This topic contains 4 replies, has 2 voices, and was last updated by Jenn Jenn 4 days, 18 hours ago.

#KatiFAQ ED ASSESSMENT

  • Jenn

    #KatiFAQ
    hi Kati,
    I recently saw an Eating Disorder nurse for an assessment as my GP thinks I have an ED. The first thing she said after saying hello was “you don’t look like you have an ED”. Yes, I’m overweight but that doesn’t mean there isn’t anything wrong. She had a student with her, I said ok when she asked if it was ok. But She wanted to see my self-harm and I said only if the student wasn’t in the room. She said that they work as a team so I don’t get to choose who is in the room and if I was admitted as an inpatient I would have to show many different people. Then we got back on topic as to why I was there and she said there isn’t anything wrong you are making the choice not to eat. She kept going on about it just being me making the choice not to eat. I asked so do you think I could wake up one morning and snap out of it. And she replied yes. I left this appointment feeling worse than when I got there. Do I have the right to choose who is in the room? (even if i consented earlier) How do you snap out of something you have no control over?
    Thanks

    Hawtflash

    Hi Jenn!
    I’m so sorry to read of your awful experience in seeking help with your ED. I’m actually obese now and have had relapses of both binge eating and anorexia. I’m also a retired registered nurse with a bachelors of science degree. I want you to know that you ABSOLUTELY have the right to refuse or except the presence of any student during your appointment. You can do this at any time. Even if at first you allowed the student in, you don’t even have to give a reason for asking them to leave. I’ve had this happen many times both to me personally and with my daughter particularly at teaching hospitals where it is most common to invite students in. Also, I think it’s very important for you to know that the things the provider said to you Were inappropriate at best, and possibly harmful at worst. I hope my response to your question helps you feel that your feelings have been validated.In fact, I believe the things that were said by the practitioner in particular, might possibly be reportable offenses. This is particularly true because here she had a student in the room and therefore you actually have a witness. However you may want to consider carefully whether not you want to report them, particularly if you choose to remain with the practice. You need to know that most likely your complaint would be disputed and measure the benefits versus the risks of doing so. There are people called on ombudsmen That should be able to advocate for you. I would first go to any supervisor or Dr. higher up in qualifications. If this was a nurse practitioner she could possibly even be reported to the Board of Registration in in nursing. I believe it takes a lot of courage to come to any medical or mental health clinician and disclose such personal and sensitive information. I hope you give yourself credit for doing so and quickly get past this negative experience. No one has the right to try and take away our hope for recovery. As I believe Kati would say, The idea that you can just simply “snap out of it” is just plain bullshit. There is an older saying “pull yourself up by your bootstraps” That basically negates any possible biological, hormonal, or genetic causes of mental illness (my parents are advocates of the bootstrap method“.) in my opinion, friends family members and other loved ones may often suggest we may not be working hard enough, making appropriate choices as much as they would, and “playing the victim“. Anyone who judges you in such away is either ignorant or uninformed or has heard the same thing said to them or others. At worst, people who judge you this way are often looking for simple easy answers so that they don’t have to feel uncomfortable, or powerless, or have to continue to deal with complex, difficult topics. Since your new, I wonder if you noticed that Kati has a free workbook available on her website and mentioned in a lot of videos, for eating disorders (ED). Also, I saw a video that Kati did where she specifically said that there are many not so good providers out there just like any other job, because were all human. In your case however, I find what the clinician said to you unconscionable and hope that you have have the opportunity to find someone else who will at least treat you with basic respect, and hopefully no heckuva lot more about eating disorders as well as federal regulations regarding patient privacy (HIPPA) laws, patient rights, and standards of care for practice of mental health care as well as standards of care required for maintaining nursing licensure. It’s particularly disturbing to me that this clinician would make such statements in front of a student. As a nursing student I worked alongside a nurse practitioner at a university clinic. It’s actually illegal to allow a student in without asking the patient and getting their consent, however in the real world I’ve seen it happen where a patient may not be aware of their rights and, particularly at teaching hospitals: I’m not sure if there’s some kind a blanket consent the patient might be signing when they except care, but I’ve seen this happen where clinicians just bring the students in without even asking. I’ve personally consented to having students in the room when I’m feeling relatively emotionally and intellectually well and feel like I’m contributing to their education. I even asked them where they’re studying in what they’re studying. Regarding your final question “how do I how do you snap out of something you can’t control” I certainly hope you don’t hold yourself to that impossible standard. However, the only thing that I would really say is likely impossible is to “snap out of it“! It takes a lot of hard work. It takes courage. It takes persistence. There wouldn’t be entire clinic dedicated to the treatment of eating disorders if it was something that could indeed, he snapped out of. I wish you all the best and hope you find this encouraging even though brevity is certainly not my strong point LOL. Pat yourself on the back Jenn, For leaving that office and reaching out here to check your perception and continue pursuing self-care for your eating disorder. God bless you!

