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Nurse ‘ick’ videos: An OBGYN explains the importance of compassion

This month, a video went viral on TikTok in which a few labor and delivery nurses from Atlanta shared their “icks” – pet peeves – about their patients. Online commenters blasted the nurse’s complaints as disrespectful and needlessly cruel. But the video prompted responses from other users who detailed their own difficult birth experiences with providers they felt didn’t listen to them.

Dr. Heather Skanes, a young OBGYN who recently opened her practice in Birmingham, Ala., has seen the video. A friend who’s also in the medical profession sent her a link to it even before it went viral. Skanes told Reckon News that the video highlighted, for her, a problem that persists in medicine and birth work: providers acting in ways that destroy trust with their patients.

“When (patients) feel like you’re not listening, they may stop talking, which means you’re not getting all the information you need, which can affect their care,” she said. “You have what I think is one of the biggest problems that can develop, which is this distrust of the medical system. It’s so harmful for the people we want to serve.”

Skanes said she built her practice, Oasis Women’s Health, to improve community healthcare particularly for Black women and birth givers. She said she’s heard from patients who have stories about providers who were dismissive, or who talk about being afraid providers won’t believe them when they talk about a problem or concern in pregnancy.

Read more: This Black-owned birth center just welcomed its first baby as the state threatens to shut it down

Reckon spoke with Skanes about this issue, what needs to change in the medical system, and steps people can take when they feel like nobody in the hospital room or doctor’s office is listening to them.

What were your initial thoughts when you watched the nurses’ “ick” video?

Skanes: One of the things that came to my mind immediately was that a lot of the things that were mentioned (by the nurses) in the video were minor inconveniences for a healthcare provider, whereas they’re a big deal for the person on the receiving end.

One of the complaints was a person asking to shower or eat before a (labor) induction. Some people don’t have a shower, or much food to eat. When you’re making a video like this, you’re not thinking about that vulnerable population. That is harmful. You just assume that person has access to food, to clean water and a safe space to shower. So keeping things like that in mind when we’re caring for people is important. It requires a conscious effort to tell yourself that not everyone is in the situation I’m in. The most important thing is not harming them and providing good care.

When we’re talking about providers being dismissive or not listening to a patient, what does that look like?

Skanes: No matter what your role is, whether you’re a nurse or a midwife or an OBGYN, everyone has to make a concerted effort to make sure people feel like they’re being heard – whether you agree or disagree with a person, and whether you feel like it is or isn’t an emergency.

Sometimes people will feel like they’re not being given all the information. If you don’t tell the person why something is normal, or what signs to look for that would make a situation abnormal, they’re more likely to feel like you’re not taking into consideration what they’re saying.

Sometimes (patients) may state a complaint and you may feel like, as a provider, you’re reassuring the person. But that person may feel like you’re brushing them off. It’s important to acknowledge the concern as a legitimate concern, even if it is something that’s normal. They just need you to acknowledge that what they’re experiencing is real.

The medical establishment has a long history of mistreatment of Black people, and mistrust of doctors and other providers persists today. How does that impact a person’s health?

Skanes: Ultimately it’s harmful for the people we want to serve. If they don’t trust us, they won’t come to us. And then their long-term health is affected. They’re not coming to their postpartum visit, they’re not coming to get their contraception, their cancer screenings. All because people are scared to go to the doctor or don’t trust us.

Often my patients are looking for a provider of color because they’re more likely to be listened to by a person of color. There is evidence of better outcomes in that situation.

What kinds of changes would you like to see in the medical system, including physicians and hospitals, to improve provider-patient relationships?

Skanes: I think cultural competency training is important. It’s a training of medical staff and thinking about the different ways in which we may unintentionally offend people or the ways in which our biases may be harmful.

That starts with people at the highest level understanding why that cultural competency training is important. Sometimes the people at the highest level don’t understand until it translates into dollars and people saying, ‘I’m not going to this hospital anymore.’

What would you recommend someone do if they feel like their provider isn’t listening or is dismissing their concerns as not valid?

Skanes: It depends. A lot of times, with obstetrical care specifically, people think you can’t change providers, which is not true. During the pregnancy, if you feel you’re not getting the care you need, you can change providers. If youre in a hospital setting, you can ask for a second opinion from a different provider. And if there is no other physician available, you can ask for a patient advocate or administrator to come and listen to what you’re saying and to make sure your voice is being heard.

I think this is also a great reason to hire a doula who can advocate for you, because they know what your concerns are because they’ve already discussed them with you. They can help say what needs to be said. It’s a great reason to have them on your care team.

And I think sometimes we get in our heads (about a specific concern), like, ‘Maybe it’s just me.’ A lot of times, it’s not just you. Other people would also be offended by what you’re offended by. Asking other people if what was told to you by a provider makes sense, can give you the confidence to take one of those other steps.

Learn more:

A quick explainer on medical mistrust from the American Journal of Managed Care

HUED to search for culturally competent providers

National Patient Advocate Foundation for information on patients’ rights and advocacy

DONA International for information on doulas

Anna Claire Vollers

Anna Claire Vollers | avollers@reckonmedia.com

I report mainly on reproductive and maternal health, working parents and family policy at Reckon News.

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