Overheard Staff Joking About My Body

[virginiaRN 60]

1 hour ago, Plucky said:

I think you should document the behavior, and report it to the practice. If you don’t it will just happen again.

The PA should not be working in healthcare with this type off attitude.

Most importantly you do not deserve this treatment. Think of it this way if you were at work and witnessed someone treating a patient in this manner, would you “let it go”? You would likely speak out for the patient. Don’t you deserve the same care?

Yup. Scroll up. Documented. Letters sent. Thanks 4 ur support!

[virginiaRN 60]

On 8/16/2018 at 7:35 PM, virginiaRN said:

Hi, folks. I have not been on this board for a long time. Today, I had a visit to my bariatric surgeon's physician assistant (PA). I am 16 months out from roux en y surgery and have lost a total of 101 pounds. I went there today because I have been experiencing severe abdominal pain, bloating and flatulence at night, every night x 2-3 weeks. I should add that I am an RN and am one semester away from completing my Family Nurse Practitioner Master's degree. The PA gave me some advice, ordered some meds and labs and I checked out--it was about 4:10pm.

She had told me to do the labs today, due to the severity of the symptoms I was having. Their office was closing. I went to my PCP's office--which has a lab tech--and they were closing and the lab tech had left. I went downstairs to the outpatient lab and it was closed. The only lab open was the STAT lab on the 2nd floor. Since I was still in the building, I thought I'd just double check that the PA did not want these labs to be drawn STAT. I went back to the office.

It was locked. I knocked on the door. I had already heard the cackling and loud voices from 10 ft away. As I got closer, I heard the PA saying "I know, and every time she moved her arms! I couldn't believe it! And she had her teenage son with her!" Needless to say both me and my teenaged son (almost 17) heard this. He drove me today because I wasn't feeling well and he also needs to rack up his driving hours to complete his driver's permit and get his regular license. Just then, the PA, the receptionist and someone from the billing dept emerged from the door. They turned white as ghosts. Their jaws almost hit the floor. Being the classy person that I am, I didn't reference that I overheard them talking about something on my body just then. Their reaction confirmed what I thought I overheard. I asked the PA if she wanted the labs STAT, she said no, and my son and I walked to the elevator. The women huddled back by the door, somehow frozen. The only way to either the stairs or the elevator was toward the direction my son and I walked. Clearly, the women felt ashamed (?)/shook by being overheard body-shaming a patient, violating HIPAA, and being overall terrible people.

As we drove home, I was pretty hurt. Most patients at a bariatric surgeon's office are going to have body image issues. Whether they are pre-op or post-op, they have likely experienced some type of negativity about their bodies (either from within or without, or both.) Also, I should add, I am a breast cancer survivor. December 2018 is my five-year anniversary of having stage 2 invasive breast cancer and having a b/l radical mastectomy and subsequent reconstruction, followed by a hysterectomy. One year after my b/l mastectomy, the reality hit me that my GG breasts were now AAs, mutilated and scarred. I felt unattractive, repulsive and beyond depressed. I was thrilled to be alive and that it was caught in time to prevent spreading to my lymph nodes and that by doing a b/l mastectomy, I didn't have to do chemo or radiation. I failed to be able to tolerate Tamoxifen, and had to be put on a cocktail of other meds that resulted in me gaining about 50 pounds to my already Rubenesque 225 lb body. It was a low time.

Then, I got my reconstruction. My breast did not, do not, and will not look like "porn star" boobs, or "stripper boobs," although many people have suggested that was the "up side" of breast cancer. See, when you get a radical mastectomy, they hollow you out like a cantaloupe. Then, either at the same time, or at a later surgery, they insert implants (or, in some cases, spacers). Because I was 220 pounds when I got my reconstruction, they put the biggest implants the FDA allows--800 cc. The reconstruction surgeon repaired a lot of the scarring caused by a severe post-op infection from the initial surgery, during which both of my breast turned black and I had to debride the dead tissue myself at home. I was and am thrilled that I had a good reconstruction surgeon and, after recovering, felt a little bit more whole.

While I had no breast tissue before, but now, any extra cushion vanished as I lost over 100 pounds. My breasts are skin and implant. It's definitely not a "hot" look. Well, all this cancer talk comes into play because what the women were talking about was my breasts. You see, when you get a breast reconstruction, your breasts don't look like regular breasts. Again, they are hard, stiff, and look like "robot boobs," as I call them. Today, at the office, I was wearing a bamboo material sundress, that was mostly dark teal, but also had other colors tie-dyed into the design. In the front is a "peekaboo" hole. The rest of the dress is just an A-line dress with a full skirt. It is not particularly "sexy." (Including my flabby/flappy wing-like arms!) But because my breasts don't move, there is a tiny bit of "side boob" seen protruding into my armpits. Not regular side boob--because remember, nothing is "soft" anymore. No, it's part of the round, button shape (just imagine an implant covered with skin, literally.)

