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?

Specializes in ICU/CVU.

"Anxiety, depression, fibromyalgia, chronic back pain, migraines etc..." = "blah blah blah I'M A MED SEEKER blah blah blah"

Take it somewhere else, I'm not here to supply your habit and take your abuse.

Specializes in CVICU, ER.

I'm sorry to say, but you're just as "bad" as she is. You're judging her based on a preconceived notion about what an"professional patient" is. It's none of your business why she left AMA before, your job is to provide nursing care for her during this hospital stay. It's easy and fun to gossip about people like this, because it makes you feel good, and you're probably "right" about her, and she is "wrong". But it doesn't help you as a human being, and definitely not as a nurse. You're not growing when you gossip like this. I'm sorry to lecture you..

It is interesting to me how patients get admitted for asthma if they don't have an obvious exacerbation going on to begin with. If this patient is a "professional" maybe now is the time to say "You have been admitted once a month for the past 9 months, and that is of grave concern to me. I will be speaking to the doctor about a meeting with him and social work to talk with you about an "alternate level of care" as seemingly, you are unable and/or unwilling to care for yourself and your asthma at home". Adult protective services perhaps if she is coming to the hospital for what should be something that she could manage at home (and sometimes asthmatics do have exacerbations) but most of the time, she should be able to care for herself. If she is coming in with sats in the 80's and wheezing continually, than that is a dangerous thing she is unwilling to treat chronically. She has some psych history, and this needs to be dealt with, as inappropriate statements, no filter, and statements such as "needing a cafeteria pass" when the emergent situation seems to be asthma exacerbation is dangerous, and her mental illness needs attention.

Speak with the doctor about this patient and her behaviors and her exacerbations and co-morbidities. Get social work involved,especially if this patient "ups the ante" to be admitted. I believe (just my opinion only) that fibromyalgia to be a trauma based illness, and her statements and behaviors are perhaps the smaller picture of a larger personality disorder. Shock statements such as wanting an "American doctor" even more so point to this type of thing. Now that she has gotten herself admitted, see what you can do for a plan of care that would help this patient to be more functional in her daily life.

Specializes in Telemetry, LTC, Hospice and Private Duty.

I agree that racism is unacceptable but I feel strongly that a patient MUST be able to understand the doctor's spoken word. It was my experience in the past with an Indian doctor who was quite dismissive of my self and my daughter so she chose to switch to a doctor she could understand and who would show her the respect she needed to feel comfortable. I supported her decision. Perhaps due to an obvious underlying bias against" professional patients" is why any non-compliance or unhappiness expressed by this particular patient would be viewed grossly magnified. IDK?

Specializes in Telemetry, LTC, Hospice and Private Duty.

Wow Jeff perhaps you should reconsider your career choice or at the VERY least review the chapters referencing subjective versus objective....

Specializes in Oncology.
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.

While what you say is true, it's a safety issue is why I don't like it. It's not like I'm chitchatting and the words are mixed up, the communication in healthcare is so vital that poor English skills among other English-speaking patients or coworkers can lead to dangerous problems. And it's not that I'm uncomfortable with my body, it's just that I prefer not to have a man I don't know looking at my most intimate areas, a woman has the same so it's just less uncomfortable.

Specializes in ICU/CVU.
Wow Jeff perhaps you should reconsider your career choice or at the VERY least review the chapters referencing subjective versus objective....
Nope. I'm just not naive and don't think everything needs to be seen through rose colored glasses. I don't see the problem with calling a spade a spade. I'm also quite content in my career choice and fairly darn good at what I do.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
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?

If this is you trying not to sound too judgmental, I'd hate to see what you're like when you're NOT trying. It's not OK to be a racist, but I guess it is OK to be judgmental about your patient's weight.

The fact is most American doctors go to medical school oversees and most foreign doctors go to school in the U.S...Have her think about that for a while.

Are you serious, or are you just saying that as something to shut the lady up? lol

Point of fact is at least 95% of all US residency programs go to the American medical school graduates. If the docs med school education was out of the US, it makes it very tough to get into an American residency program. So, overall, this makes the "most American doctors" part statistically improbable.

While what you say is true, it's a safety issue is why I don't like it. It's not like I'm chitchatting and the words are mixed up, the communication in healthcare is so vital that poor English skills among other English-speaking patients or coworkers can lead to dangerous problems. And it's not that I'm uncomfortable with my body, it's just that I prefer not to have a man I don't know looking at my most intimate areas, a woman has the same so it's just less uncomfortable.

:) Another reason healthcare workers need to be able to hold on to their cell phones. I have used the online translators directly in conversation, and while there is a reading delay, it can go fairly well--but they have to be able to read. If they cannot, you need a direct translator. I know some Spanish, and I am working on refreshing and gaining ground with the language. In the meantime, the iPhone or iPad use of online translators is quite handy for readers.

Things are changing so much, I am beginning to think that they should make Spanish a requirement in schools. It sure is handy. :)

Anyway JZ, I get what you are saying. IDK, depends on how you look at it to me. It doesn't bother me if the physician or nurse is a male or female, so long as they know what they are doing, are courteous, and have some sense of compassion.

Either situation in most cases can be overcome, and to me, the motivation to overcome such biases, concerns, and barriers increases exponentially with the level of pain or severity of health concern. Thus if the woman isn't in pain, discomfort, or imminent jeopardy, and she feels as she does, then she needs to go to her pre-selected primary physician or pulmonologist, a clinic, or an urgent care center.

If this is you trying not to sound too judgmental, I'd hate to see what you're like when you're NOT trying. It's not OK to be a racist, but I guess it is OK to be judgmental about your patient's weight.

Wait, I am sorry, I don't get this? How is reporting or describing the patient/situation using the word obese judgmental?

Isn't obese indeed a medical term, which we nurses and healthcare practitioners use? Maybe the OP didn't mean it any other way than as a medical description. IDK.

All of America (Except hte Native Indingenious Americans) Are immigrants.

Not true.

Even the natives immigrated here, in various waves of course. The Navajo only immigrated the the Southern United States around the 1400's.

Nearly every single, all that I am aware of, native tribe have moved from one area to another, displacing and replacing the native tirbes that once lived there again and again.

I consider everyone born in the United States a native.

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