First Impressions Matter, B**ch!!!!

[shay]

Yanno, I always try to make a good first impression with patients and their families. It freakin' matters. It sets the whole tone, and it really makes a difference in what kind of rapport you can develop with your patients.

I had a special consult today in my recent quest re: possible ttc. The office nurse, the ONLY nurse btw, was a total rude, snotty little twit. This was a visit regarding which antidepressants I can and can't take during pregnancy. It was a one time consult, damn it. It had nothing to do with my physical health, no meds were going to be prescribed, NOTHING. MERELY A CONSULT OF THIS PARTICULAR DOC'S MEDICAL OPINION. NOTHING ELSE.

Office b**ch tells me as a part of her duties, each pt. gets BP/P/R and WEIGHT.......................................................

Folks, my DOG doesn't even know my weight, okay? I don't weigh for ANYBODY. I DON'T CARE WHO YOU ARE. UNLESS MY MEDICATION IS WEIGHT BASED, YOU WILL NOT KNOW MY WEIGHT. PERIOD. END OF STORY. So I politely tell her I will decline weighing, and she looks at me, up and down, pursed lips, and says, "well, we do have women who just don't look, you know."

I wanted to smack her. I am immediately on the defensive. I have weight issues, okay, and I don't effing need her crap about "there are women who don't look." I wanted to say, "I'm sorry, B**CH, WHAT PART OF NO DON'T YOU UNDERSTAND????!!??" I told her NO again, and she proceeded with my vs. I was sooooooooooooooooooooooooooooooooooooooooooooooooooooo put off by her. I was just clawing at my purse, thinking a million different ugly things about her. When searching through my purse for my insurance card, I MADE SURE TO WHIP OUT MY NURSING LICENSE WHILE "SHUFFLING" THROUGH MY THINGS IN MY WALLET in hopes she'd see and know that she was not only being a snot to a patient she didn't know from ADAM, but to a FELLOW NURSE.

:( REFUSAL OF TREATMENT INCLUDES BEING ABLE TO REFUSE CERTAIN PROCEDURES, AND BEING WEIGHED IS ONE OF THEM. WHY IS IT SO HARD FOR ALL THE OFFICE NURSES OUT THERE TO UNDERSTAND THIS????? I RESPECT MY PATIENTS' BOUNDARIES, WHY DO THESE PEOPLE GET SO PISSY WHEN I REFUSE TO WEIGH??? IT IS NONE OF YOUR FREAKIN' BUSINESS WHY OR WHY NOT I WEIGH, I SAID NO, NOW BACK THE F OFF.

Look, people. All you students and new nurses especially........PLEASE REMEMBER..........your patient can refuse whatever he/she wishes unless their is a COURT ORDER stating they are incompetent, and there is someone acting in their stead, OKAY??? Do not get all rude and snotty if someone refuses treatment. I had a patient yesterday that signed out AMA for familial reasons. Was I rude to her? NO. Did I disagree with her decision? YES. Did I reflect that in my treatment of her? NO. I told her, respectfully and politely, the risks of leaving, and encouraged her to return to the hospital if she has any further problems. Part of nursing is learning how to CONTROL YOUR OUTWARD APPEARANCE. You can be frustrated or put off. You can not like what someone is doing. But damn it, they teach you in nursing school (at least they taught MY class) how to friggin' watch your body language and facial expressions so as not to MAKE YOUR PATIENT FEEL UNCOMFORTABLE.

Please be aware of how you're coming off. It MATTERS. It MAKES A DIFFERENCE. BODY LANGUAGE, FACIAL EXPRESSIONS, AND TONE OF VOICE SAY A LOT MORE THAN THE WORDS COMING OUT OF YOUR MOUTH. Please, people. Remember this.

[JailRN]

Shay,

Some people are just stuck on stupid.

[shay]

Susy,

got your e-mail!!!!! Working like a slave.....night shift. Respond tomorrow, 'kay? :kiss

And PEBBLES..................................

Alright, this is my official public apology and mea culpa. I do apologize wholeheartedly for flaming you and making ASSumptions. It was wrong and stupid and I apologize 100%.

As you can probably tell, yep, this is a big ol' sensitive subject. Susy states is beautifully (btw, nice moderating Suz.. ). Anyway, mea culpa. Peace sister.

Shay

[pebbles, BSN, RN]

Thanks, Shay. No hard feelings... I, of all people, should know how easy it is to misunderstand people in print media.

I wasn't clear in my original post because I assumed everyone would know how I felt! lol....

Peace,

-Pebbs :kiss

[l.rae]

Originally posted by JonRN

Last time I went to my PCP the nurse weighed me and said "you lost a pound" Like that would make a difference when you are a sausage and egg biscuit away from 300. I said " I didn't mean to", cracked him up.

Pappy

You ablolutely CRACK me up:roll :roll

[shay]

Just would like to update you all......

I talked to patient relations today and suggested that they speak to

Nurse Skinny McB!tchy

about learning to control her facial expressions, body language, and review the patient bill of rights with her. And of course I made sure to tell them, "as a NURSE, when MY patients refuse something, I document 'pt. refused' and move on. I just was so offended, being a NURSE, that she seemed to completely forget the patient bill of rights."

Grrrr. I hope she learns something and changes her m.o..