As I reconstructed what the women were saying, I recalled more and more of the beginning. I guess in the moment, in shock, my brain kind of protected me and I somewhat blanked out. Look, we are all human, I get it. We all make mistakes. But for God's sakes, you would think that the staff--including a provider--would be a little more sensitive about yucking it up about patient's bodies while anywhere near the doors/exit.

I am posting here in general for support because it just feels yucky. I know I've never done anything like that as an RN, but one never knows how one's words may affect another person. Also, the HIPAA violation bothers me. I work very hard to whisper, even when I am behind closed office doors, because I know how much sound carries in offices. I often tell my patients "I'm sorry I'm kind of talking softly, but these room walls are paper-thin and I want to protect your privacy." I know I won't have the b*lls to tell the office. I feel like somehow they would turn it around on me, even though 3 of them were there and me *AND* my son heard that. And as a mother of a 16 year old son, a 19 year old son, and a 21 year old daughter--it's creepy.

The implication that my son--who has seen me go through hell and high Water with cancer and this gastric bypass--would even think about looking at my breasts is disgusting. This can only come from a woman with no children. The PA is probably like 35 (I am 44), no wedding ring. Normally, I wouldn't even mention any of that because I fully believe in living my own life and others live theirs but for f*cks sake, please don't foist your sick thoughts on me.

I would like some thoughts on how I might handle this. I feel like I won't have the courage to say anything, for fear of being "gaslighted." But, I also feel like there is a lesson for their staff to learn. It occurred to me to write an anonymous letter to the surgeon/head of practice and give a little vague summary of what happened and advise that his staff might want to not be so catty, mean, and to stop violating HIPAA. I don't know. I just know it hurt. I'm hurt. Thanks in advance for any words of wisdom.

I can't seem to edit the OP, but I wanted to make sure you all knew the update which is that yesterday morning, I wrote a letter to the practice manager & to the surgeon. Love all the comments and they are great. Just wanted to let you know the "reporting" has been done, at least at "level 1." There are more levels to go and I am contemplating my next moves. Thank you!

[virginiaRN 60]

Part of me would also like to start sending postcards to the office of me in bathing suit with lots of SIDE BOOB showing. But... that'd be super-ornery. LOL

[ChaosUnlimited 559]

1 hour ago, virginiaRN said:

I can't seem to edit the OP, but I wanted to make sure you all knew the update which is that yesterday morning, I wrote a letter to the practice manager & to the surgeon. Love all the comments and they are great. Just wanted to let you know the "reporting" has been done, at least at "level 1." There are more levels to go and I am contemplating my next moves. Thank you!

I'm glad to hear you decided to report it. I hate that it happened to you at all, but hopefully your experience will keep it from happening to anyone else. I'd be interested in hearing the follow up and how they respond if you're willing to share it. I hope the response you get will be an appropriate one for the situation and help you put some closure to it if that's even possible.

[Missouri-Lee's Summit 1,256]

7 hours ago, virginiaRN said:

I empathize with Bootscraper's feelings that feels she should have spoken up, but personally I don't have one lick of regret. I know that had I done so, no justice would have been served. The real justice is reporting her higher up the food chain, which is what I am doing. That would have been squashed, and ended there. I am playing the long game, not a quick adrenaline hit. I kept my cool and showed restraint, which now will give me much more credibility in the retelling of the story to the surgeon and the office manager (which I have done). Further, had I said something, that would then be fodder for the PA and her minions to twist in a game of telephone. I will not have my words twisted. I gave her *nothing* to twist around. I walked away or "turned the other cheek." But I am making sure that the right people are aware of her actions.

While current circumstances may not reflect it, the culture around the DC area is not one in which you can just have confrontations and say whatever you want. So, I cannot think of a word I could have said or anything I could have done differently that would change anything. Had the office manager or surgeon been there, I could have told them. But they weren't in the office. Anyway, to each his own.

This advice was directed at Bootscraper's case. It wasn't meant for the VirginiaRN's PA/staff case. Two different scenarios. I saw absolutely no point in confronting the PA/staff. They needed the "guidance" of a higher up. Confronting them would have done about the same as confronting the elevators.

[IveGotThePower 395]

On 8/16/2018 at 7:59 PM, Orchids&Dragons said:

I am so sorry that you went through this. When you go back for your blood work, bring 3 copies of your post with you. Stop in and tell the PA that you need a moment of her time and that her "friends" need to join you. Give them each a copy of your post and add a p.s. at the bottom to them know if you ever hear the slightest hint that this behavior has been repeated, you will report them to the surgeon, the office manager and maybe even post it on YELP. Remind them that patients DO talk. You don't have to say a word, then walk out with your head high. If the PA won't meet with you, go straight to the surgeon and office manager.

