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Learning to treat patients with respect

By Lydia Jade Turner

Last month, a woman in her early twenties contacted me, distressed upon witnessing the mistreatment of her housemate by an Emergency Medicine Specialist. Her housemate Joanie*, also in her twenties, had just been admitted into hospital following a serious suicide attempt.

What follows is an excerpt from a letter of complaint written by Anna* to the directors of a prestigious public hospital in Sydney. The hospital has since sparked an internal investigation:

“… this doctor … repeatedly called [my housemate] “Cassie” despite numerous corrections made by both Joanie and I.

While one of the nurses was inserting an intravenous cannula (IVC) into Joanie, this doctor came past to use some of the equipment off the trolley. She remarked to the nurse “stupid fucking overdoses, waste of my time” right in front of Joanie – unaware of her reason for admission. When she eventually came around to see Joanie, she was incredibly patronising in her tone. She asked Joanie’s medical history, which Joanie was not able to complete so I filled her in.

On telling her that Joanie had struggled with anorexia nervosa and bulimia nervosa, she asked Joanie if she’d ever been in hospital with the condition. Joanie had not and told the doctor she had received outpatient support co-ordinated by her GP. Following this response, this medical officer (MO) stated “well it wasn’t real anorexia then was it dear?”

Not only was this statement invalidating, but my housemate already struggles to accept she has a genuine eating disorder. Joanie also expresses shame at the fact that she is not “thin enough.” Since that night, Joanie has continuously stated that “food is not a problem for [her]”, despite engaging in repeated purging, exercise and restrictive behavior.

Joanie feels that as she no longer meets the weight criteria for anorexia nervosa as she once did, and having had her condition dismissed so easily, that there’s nothing wrong with her. She has told me repeatedly that “if a doctor says I don’t have an eating disorder than I mustn’t” – besides having a diagnosis of EDNOS from a psychologist and her own GP.”

Clearly this MO has absolutely no training in eating disorders, and very limited training in mental health. For an emergency department MO, this is entirely unacceptable, especially for a hospital like [named removed].

Following on from this, I expressed concern for Joanie’s safety as, had I left, she would have been left alone in the Acute section of the emergency department – with railings, a very sharp, serrated edge on the tap broken in the bathroom, oxygen tubing and other wires – just to name a few of the hazards to an acutely suicidal patient.

Joanie had repeatedly expressed a desire to pull her IVC out and had collapsed when I helped her to the bathroom (with permission from a nurse). I asked the doctor if it was possible for a “special nurse” (IPS) to be provided for Joanie as I didn’t feel she was safe. The reply I got was “well dear, if you’re that worried about her, you’ll stay, won’t you.”

At this I feel it important to mention that a) it was 2am and I hadn’t slept since the night before b) I am not trained to look after acutely suicidal mental health patients c) I am Joanie’s flatmate and friend, NOT her carer d) This doctor had done absolutely no assessment of Joanie’s safety.

I found it a highly inappropriate response for her to assume that I would assume responsibility for Joanie’s wellbeing. To push me into a role of carer is an entirely inappropriate course of action. She did not ask me how I would feel about that, or if I would be able to do just that. Had she enquired into Joanie’s psychosocial history, she would have found that I struggle with chronic illness myself and am not in a state to become Joanie’s carer, or her IPS.

…I found [the doctor’s] conduct remarkably unprofessional. A mental health patient is still a patient and thus should be treated with the same respect and dignity of any other patient…”

It is unfortunate that the attitude displayed by this particular doctor towards Joanie is not rare. While it’s important to recognise that health professionals are only human and will, from time to time, make mistakes, some ‘mistakes’ are not acceptable. It is never acceptable for health professionals to laugh at patients behind their backs, call them names, or speak abusively towards them.

When health-care providers treat their patients with contempt, with or without their patients’ knowledge, it bears significant consequences. For example, a study of 498 women published in 2006 in the International Journal of Obesity, showed that obese women were more likely to postpone cancer screenings compared to thinner women, citing doctor’s disrespectful attitudes as a significant reason.

Negative attitudes towards patients makes it easier for practitioners to ‘write them off,’ and enables minimal effort to assist the patient. Patients are also more likely to avoid check-ups and treatment – sometimes even leading to patient death.

While it seems most health professionals do treat their patients with regard, it’s important to know your rights and to take action should you or your loved one experience mistreatment, such as in Anna’s case above.

So tell us, have you ever been disrespected or mistreated by a health professional? What did you do about the situation and what impact did it have on you?

Also see http://www.dailytelegraph.com.au/news/doctor-in-online-tirade/story-e6freuy9-1225939622504

*names have been changed to protect privacy
Follow me on www.twitter.com/lydiajadeturner
Follow us on www.twitter.com/BodyMattersAust

7 responses to “Learning to treat patients with respect

  1. This post angers me so much. I can’t tell you how many times I have been treated like a waste of space by doctors who are supposed to give a damn about your health.

    I never had anorexia and so many times I could see doctors just not taking me seriously. Whether it was a GP in a medical centre that I had queued 2 hours to see, turning me away and telling me I wasn’t really sick, to seeing a so-called “specialist” in a public hospital, I’m sick of the bullshit.

