Natalia Grace #24 - (Who is the victim?) - Therapist Reacts
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- Опубліковано 15 тра 2024
- Dr. Kirk Honda reacts to the documentary about Natalia Grace. Includes clips from The Curious Case of Natalia Grace.
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Poor Natalia. I don't understand this fixation on victim or villain. Why doesn't anyone see that she's absolutely a victim and that her circumstances damaged her so her behaviors are sometimes problematic? Anyone who expects a child with her background to be totally fine with no attachment issues is either very misinformed or very naive. I'm an adoptive parent and while my child managed to avoid all of this because she came to us as a tiny baby, it was a big part of our training to expect attachment issues, anxiety, fear, PTSD, etc. This is especially common with international adoptions. I think most of the families involved used her one way or another or either refused or didn't know how to get her the support she needed to help her with any behaviors. So she just got passed off to someone else time and time again.
There's an unfortunate general sentiment in our culture that victims have to be perfect. And if you're flawed you're not a victim. It pops up in true crime stuff all the time. We should be better than that. But, unfortunately, we're not.
@@h8a1c3 yup. It seems to particularly apply to women and children victims.
Well f-ing said
Michael tells Natalia that he was afraid to lose his sons. So cruel, he says nothing about his daughter
He’s never seen her as his daughter.
I thought this exact same thing. Imagine sitting there while he said that meanwhile he was, at one point, supposed to be your family. God that sucks
24:32 I think this image tells the whole story. The parent attempting to compete with their own child in displays of distress, sending the message "your pain is not important, only MY pain is". Any child of abuse or dysfunction can relate to what it feels like to be Natalia here, this empty, falling, 'no one is ever looking out for me' feeling.
💯💯💯
Yep 💯😢
So unfortunately true
I feel that ALL of the adults in this documentary are performative, don’t seem genuine, and only say things that wouldn’t make them look too bad. It’s heart breaking that she probably can’t even tell what the reality and truth are because everyone else lies to fit their needs and she is traumatized.
At 25:00 it looks like Natalia is frustrated and in despair. She's already been hurt so much and now when she's looking for answers, he's not answering with anything that might help her. She can see Michael is not getting the magnitude of what's been done to her and he's focused on making it about himself.
This is the writing style we were taught when we trained to become registered nurses. The idea was to avoid that a specific member of staff could be accused of wrong doing. By leaving out the subject a text can be viewed as if the entire ward/hospital is behind the claims in the text. (I wish my English was a bit better here)
Whether or not people were taught to chart that way and whether or not the stated purpose was “efficiency”, the overall effect of writing that way is to increase distance and give a greater sense of clinical detachment. It is a form of medical jargon and it only helps the provider and the institution, not the patient. Thank you for considering the patients best interest even in this small detail.
I agree with your sentiment advocating for patient centered. At the same time, it really comes down to individual perception. As someone with ADHD myself, I prefer my providers use technical writing. I don’t want a narrative that requires me to filter through the extraneous details like who is writing the note because that’s a given and thus useless to me. Side note: Jargon is terminology. What you’re talking about is style and that you dislike the style of technical writing. I totally agree that there’s an element of detachment to it and unfortunately larger clinical institutions have no choice but to prioritize efficiency because access is so limited, clinics are chronically understaffed, and providers aren’t given dedicated time for charting during their work day. The detached writing imo is a symptom of broader systemic issues. Patient centered care can only be as patient-centered as our for-profit medical system allows. The cynical side of me also thinks the use of technical writing is a way a medical institution can maintain plausible deniability under the law. For-profit medical systems are for-profit not for-patients. It’s really unfortunate. In the U. S., personalized heath care seems
more like a mirage than a reality. ☹️
That’s how you were though in nursing school
I'm an ICU nurse. We are taught to chart that way to keep the focus on the patient. It doesn't matter that "I" did something - what matters is the patient's experience, "Patient's dressing was changed via sterile technique". We are electronically signing everything somewhere in the flowsheet anyway, so it is not a question of who did what. It also helps reduce someone reading it from interpreting the nurses' writing as purely "opinion". "Patient told this nurse to fuck off. Will continue to monitor".