    Jenn

    Thank you so much for your reply. It has helped me to understand that I am not over reacting and that what she said was not appropriate. It’s been 10 days since that appointment and I haven’t been able to bring myself to go back to my GP. He has probably received a letter from the nurse with the appointment outcome. But she wouldn’t have written all the stuff she said to me. Am I allowed to request a copy of this letter? I’m terrified that if I go back to my GP he will either send me back or not believe me. This appointment has made me feel so much worse. It’s on my mind all day everyday. When the ED voice says something nasty to me straight after I hear her voice saying one of the nasty comments.
    I wish there was another way to get help. We only have 1 mental health unit where I live. There are independant therapists and counsellors but none specialise in ED. The closest is 2 hours away.
    Trying to complete assignments as well is making me feel like I’m reaching breaking point. I’m already behind due to my emotional reaction to this appointment.
    Thanks again for your reply

    Hawtflash

    Good Sunday morning from Boston Jenn! I just wanted you to know that I got your message from yesterday. I’m relatively new to this site and I’m so glad to see you excepted my friendship request. I think you’re my first friend here! I also just figured out how to navigate to your profile and have been looking at my own. I see that you’re from New Zealand. When I was in high school I dream of mine was to go to visit Australia and hike around Queensland and see Ayres rock and such. I wish I knew more about New Zealand. In any case I wanted to let you know that my experience here in the United States has been that our medical records belong to US. Just for a frame of reference, to let you know where I’m coming from, I worked as a secretary for a major health insurer through college. I learned a lot about medical record confidentiality and the rights of patients as regards there are medical records. But that was 25 years ago. Also I only learned it as is as it applied to United States law. Here I do believe you absolutely would be entitled to a copy The record of the communication from the nurse you saw that sent to your general practitioner. In my experience specialist off and send a copy out of courtesy to their patients. I don’t think that necessarily means that a patient gets all of the communication (such as any verbal communication between providers?) But it is comforting when everyone is “ on the same page“. If it’s OK for me to suggest, me trying to put myself in your shoes, as a person not as a professional, I would request a copy of the record of your visit to the specialist. I would wait if I could until I received the copy. Here in the United States you would likely have to fill out forms to authorize release of information even To yourself. They are consent forms and for “sensitive” information such as mental health substance-abuse HIV related information there are often separate boxes and more “hoops” that anyone requesting your medical records has to sort of jump through. In other words here in the United States are medical records are protected to a certain degree and what they call sensitive materials have even a degree more protection before they released her. I do ask them about how long it might take for you to receive a copy of what I believe they might call a consultation letter if you were directly referred from your general practitioner to this particular ED provider. If it were me, with my own anxiety, I would feel better to see what was sent in writing to my general practitioner. I think I would find it helpful to check my perception against what was actually communicated to my general practitioner? I think it would be helpful to me to see that to formulate questions for my general practitioner as to where to go next. I’m not quite sure why you might be afraid of what your general practitioner Mike to you and that concerns me. I wish everyone could feel safe with the people giving them any kind of medical or mental health care. I personally think that it’s human and to be expected, for any patient for any reason (medical mental health otherwise) to feel as if they are vulnerable when seeing someone that might have more education and them; Sometimes it can just be the personality of the provider that’s intimidating, I know for myself a lot of times it’s hard for me to see a mail provider no matter what there specialty is? Again no I understand at least I think I do your anxiety about only having a very limited pool of people to choose from and having to work with what you’ve got. I’m hoping in what I write to you to have encouraged you and give you confidence to speak your mind without fear the most appropriate way you can advocate for yourself. At the end of the day we all go home with ourselves no matter who we meet I think. In the spirit of “talking back to her negative voices” whether you get to see anything in writing from the specialist or not, it’s my wish that you are able to say to yourself “My