What would you say to this shocking patient statement?

[aboucherrn]

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?

[Asystole RN]

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.

You know and we know that the term was used in a pejorative fashion and the overall description of the patient was created to pain the least attractive picture possible. You are being disingenuous if you are attempting to hide behind the term as a medical term.

Retarded is also a medical term but I doubt anyone would appreciate that being a descriptor either.

Context my friend, context.

[JZ_RN]

:) 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.

I can agree with what you're saying totally, I just personally feel more comfortable with a female doctor if they need to do a pelvic or breast exam. Otherwise it couldn't matter less to me what gender or race a person is. I do struggle with people whose English fluency is poor though, it's so hard to understand is all.

[Guest343211]

You know and we know that the term was used in a pejorative fashion and the overall description of the patient was created to pain the least attractive picture possible. You are being disingenuous if you are attempting to hide behind the term as a medical term.

Retarded is also a medical term but I doubt anyone would appreciate that being a descriptor either.

Context my friend, context.

Perhaps, but the fact IS this. I don't know. I don't read minds, and I learned a long time ago about the potential for being wrong--even if one is quite discerning and intuitive. I am not God, thus I will not judge the poster's "contextual" message. This kind of thing only adds to problems in human relations.

Allow the poster to clarify for himself/herself. We humans are often more wrong that we realize or would admit.

No, I don't find the use of the word 'retarded,' with the now long-used mentally handicapped the same thing as referring to a person's condition--that is, being obese. The only context is that she was painting a word picture. Obesity is in fact a major risk factor for asthma. Perhaps that is how she was pulling it altogether in her mind as she began to describe the situation and the story.

I think some are being a little tough on this person is all I am saying.

[SweetPEI]

Perhaps, but the fact IS this. I don't know. I don't read minds, and I learned a long time ago about the potential for being wrong--even if one is quite discerning and intuitive. I am not God, thus I will not judge the poster's "contextual" message. This kind of thing only adds to problems in human relations.

Allow the poster to clarify for himself/herself. We humans are often more wrong that we realize or would admit.

No, I don't find the use of the word 'retarded,' with the now long-used mentally handicapped the same thing as referring to a person's condition--that is, being obese. The only context is that she was painting a word picture. Obesity is in fact a major risk factor for asthma. Perhaps that is how she was pulling it altogether in her mind as she began to describe the situation and the story.

I think some are being a little tough on this person is all I am saying.

All of what you are saying is understood. However, allow us to open your eyes to our rationale. If a patient said an inappropriate prejudiced comment and I'm seeking advice on how I should have handled it, is giving information regarding the patients medical condition, belongings and request for a meal pass going to give you a better chance to give me sound advice? NO. The AMA situation has some relevance, as it is directly related to her prejudiced comment. Obese is a medical term, yes it has a correlation with asthma, but what position does it have in the situation at hand? None

[Guest343211]

All of what you are saying is understood. However, allow us to open your eyes to our rationale. If a patient said an inappropriate prejudiced comment and I'm seeking advice on how I should have handled it, is giving information regarding the patients medical condition, belongings and request for a meal pass going to give you a better chance to give me sound advice? NO. The AMA situation has some relevance, as it is directly related to her prejudiced comment. Obese is a medical term, yes it has a correlation with asthma, but what position does it have in the situation at hand? None

All I'm saying is that in her mind, she saw the patient as a cluster of information. If so, that, at least in my mind, is still a problem.

We can get caught up in seeing pts as health problems---as well as seeing them as problems. Pts are not clusters of data that are pains in the butts. Aggravating or not, they are people.

At any rate, it's sadly interesting to try and look at both people's perspectives.You are right. The detailed description isn't necessary. Seems like she is reacting. I just don't think, necessarily, that she was trying to be malicious about the women/pt. I think she was just surprised and frustrated w the pt and her attitude .

Finally, people complain about pts all the time on this and other sites. Why is this nurse worse than others that vent?

[SweetPEI]

No one said she is worse than any other nurse that vents. The point is that when we try to call people out on something they have done we, at times, do the very thing we call then out on. So I think it is important to recognize that in us. In this example it was extremely obvious that the OP was reacting. No doubt about that. It showed in the way she presented her post. If it were strictly about the event, some comments may not have been posted, but who knows if comments to this was posted based on the irrelevant information

[Guest343211]

No one said she is worse than any other nurse that vents. The point is that when we try to call people out on something they have done we, at times, do the very thing we call then out on. So I think it is important to recognize that in us. In this example it was extremely obvious that the OP was reacting. No doubt about that. It showed in the way she presented her post. If it were strictly about the event, some comments may not have been posted, but who knows if comments to this was posted based on the irrelevant information

Yes, it's so easy for any of use to be reactionary.

When you encounter patients that appear demanding and bigoted, all you can do is strive to be professional, caring, and do the best you can.

I've been in the field a long time, and I really have learned, in general, that it's allowing oppression to take over my life when I let others get to me. Sucks up too much energy.

It does, however, get frustrating at times. You're busy with people that really want and need help, only to find people coming in that want things that are often beyond what is supposed to be provided. This is why the Press-Ganey business in many ED's is sort of baffling to me.

It's important for people that go into ED to realize that, at times, a lot of your efforts seemed geared towards being a waitress and customer service rep. You even hear ED physicians complain about this ALL the time.

[SweetPEI]

Yes, it's so easy for any of use to be reactionary.

When you encounter patients that appear demanding and bigoted, all you can do is strive to be professional, caring, and do the best you can.

I've been in the field a long time, and I really have learned, in general, that it's allowing oppression to take over my life when I let others get to me. Sucks up too much energy.

It does, however, get frustrating at times. You're busy with people that really want and need help, only to find people coming in that want things that are often beyond what is supposed to be provided. This is why the Press-Ganey business in many ED's is sort of baffling to me.

It's important for people that go into ED to realize that, at times, a lot of your efforts seemed geared towards being a waitress and customer service rep. You even hear ED physicians complain about this ALL the time.

Indeed, it is pure oppression to let those kind of things control how we act. And please don't even get me started on that... Customer service fast food restaurant mentality... The customer is always right, even though they may be killing themselves. Understaffed, mentally drained, but still we smile for the "greater good" of the facility

[Guest343211]

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

And usually the rest of society ends of eating the costs.

[Guest343211]

Indeed, it is pure oppression to let those kind of things control how we act. And please don't even get me started on that... Customer service fast food restaurant mentality... The customer is always right, even though they may be killing themselves. Understaffed, mentally drained, but still we smile for the "greater good" of the facility

Too too true SweetPEI.

Nowadays, many of such folks will wait to be seen by a PA or NP. I'm sure if she pushed the issue, it would be different. It's the silly games that go on. People don't realize an ED can be a big money draw for a hospital, one way or the other.

But too my other point, everyone ends up eating the costs when this nonsense is not limited.

They need more psych sections to EDs, but then, who would want to work them? Seriously.