That idiot is an adult male. If he isn’t playing a role, how did he ever get past the adoption process. He acts like a child himself. Poor Michael was a victim of his horrible wife. Really? Could he not intervene on behalf of a disabled child?
Right?!
24:10 I think we need to approach Michael differently. I believe Natalia was *never* his “daughter” in his mind. I don’t think he ever formed any kind of attachment to her, either because he simply wasn’t capable, he doesn’t strike me as someone who can easily form healthy attachments to anyone, or because the jealousy and rage of Christine prevented him from getting close to an adopted child. Natalia was never his child. Almost like they took in a pet they weren’t ready to care for. He’s not going to have that attachment. You’re never going to see his reactions towards her look anything like what even an awful father’s reactions should be.
Great video!
Regarding the notes... I worked in several hospital capacities doing notes and yes, it's how I was taught to do notes, but the biggest thing was how it came down to others reading it for auditing purposes and court cases. We were taught to refer to ourselves as "this worker" and it's supposed to give a more "neutral" or "3rd party" description of the events to look "more professional" --- all things I was told in trainings
Not saying that is right or wrong, just that that's why we were told to use that language
Hurt people hurt people. Especially given how young Natalia was, interpreting her behavior, (even if all allegations are true!), as malicious and prosecutable, instead of 'cries for help' just bothers me. If she felt alone and like no one was on her side, Natalia would have been right! That would bring out at least mildly antisocial behavior in anyone. Children without empathetic caretakers have no good options, and honestly I'm so impressed with how she turned out in adulthood.
This is an excellent point. How was she supposed to behave considering what she was going through!?!? Of course we don’t know how she actually behaved but even it she did do all of the strange and at time violent things alleged we know she was a child
Trained to write notes that way Dr Honda. Subject is already known unless stated otherwise
Yeah lol. Subject is implied. It's efficient.
I’m a nurse. I was taught in school to write that way.
Regarding the abbreviated sentences, I think the "I" is left out because the subject wants to distance themselves from the patient/case🤷🏻😕
I'm not watching the next installment, but this video was in my feed, and I mean, I'm still a little curious, at least. Better to give this my view instead anyways.
The thing that bothers me about this whole TV series is the weird he said/she said/mystery/sensational element. We're not stupid. We know Natalia was a kid. We get it. So rather than...whatever this "docuseries" is, why not just say--these things happened, here are some theories on why, such as RAD, loopholes in the international adoption system, etc. Instead...I guess we're supposed to constantly teeter on the edge of blaming a child victim?
Booo 0:05. To the film makers for recording and publishing this little girls hesitant "secret". They didn't even give an answer back to her. I get that their guardian would be the one to ok it. But little one didn't seem like she wanted to be rude.
I think this series makes me angry because it is confusing on purpose. And if this is the filmmakers style I wonder if they will have more child victims face their abusers. Like a s.a. victim meet with their offender and we get "both sides" of the story like this series. I am sorry for the dark sarcasm. But I am so angry for Natalie. And Micheal is really triggering me.
She wouldn't remember being bitten as a baby, right? I mean, is this even possible? She's just reiterating what adults told her.
Writing in such a way give you less responsibility than using "I" subject
Good point.
Also what dr Kirk said. At least in my experience. I was taught to not say “I” in professional contexts. When I think about it now it seems silly and so wrong but I’m just so used to it. I hadn’t questioned it until today.
Re: not using "I" in notes. This is how I was trained to document as a social worker. It has always annoyed me, but I feel that a lot of professionals are trained that way and it feels expected.
Re: nursing notes, yes that is how we are taught to write nursing notes. If necessary for clarity, you’re supposed to write something like “this writer” or “this RN” instead of I. I’m not necessarily sure why outside it’s carryover from paper charting where there was more of narrative style of charting that highlighted events throughout the shift. Many things were abbreviated for efficiency. Now the majority of our charting is clicking drop down boxes on a spreadsheet, but still taught to write notes like this.
I was taught this as well. "this MHP" or "this therapist"
I went to school to be a HCA (CNA in Canada) and we were taught to chart that way! I forget why, maybe to save time/space in the chart? We were told to never use “I”. When I worked in long term care, the RN and doctors would chart the same way.
