What would you say to this shocking patient statement? - page 8
by aboucherrn | 14,825 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
- 1Sep 10, '12 by needshaldolI agree with the OP who gives the "look" because that is exactly what I do. It is not worth my time or effort to try to talk sense into a senseless person. I once had an elderly alert man, German, who started to talk about WWII which he was in. I asked him what side? And he said "the correct one of course, the side who wanted to get rid of all the Jews". I refused to care for him and gave him to someone else. Sorry, but I could not care for this cockroach. Just sayin the truth.
- 1Sep 10, '12 by fgreenI do not have any issues with the color of someone's skin, but I have to be able to understand them clearly. Unfortunately, I have come across many foreign doctors who have such bad accents you can't understand a word they say, which could be dangerous especially if taking a phone medication order.
I think everyone is judging the patient too harshly... I think if she could clearly understand the doctor's speaking voice, it wouldn't be such an issue.
- 2Sep 10, '12 by RoyalNurseI'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..
- 3Sep 11, '12 by jadelpn GuideIt 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.
- 0Sep 11, '12 by biggybigmcnurseypooI 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?
- 0Sep 11, '12 by JZ_RNQuote from samadams8Same 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.
- 0Sep 11, '12 by JeffTheRNQuote from biggybigmcnurseypooNope. 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.Wow Jeff perhaps you should reconsider your career choice or at the VERY least review the chapters referencing subjective versus objective....
- 0Sep 12, '12 by Ruby VeeQuote from aboucherrnIf 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.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?