    I get that doctors are stressed, but that doesn’t give you permission to be a jerkoff. Like the author said there are some things that are just not okay. Especially to people who are most vulnerable, suffering from mental illness.

    This girl was lucky, having a friend able to complain on her behalf. When you are sick, standing up for yourself is the last thing on your mind.

    Having said that, I have also had great doctors. But boy are there a couple I wouldn’t mind sending this link to!

  2. When I overdosed intentionally (I don’t call it a suicide attempt, I was in a lot of pain and wanted to hurt myself very badly) eight or so years ago, I was treated with little to no respect by all the medical professionals I encountered. The doctors and nurses were both rude and dismissive, expressed the opinion that I deserved poor treatment because I had ‘put myself in this situation’ and refused to allow me to see a mental health specialist. Even the smallest act of kindness would have helped me enormously at the time, but I was given none. At one point I was left for thirty minutes to sit in my own charcol-vomit covered bed and gown before anyone would bring me another.

    My treatment was terrible and made me feel worse at one of my most vulnerable moments. But it did wake me up to the fact that I had to help myself, or no one else would. I was lucky in that i had insight into the situation – not everyone would be so lucky.

  3. I am a health professional and I have to agree with you, it’s not uncommon for doctors and therapists to hold attitudes of disdain and contempt for their patients, especially if the patient is a “chronic” case or is labelled something like ‘borderline.’

    These patients are at risk of beign gossiped about, mocked (when they’re not present), and essentially not treated properly.
    I have also worked with some outstanding professionals but this is a real problem that needs to be addressed, especially in hospitals. I regularly liaise with doctors at hospitals and sometimes even the head of department can talk about patients in ways that are disrespectful “how come I get the fat one, ha ha” or saying nasty things about their parents. Sure some parents are not well, but mocking them is not helpful to anyone, and breed distrust and stigma with real-life consequences.

  4. This is so very *very* sad. My heart feels for this girl.
    *sigh* this is so indicative of how misunderstood this illness is.

    Ive had some past experiences with medical profressionals in a similar way:

    …1. I visted my GP years ago when I was physically quite unwell with an eating disorder. My weight was way below the reccommended BMI for my height. I was quite sick.
    I confessed to this doctor that I felt I had a problem, possibly an eating disorder. His response was “I think you look fine…lots of girls go through this…” Finally when I was to leave his office he handed me a jar of jelly beans and said “You probably wouldnt take one anyway.”

    2. Whilst having blood taken to prepare myself for an inpatient eating disorder stay the nurse said to me “Why are we taking blood today?”. I explained my situation stating i had an eating disorder and was going into hospital. The Nurse took a step back, looked at me and said “Eating Disorder? You dont look like you have a problem with food!”

    3. During a really bad episode of depression, major OCD intrusive thoughts I took myself to the emergency room of a hospital. I explained to them my situation – history of anorxia, depression, OCD, anxiety etc. They basically sat me on a bed with no contact with anyone from 9:00am till 3:00pm . . .No one came to see me, no doctor visited, no counsellor, no psychologist….no one. I had never felt so worthless, so invalidated in my whole life.

    These are just some examples of experiences I’ve had…

    Im sure there are many people out there with similiar situations.

  5. It’s always so devastating and frustrating to hear stories like this. We do live in the 21st century but every now and again we are reminded that the mindset and compassion (not to mention the appropriate education) of some is not modern at all.

    I wish the woman central to the story all the best and hope she finds herself supportive professional help that can guide her to wellness.

  6. I’d like to highlight that the attitude expressed here is not simply limited to mental health patients.

    During January and February of this year my eight-seven year-old, moderately demented grandmother was dying. She was admitted to a prestigious Sydney hospital with end stage respiratory and cardiac failure. When it was determined that no further curative treatment was to be implemented and a hospice course of care be entered into it was discovered that no palliative care facility in Sydney was able to accommodate her needs. As a result, she remained, as a hospice patient, on a medical ward at this hospital in a four bedded bay with three other patients of mixed sex for the course of her death.

    As her life drew to a close and her care needs required the full assistance of her carers, she remained in this room with three other people, dying. & let utterly alone by the nurses staff who only arrived at her bedside of their only volition on mandatory medication rounds twice a day.

    My grandmother was the absolute candidate for “a special”, described by the author of the above letter, for various reasons. We were told that it was not possible for a special to be arranged as they were “too expensive”. Instead, I, the twenty-year-old granddaughter, stayed at the hospital with my grandmother, by her bedside, twenty hours a day, replaced only when other family members were able to relieve me. I provided all my grandmother’s care for the sole reason as no staff on the floor seemed interested or willing to carrying out basic nursing duties such as providing a bedpan, changing sheets or securing oxygen delivery equipment.

    I know that this website is dedicated to changing societal attitudes to mental health concerns however I feel that it is significant to point out that situations as outlined in this posting are not limited to mental health patients. They happen every day – to every sort of patient, in every sort of setting. I’ve seen it as a nurse in major public hospitals and I’ve seen it as a granddaughter in the local community hospital.

    If this hospital is to respond to this complaint, they should be made aware that there are hundreds of other situations just as this that never make it to their desks.

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