Emergency physician here, I have some insight about the notes in the ER. First of them is that we are taught in school and in our training not to use the first person in our notes. Instead write “this writer” or something like that. However, we write such a volume of notes and are in such a hurry, that a lot of people end up using that shorthand of skipping pronouns. I agree with you that it is unclear. I reached a point years ago where I just stopped worrying about it, because it makes no sense not to use the word “I”, since I am the one writing the note. But a lot of people still avoid it. It’s odd, I agree with you. The second part is the shorthand with all of the abbreviations. Again, this goes back to the volume of notes we write in the ER. Everything has to protect us legally, so we end up writing more than we would like to, and we are always crunched for time since things are busy and can get out of hand in a matter of a few seconds. Also, just having observed the sheer volume of documentation that nurses are made to fill out by hospitals- it is absolutely crazy. It takes up SO much of their time, and they are rushed, so there are a lot of abbreviations. Each patient has multiple documents that the nurse is forced to fill out. Looking at the note you are reading, that is a really long note for an ER nurse, and I would assume it is because they realize this is a legal nightmare. But for them to take the time to write this much is definitely a big deal. Hope this sheds some light.
Dr Honda, to answer your question about how medical professionals write, I was taught this in school as well. Writing in the first person is just not a thing. We were taught to write "This PT called the pt" (this PT means me this physical therapist. Using shorthand is important to us because we have so much to write and others have to read it to treat the patient after us. In a hospital the amount of productivity expected forces shorthand to be used as much as possible.
I QC scientific data. The rule is always that it should be completely repeatable by someone 10 years from now by only reading the data.
When I was medic in the army I used to write notes like that too. I was just doing what everyone else was doing though lol. Also we used a ton of abbreviations and short hand medical script, for example: 24 yo f complains of NVD. TTP RLQ (............etc) I think because we were army medics and working in a field hospital, we did sick call and trauma care, so we had to short hand and write fast. Maybe that is why everyone knew the short hand.
Thanks Dr. HONDA & STACY!
I think the reason many clinicians avoid the first person is because it makes the notes feel more objective and gives the impression there is no bias in them and they are 100% fact. However, the truth is that of course, we all have biases, many subconscious, that come out when we summarize or paraphrase the way these notes do. It’s my belief that avoiding the first person is a clever way of trying to hide those biases, not just for others who may read the notes, but subconsciously it might even make the clinician feel better by seeming to free them from judgment about how they handled the situation.
5:26 How old is Natalie here? Is she identified as older from her families falsification?
11:17 How rich, Micheal is solidifying the history of event's AS HE sees it. I know I am getting spicy. But I DON'T UNDERSTAND these adoptive parents that are just hot potatoe-ing a CHILD. Completely ignorant to her experiences and surprised by her behavioral health not being manageable or different from the other kids.
14:42 Seething again. No one is saying she didn't act out. But FFS she is a child with unique needs, has no foundation, and didn't get to develop in a healthy relationship. I am just perplexed here. The damage to Natalie had been compounded in her childhood. Things weren't just going to get better at home without professional help and patient one on one available guardians. She has had good experiences in school from the staff's recollection. This is a clusterfck of a series.
Also, maybe Christine called and told the hospital stuff pretending to be the new family.
I was taught to chart that way as well
I write in great detail but from third person lol "the therapist then did such and such" as an ABA therapist
They teach us not to put ourselves
I’m the note.
Great insight as usual. In training for progress notes I had to write "This therapist met with the pt on this day to discuss.... etc." I just had a google doc set aside for typical words and phrases like that so it only took a few minutes to describe what was done that day! My supervisor was unique I guess! :)
Around 10 - I know I was taught to never use personal singular or plural pronouns (I, me, we, us) in anything EXCEPT creative writing. It is kinda dumb, when you think about it, but it was strictly enforced in high school.
It was also okay in correspondence when I was taught, but absolutely not in any kind of report, essay, or research
You can't kill somebody by an electric fence. I lived on a farm and touched the electric fence as a small child and didn't come anywhere near dying. It just hurts.