thoughts, opinions, Values, are just as important as anyone else’s including doctors lawyers presidents (LOL) Nobody knows you better than you can yourself. They may be able to give you some insights that you may choose to except or reject. When reaching out for help it can be especially true of tricky to navigate. I think it’s perfectly fine for you to tell your general practitioner that you had a bad experience with the person you saw. Perhaps a better wording for brevity Would be a phrase I hear a lot “I just don’t think that person is a good fit for me“ and “might I be able to see someone else?. That way you can explain as much or as little as you feel comfortable with. I’m quite concerned about your fearing the opinions of either the specialist or your general practitioner. In an ideal world we would all feel comfortable and be able to trust the people that we are seeking help from. In the real world, though, this is not always the case. In the United States follow up appointments for both physical and mental health care in the Medicare Medicaid and a few private healthcare system is that I’m familiar with generally speaking initial appointments are given 45 minutes to an hour, meaning the very first appointment when you see someone, then after that only 15 minutes are allotted for follow up. In my humble opinion, it can be really hard for even the most healthy well spoken people to communicate effectively their needs in 15 minutes or less. And those 15 minutes actually include time for the patient to say what they have to say and the doctor to give feedback and both of us to come up with a plan! I certainly hope you don’t feel alone in these challenges. And of course I don’t know how things work in New Zealand. If it is of comfort to you and you can discern whether or not you are productively problem-solving versus ruminating and increasing your own anxiety, perhaps you could Google patient rights in New Zealand? Perhaps you could Google your right to medical record information in New Zealand? If you feel overwhelmed I think you should be able to call your general practitioners office and simply ask them how you might get a copy of something that you’re interested in seeing. I think from being a patient myself and what I’ve heard from Katie, It’s really important to be able to understand and look at the way we are thinking and then if we feel the need or if those opinions are negative and we need to “argue back” Against the negative “voices”, checking our fears against reality can be helpful. Here in the knighted states government websites are labeled.gov that helps me know that they are legitimate. I hope you know we New Zealand what are credible websites to look out for patient advocacy. By that I mean your own, our own advocacy for ourselves and our rights As patients. Here in the United States my experience has been that when requesting mental health records they are not as forthcoming as I would hope and by that I mean there’s are simply more administrative hoops to jump through but we are able to get them. I wouldn’t be surprised if the provider wanted to have you come in and look at your record while they’re still there. The reason they do that is in case anything Distresses you to read, then they are there to talk about it with you. However I don’t think that that’s the only way you can get your record here in the United States. I was able to get a copy of my for medical recordThough I did have to pay a copying fee per page. In the meantime if there any videos of Katie’s about what to do when you’re afraid of what your clinicians might say, and how to get out of the “Fight, flight or freeze” stage/process of responding to stress I would encourage you to listen and read about that. I would encourage you to journal and maybe even prepare something in writing if that’s comforting to you. If there’s anyone that can come with you that you feel comfortable with I hope that you can find someone to go with you. I have also had personal experience with being patient a patient feeling Very vulnerable and the person or persons that I’ve gone to for help in the medical/mental health community saying or doing something inappropriate at best, damaging at worst. For me on some occasions it was Traumatic. On other occasions I was able to speak well enough for myself to straighten things out things and even get an apology that made me feel better. Other times, I just didn’t feel like I could work things out and was able to go somewhere else or I had to wait to see someone else is probably a better way to say that. I am praying for you about this if that’s of any help to you. Above all don’t give up, and be patient with yourself. Your feelings are valid.

    Jenn

    Thanks for your reply. I spoke to my GP today when I took my 4 year old in and he is happy to get me a copy of the letter the ED nurse wrote. Apparently she told him I wasn’t interested in getting help. I’m so nervous to read the whole letter. Why would I go if I didn’t want help? What else has she wrote that isn’t true. Omg my anxiety is going crazy.

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