You've dealt with enough sh!t in your life. You don't need to deal with theirs, too.

What she said.

[TropicalBeachDoll 70]

Sorry you had to go through that .

[IveGotThePower 395]

Glad you reported it. Consider this a thoughtful gesture on your part in that you are facilitating an excellent learning opportunity for the idiots. You are doing a kindness to others who come after you who also do not have stripper boobs.

[KimTriesRNY 1,853]

@virginiaRN I just wanted to say that I really admire how you handled everything with such poise, dignity, and grace. If everyone was this way the world would be a much improved place.

May you enjoy good health!

[PALOMABELLA 45]

If this were just a bunch of sorority girls, yeah, maybe (?) let it go--or have the confrontation there. But this PA--a provider with a lot of power over the lives of others--needs to have her card pulled. Trust that I am on this. After sleeping on it, and waking up a little fresher, I wrote a letter to the surgeon and the practice manager. But I may not be done there. Taking stock and deciding about next steps.

Sue them for pain n anguish for you n your son. And also for violating the HIPPA LAW OF CONFIENRIALITY
Keep us posted. We want to no that they got what they deserve

[Mainelykaren 4]

I hate this for you ! I was in the medical profession for 30 years and to think of MY provider talking amongst peers in my work place makes me sick . I would have handled this way differently only because my temper would have got the best of me . I would also seek a different provider . And you handled yourself so gracefully and were indeed the superior .
I applaud you .
Getting older ( I’m 57 ) I tend to be more blunt now and call people out right then .
I kind of like it 😁 .
I feel I am too old to start this whole weight loss journey, but for health concerns I know I need to .

[Mainelykaren 4]

P.S. you absolutely did the right thing in reporting this !

[jess9395 5,448]

I’m gonna be the odd duck here; but while I am truly sorry you had to hear what they were saying.... what is the HIPPA violation here? They were in a closed office with the door locked, taking amongst themselves. It was not meant for anyone else to hear, they believed they were in a private, secure, locked, closed office. They did not mention a name or any confidential medical information. They were letting off steam and venting in the black humor those who deal with life or death medical and mental health scenarios do.

I may get stoned for this, but what did they violate?

[Hop_Scotch 1,625]

14 minutes ago, jess9395 said:

I’m gonna be the odd duck here; but while I am truly sorry you had to hear what they were saying.... what is the HIPPA violation here? They were in a closed office with the door locked, taking amongst themselves. It was not meant for anyone else to hear, they believed they were in a private, secure, locked, closed office. They did not mention a name or any confidential medical information. They were letting off steam and venting in the black humor those who deal with life or death medical and mental health scenarios do.

I may get stoned for this, but what did they violate?

I know nothing of HIPPA as I am in Australia, so can't have an opinion whether they did or didn't violate the regulation.

What did they violate? In my opinion, good old plain human decency. Laughing about a patient's arms or other body part is not letting off steam or venting in a black humour way, they were being downright nasty and mean spirited towards a patient/client. It doesn't make it any less so that they were among themselves behind a closed door thinking they couldn't be heard.

Edited August 19, 2018 by 2shea

[virginiaRN 60]

48 minutes ago, jess9395 said:

I’m gonna be the odd duck here; but while I am truly sorry you had to hear what they were saying.... what is the HIPPA violation here? They were in a closed office with the door locked, taking amongst themselves. It was not meant for anyone else to hear, they believed they were in a private, secure, locked, closed office. They did not mention a name or any confidential medical information. They were letting off steam and venting in the black humor those who deal with life or death medical and mental health scenarios do.

I may get stoned for this, but what did they violate?

Happy to enlighten you. I teach nursing students of all levels at university, so this is something I am up to speed on. HIPAA specifically states a few things that are of issue here. 1) A member of the care team should not discuss patient information with anyone (in the office, out of the office, or whatever) who is not DIRECTLY involved with the care of the patient. That would include the receptionist and the billing employee. The particulars of the PAs discussion were not need-to-know for the receptionist to check me in or out, nor for billing to submit my bill to my insurance. 2) They were EXITING the office. Even prior to the them exiting (about half of their statements came out as they exited the office--literally walked into the hallway), their words were audible from the hallway. The onus of privacy is on the office. That is why many offices have "white noise machines," to obliterate the private patient information being discussed within the office space. 3) Even within the office, staff is required to use a low tone, and to only talk about information that is relevant to care. Hope that helps.