When I write my therapy notes I will use “therapist” when referring to myself rather than “I.” The consequence is people questioning my professionalism when writing I in a note. I know it’s not logical but it feels less formal when writing “I” in progress notes. I think there is a gender aspect at play. People are much more likely to question my professionalism rather than a male therapist or health professional
maybe omitting "I" in reports is a liability thing? like if something bad happens with the patient after the report, and the medical staff's actions are called into question for whatever reason, maybe if they write "I called" or "I asked", then they're more likely to be held responsible for any mistakes, real or perceived, than if they leave it ambiguous. that's my guess 🤔
Former litigation paralegal here -
Staff using an electronic charting system would have user ids that would allow their system inputs to be tracked back to them. Back in the days of paper charting, authorship would be discoverable based on who was working when, and their assigned rounds. Also, healthcare is highly regulated; chain of custody of records is maintained. All that's to say, leaving off the 'I' does not eliminate liability. I suspect that removal of the subject / pronoun as relates to the writer intends to depersonalize the writer from the clinical notes that they are recording.
@@Nonameforyoudangit ah, that makes sense! thank you for sharing your knowledge!
As a nurse, we are taught to refer to ourselves in the third person, so the notes make sense also to other healthcare professionals. If I write "I asked her", the reader will have to check who I am and what is my role in the patients' healthcare. So instead, I would write "in-home nurse asked the patient".
However "asked patient" is not a professional way of writing and likely due to being in a hurry. I know we shouldn't be, but sometimes if your choice is to write carefully and to tend to a patient's more urgent need, then the writing is sacrificed. I try not to let that happen, but also won't be casting the first stone at a nurse who cuts corners like that - instead of cutting corners elsewhere.
Thank you
Speaking to medical professionals not using proper grammar/full sentences, my mom was diagnosed with dementia a few years ago and my dad shared the report that was provided to him by the team who evaluated her with my sister and I. I was very put off by all the grammatical errors and incomplete sentences used throughout the report. My sister also pointed it out. It made me question their expertise because, to me, it shows a lack of care for the patient and the family to not be able to effectively communicate. So strange. Also, the excuse of "this is always how we have done it" is one of my pet peeves.
So I'm a nurse and I'm going to "keep it an 8th grade reading level" in mind.
It was how we taught to not include the self in the notes typically but I never really thought as to why.
Uhh, with video evidence of someone beating a child to the extent he describes, he didn't think that would be enough for the courts to grant him All of his kids?
I can imagine being tortured by Christine and her saying tell me who you are she would be triggered if people started asking you about your past.
This video and #23 are in the wrong order in the playlist. There are also a lot of doubles in the playlist (of #1-16).
I used to work in the court system, and leaving out the personal “I” in notes is taught. It’s some very old fashioned idea of “professionalism” where underlings would get called out if we added that one simple personalized bit to our notes. I imagine it carried over into all serious professions, especially those that employed a lot of women.
I always found it creepy, but I personally believe it to come from a time in the beginnings of our entire society holding up really awful people who have no empathy as the leaders of civilization.
4:04 Nope!
They brought her her in because you have to get immediate treatment for a bite from another human bc for whatever reason it’s extra likely to get infected.
All this really tells us is that Natalia broke skin when she bit.
No they brought Natalia in to the hospital after biting, not the child that was bitten
I used to have to write progress notes & I was taught they have to be 3rd person (so I can’t say I) but i usually said Provider, or QBHS (qualified behavioral health specialist) when referring to myself.
so “QBHS talked to patient about ___”
It sounded to me like Mrs. Mans was thinking that maybe it’s possible that Christine spoke to the hospital and that’s where the report came from. Meaning she could have called as herself, called pretending to be Mrs. Man’s or anyone else for that matter. Michael and Christine were still legally Natalia’s parents, so it could have even been something she claimed Mrs. Mans told her. To me there’s a million ways that report was made in good faith by the doctor but manipulated by the person giving the info. Especially with what we’ve seen from the Barnetts so far.
It was strange that during this interview not once did he ask if she was ok or if she wanted him to stop talking about it, she was clearly distressed/upset but he didn’t even seem to notice. And the way he role played it was just too much. I wouldn’t be surprised if doing this series has triggered lots of things from her past.
