaving AMA from another hospital was just her way of getting more attention... I believe she prob. didn't have a gripe with her 2 MD's, she was just stalling for a way to get tx. longer... I've seen this scenerio alot before... c/o breathing difficulties... get admitted... get some steriods... gain more weight... blame it on the meds... but in the mean time, no effort shown to reduce weight and improve health... Treatment is treatment. doesn't matter who prescribes it... or what ehtnicity... where not talking bypass surgery here... Oh n the dx. of fibromyalgia... Prednisone is used for what?... HMMMM? She knows what she's doing... She'll be back!

And to make matter worse many of these professional patients don't have insurance and abuse the system and we wonder why health care cost keeps rising....

Specializes in (Nursing Support) Psych and rehab.
I wonder what her insurance has to say about leaving AMA due to race of the doctor....

Usually with AMA, you pay out of pocket. Insurance doesn't have to cover your stay if you leave against doctor's advice. In my facility, we have tons of people who end up with huge bills because of that

I'm not sure how all I would react if this were to happen to me. I too, also felt that you handled it rather well. In the other hand, I am half filipino so my skin tone is darker, and I was born here in Oregon. I'm thinking this pt. wouldn't like me taking care of them at all. Which reminds me of this one time I went to take care of a pt. and they wouldn't allow me to touch them while giving care...not until I answered the question.... "Are you mexican?" no...I'm not...oh...okay...and then I was allowed to give my care. Wow. WOW!!

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