[VivaLasViejas, ASN, RN]

Oh, man, I am so glad I'm not the only one who refuses to get on the scale at the doctor's office! Of course, my doctor AND his MA know better than to give me any crap about it, but that's because they've seen me through a lot in the 10 or 12 years I've been a patient there. The only time I ever get any static now is when I go to my pulmonologist, whose nurse looks at me when I stride defiantly past the scale as if I've lost my mind. Of course, she's a skinny little thing who has probably never weighed more than 100# wringing wet, but the very first time I went in there, she told me, "The doctor can't treat you correctly if he doesn't know what you weigh", as if I were a stubborn child rather than a 40-something (and an RN to boot). To this day, I have never once allowed myself to be weighed at that office; my doctor couldn't care less, but that nurse.....well, I'm not gonna give her the satisfaction! :-)

[Q.]

Reading mjlrn97's post made me wonder.

At what point DO you allow yourself to get weighed? I would imagine esp with a pulmonologist, who may be watching for edema or other things. At what point do you as a nurse with limited knowledge say "ya know, maybe my doc needs this weight for reasons I have no clue about."

I'm not trying to start an argument, I am trying to explore this. No, I've never had an eating disorder, yes, I've had weight problems in the past, and yes there are many things done at the doctor's office that I hate: paps are among them.

Plus, I don't think it matters if the nurse asking for the weight is skinny or not. Sometimes in reading these posts the anger towards "thin people" seems a bit...misdirected. The nurse in mjlrn97's post did nothing that I myself would not have done. I ask for a weight. Patient refuses. I explain why it's needed, patient refuses. Fine. It shouldn't matter I'm thin. What matters is I've presented to my patient WHY something is needed so that as her nurse, I feel like I've done my job and her refusal is an informed one.

Let's remember that Shay is upset that this nurse passed judgement on her with her apparent disapproval that Shay picked up on. That is the problem here. Not that the nurse asked for the weight!

[shay]

Good question, Susy.

I will allow myself to be weighed when I am pregnant. I will allow myself to be weighed if I have an obvious health problem (like pulm. edema, kidney malfunction, yadda yadda....you get my gist). I will allow myself to be weighed if a RX is weight-based.

I won't allow you to weigh me if I'm in a psychiatrist's office for a consult (....think we've established that? LOL!), I won't allow you to weigh me if I'm coming to see you for a mysterious bump on my wrist, I won't allow you to weigh me if I'm coming in for a re-check of a problem to make sure it has resolved and that problem had nothing to do with my weight.

But if you tsk tsk me and give me disapproving looks and look me up and down, you not only have a snowball's chance in hell of getting me on the scale, you've also just opened yourself up to the wrath of the Queen B*tch of the Universe and should duck or run. :chuckle

[researchrabbit]

Originally posted by shay

But if you tsk tsk me and give me disapproving looks and look me up and down

I've never seen a fat person do this to another fat person, it's always someone who's never had a weight problem.

A former fat but now thin person will be more than happy to share what worked for them (think Richard Simmons), and may even go too far in wanting to help someone else (and then irritate the heck out of someone), but they are rarely judgemental. They've been there.

Thin people are not uniformly judgemental. Most thin people are lovely people, just as most fat people are lovely people.

Suzy, it's not really anger at thin people, it's anger at thin people who are judgemental about a problem they've never had to deal with. (think Elizabeth Hurley's comment about Marilyn Monroe's dress..."I'd kill myself if I ever got that fat.")

[VivaLasViejas, ASN, RN]

SuzyK---In response to your post: I probably should've clarified why I go to a pulmonologist in the first place. He's my asthma doctor. I've never had problems with CHF, edema etc. As for the weight thing......well, I love thin people, wish I were one of them etc. It's just this particular nurse......she's very polite, and I'm just as polite in return when I refuse to get on the scale, but she always speaks to me like I'm a child, and I don't care for that.

Now, I always let myself be weighed when I was pregnant (that's been a long time ago), and of course when I had to have laser surgery for kidney stones. I will also allow it when I've been away from a scale for awhile and honestly don't know what I weigh. But as an overweight woman, I've gone through so much crap in doctors' offices where I'd go in with carpal tunnel or a sore throat, and the first thing out of their mouths was "I can't treat you unless you lose weight first". I'm not kidding. So if I sound a little snotty about the weight issue, that's why I won't get on the scale unless there's a DAMN good reason for it.

[mario_ragucci]

Don't sweat it, Shay. There are many insensitive and down right idiot people in this world. they serve to test you. I can appreciate what you are saying.

There are several questions that are not considered polite to ask. Like, when people ask me, "where you from." If you are intrigued by my sounds, you got no right to ask my history! Or, when someone asks you, "do you smoke"....its the same thing. There is not a thing you can do about these people, and you just have to love them, despite their intent. Banish memories of them after you brain storm it.

If a person is over-weight, I certainly wouldn't hassle them about their weight. Just take it in stride.

[Flo1216]

Since we are talking about refusing stuff...I always remind myself of that. I saw a pt today refuse a med because she didn't know what it was or why she was getting it because she had never seen it before. The nurse just said, " OK " but she didn't tell her what the med was or why she needed it. So I said to her, " By the way, what is that med for?," She said, " I CAN"T REMEMBER" The pt also has a TLC(she didn't understand why) and the nurse was about to hang Rocephin and the pt said, " I don't want an antiobiotic..I don't need it ...I feel fine," And the nurse said , " OK" She never explained to the pt what the antiobiotic was for nor did she tell the pt what kind of infectious process she had. All she said was, " OK " I know I am getting off the subject but it bothered me.