On the subject of the medical letters, I have long term health conditions so have had many doctors and hospital appointments over the years and some of the letters on my record can make for entertaining reading, there would be parts in them that were just nonsense 😆 I think the doctor just takes brief notes during the appointment and then types up or dictates to secretary a full letter later, so they must end up just adding lots in from memory after seeing however many patients and being exhausted.
2:59 Are you fcking kidding me!? I honestly can't view this as anything close to a documentary. Like wth with the dramatizations and theatrical music. I think I am reaching my limit. 😂
18:50 I was trying to be compassionate to Micheal as a possible victim to his wife. But he keeps centering. He was an adult that adopted a special needs and very in need of support child. Then when it became too difficult they abused her. Made up conspiracies. And wanted to save face instead of doing what was best for Natalie. I keep watching these accounts from these surrounding people and try to figure Natalie's age at each point. And she was a freaking child that was abandoned over and over again. Disgraceful.
23:50 And even here Micheal is showing Natalie she was "an other" she wasn't family.
Technical writing is more efficient and keeps the focus on the patient. Also supposedly more objective though I think that's dubious. I mostly do outpatient these days and write 90% of notes as bullet points.
The hospital report is from 2013, so before Natalia was with the Man's - she was 9!
I work in insurance and we were told not to refer to ourselves as I... so I refer to myself as CS.. Claim Specialist did XYZ...
Lawyer is wrong or just lying. The little people who tried to adopt Natalia didn't had these complaints. The couple who had a daughter, apparently fostered her for a while and only said good things. Same whit the lady who's a teacher. The other couple were weird out by the Cciacones and the money they asked. Not "dangerous Natalia". A child who went through so much probably will face some issues. But is not true that every place and everyone had the same complaints that Natalia tried to harm someone
The Mans are sketchy
Re: process notes, I get what you’re saying, particularly for clinicians in private practice who have a lot more control over their schedule. Outside of that setting, however, clinicians have to find ways to improve their efficiency and technical writing is one way to do that. I work at an academic medical center supporting over 20 faculty physicians and advanced practice providers in three outpatient clinics. They work in 4 hour blocks with 30 min appointments back to back. They are seeing up to 16 pts a day. They don’t get dedicated time for charting built in to their FTE and their care teams don’t have time to sift through a narrative. They need the pertinent information. Improving clinical efficiency requires the use of technical writing because it does save time and assists other clinical staff to triage effectively and provide the best supportive care possible. (Side note: Maybe this is my cynical side but I also think they’re taught to write like that for legal reasons. Plausible deniability comes to mind.)
Former litigation paralegal here - the authors of clinical notes could be easily determined through legal discovery.
@@Nonameforyoudangit Thanks!!!
When I leave out I it’s because when every sentence or every other sentence starts with I, it sounds repetitive and I don’t like that. Just me tho
PLEASE PLEASE REACT TO THE ULTIMATUM SOUTH AFRICA
I think avoiding using “I” might come from resumes and annual reviews- it’s the kind of language I use whenever communicating my achievements to my manager or applying for a job. I bet when we are taught this in college “career development” we carry it into other professional communications haha
OMG Dr Honda! I work in insurance and I haaaaaaate reading clinical notes…some of them are atrocious. Constant complaining about the fact that documentation is even needed…People think the insurers are heartlessly denying authorizations left and right but I promise 50% of the time we get requests with virtually no legible information. I once had to beg a doctor for diagnosis so we could push an auth for a seizure medication through and he yelled it at the nurse who was holding the phone!! And the patient had been waiting for days…ugh. If your doctor has a million excuses for why you’re not getting your referral/medication….Our fax machines aren’t down, I’ll just say that 🙄
No, you're not writing a narrative. They're written that way because some things are understood. and abbreviations are used all the time. If you have 8 "patients", you are not going to write out every word.
Yeah the nurses probably don't have a lot of time to write to much.
@colorsflight6432 And doctors write progess notes in exactly the same way. It just is what is done.
you are surprised at arrogance in the medical field, have you ever read a surgeons operation note its bare legible.
It’s about Professional negligence. The lawyers can create doubt about who said it. It’s an insurance things.
You can't kill somebody by an electric fence. I lived on a farm and touched the electric fence as a small child and didn't come anywhere near dying. It just hurts.