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.

Edited August 17, 20187 yr by virginiaRN
added detail and typo

50 minutes ago, 2shea said:

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.

Oh, and sorry about not being clear in my OP. They were laughing about my SIDE BOOB coming out of my dress. This only hit me as I replayed the scene in my mind going down on the elevator. I was so stunned, initially I wasn't clear what I heard. But my son confirmed what I heard. I can't update the OP, I don't think or else I would! Thanks.

There are so many fields that have now enacted similar privacy and privileged acts to stop this type of nonsense, mandatory retraining now...

2 hours 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'm sure they are the type of people that have been doing this all their lives... Bad behaviors don't start at 32

Oh and I forgot they violated a clause in the Hippocratic oath

"Into whatsoever houses I enter, I will enter to help the sick, and I will abstain from all intentional wrong-doing and harm, especially from abusing the bodies of man or woman, bond or free. And whatsoever I shall see or hear in the course of my profession, as well as outside my profession in my intercourse with men, if it be what should not be published abroad, I will never divulge, holding such things to be holy secrets."

Edited August 19, 20187 yr by GreenTealael

I read this post in tears. I am so sorry that you had to experience this. I will pray that your heart will heal from this event. Be strong and absolutely report it.

In my mind I’m picturing a Julia Roberts in Pretty Woman scene, where she tells the nasty lady in the store, “big mistake”. Lol, my mind just goes there. Seriously though, I’m really pissed off on your behalf, definitely file a report. Just know that you are an amazing warrior, fighting cancer and losing all that weight!! We all have your back!

2 hours 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?

HIPAA is pretty specific on when and how a person's information can be used. It wouldn't matter where they told each this or if it was meant for anyone but themselves. The issue is if there was no "need to know". If there was no pertinent medical reason for them to be sharing her health information then it would be a HIPAA violation. Locked door or otherwise. Further, the fact that the patient herself overheard the conversation is proof enough that they weren't being discreet. If she could overhear their conversation, who's to say they couldn't have shared tons of other health information? That's the issue HR is going to have when this complaint comes through.

If they had been talking without using ANY identifying information i.e. "she had her teenage son with her" it would be rude but likely wouldn't be an actual case. However, in my healthcare experience, I have seen people fired for much less tbh.

On 08/18/2018 at 18:42, virginiaRN said:

Oh, and they do NOT deal with "life or death scenarios." As I wrote in earlier posts, their office closes at 4pm, opens at 9am. They see people in the office. The one time I actually came in with blood pressure of 70/50 and dizziness, they left me in the waiting room for 1 hour. They know NOTHING of dealing with real emergencies. In the 14 years this physician has been in practice, never has there been a patient death. I was an ER nurse. I know from "life or death medical and mental health scenarios." Further, even in the ER, if we EVER did joke about a patient--typically never about the body but about a bogus story about how a man got a Shampoo bottle stuck up his anus ("I fell in the shower), we did it in the BREAK ROOM, which is located strategically far from patient rooms. Just curious, do you work in healthcare/medicine?

My misunderstanding. I thought they were in the office and both involved in the care. I stand corrected.

Yes. I do.

I don’t disagree that what they did was rude, catty and whatever else has been said. I was just talking about the HIPPA issue. I misunderstood the situation—seemed to me like the break room shampoo bottle situation you describe. A locked office after hours. My mistake.

Nope. Walking in the hallway & talking abt patient details is the kind of stuff covered in first semester of clinicals, in any part of the medical profession, as you know. No worries. My post was more of a stream of consciousness, a vent. Certainly not organized very well. ✌?

34 minutes ago, jess9395 said:

My misunderstanding. I thought they were in the office and both involved in the care. I stand corrected.

Yes. I do.

No worries.

As a long time nurse myself, your story sickens me. I know there are co-workers and healthcare personnel out there like this, and I truly believe they should be reported. Not only because they were unprofessional, violated HIPAA and caused you, as a patient, emotional pain; but because your son heard it too. You need to show him that you will stand up for yourself. Hugs for you and bad vibes to bad caregivers.

I’ve been through hell and back. What would I do? Let their boss know, get over and move on. You don’t want to spend all your good energy hitting over someone who is not really all that important in your life. It’s already happened, you can’t change a thing. What you can change is your way of thinking. Place your energy onto something you enjoy rather than these idiots.

Ps. No idea how to edit or anything here but I forgot to add:

A few years ago I would have worried about all that stuff. Going to hell and back makes you realise that those people are not important. You are, and the ones that love you are. Don’t let them get to you. It is human nature for everyone to comment on everyone whether it is complimentary or not. Some people are just more horrible than others. They will have forgotten about it by now and although you don’t, you are the only one who can change it. Do something for yourself and put your energy into that. I’m sure the manager will respond to them especially if it’s in writing. Then.... move on. X

You poor thing, that is horrendous. You are a beautiful strong woman, those absolute b****s have no idea the battle your body and mind have done to get you to the point you’re at today. The worst thing about that is that they have nothing better to do then to body shame to pass the day. You’re better than that and you handled it like a queen.

I think you should absolutely write the surgeon and/or office manager. This behavior is unacceptable and they need to know about it. Don’t expect the shame and embarrassment of you catching them to alone to correct their attitude and behavior.