"Old" Neuro assessmet of Nipple Twisting of Pinching

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Can anyone give a little history regarding nursing's involvement with nipple twisting or pinching in order to elicit a neurologic response? Approx. how long was it a part of our nursing assessment? Appreciate any information on the subject.

Zachhorse

Specializes in Emergency.

Ummmm, I hate to even say this here, after reading the other responses, but I do this all the time! I work in the ER so maybe it's a little different.....I don't do it to assess for responsiveness to pain, I do it to arouse a drunk or a high drama pt. For instance, I may have a pt who I know can hear me, but refuses to follow commands due to high drama serum level so, I little nipple twist always gets an appropriate response. It's sort of a quick assessment on initial arrival to the ER to determine a true level of consciousness.

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Ummmm, I hate to even say this here, after reading the other responses, but I do this all the time! I work in the ER so maybe it's a little different.....I don't do it to assess for responsiveness to pain, I do it to arouse a drunk or a high drama pt. For instance, I may have a pt who I know can hear me, but refuses to follow commands due to high drama serum level so, I little nipple twist always gets an appropriate response. It's sort of a quick assessment on initial arrival to the ER to determine a true level of consciousness.

and what happens when that "high drama"young female complains? and if you get a good right hook from one of the guys, i would have NO sympathy for you, what so ever!

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Specializes in Peds/outpatient FP,derm,allergy/private duty.
and what happens when that "high drama"young female complains? and if you get a good right hook from one of the guys, i would have NO sympathy for you, what so ever!

I've never heard of that. Nipple twisting as a form of behavior modification on a patient who is not unconscious? I thought the nipple twist was intended to determine an unconscious patient's response to what we used to call "deep pain". If you twist the nipple with the intention of causing pain, that's not a neuro check. Maybe some of the other neuro nurses can explain that. Thanks!

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Specializes in Emergency.

They don't complain because they are either truly altered or because they are faking and the complaining would give them away. Believe me it works! Kind of like shoving an ammonia cap in their face, except I don't have to go fetch the ammonia. I am shocked that a nurse like yourself who is so sympathetic, compassionate, and caring would "have no sympathy" for a fellow nurse who catches a "right hook." Wow, show those true colors. Also, never said it was "behavior modification." I believe I called it a quick assessment. Any of you are welcome in my ER to show me a better way. I always welcome constructive criticism from a knowledgeable, experienced source.

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They don't complain because they are either truly altered or because they are faking and the complaining would give them away. Believe me it works! Kind of like shoving an ammonia cap in their face, except I don't have to go fetch the ammonia. I am shocked that a nurse like yourself who is so sympathetic, compassionate, and caring would "have no sympathy" for a fellow nurse who catches a "right hook." Wow, show those true colors. Also, never said it was "behavior modification." I believe I called it a quick assessment. Any of you are welcome in my ER to show me a better way. I always welcome constructive criticism from a knowledgeable, experienced source.
i reiterate, not one damn bit of sympathy! and i hope for it to happen! this is battery, plain and simple!
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Specializes in Emergency.

tell me how you really feel!

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Specializes in Peds/outpatient FP,derm,allergy/private duty.

I'm not criticizing you. I only used the term "behavior modification" as shorthand to mean that you employed the technique when you knew the person could hear you but was was not following commands. All ERs have unresponsive drunks and drama, that's why I asked the question. Maybe I should ask it as a thread in the Emergency nurse's forum-- or maybe curiosity about something outside my sphere is violating an unwritten code of etiquette since I'm not an ER nurse myself.

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Specializes in Emergency.

No offense taken, nursel56. I only found this question when I stumbled across it because I had a burn question. Maybe you'll get more varied and open minded opinions and experiences in the ER forum. I've posted alot there and never been told by someone who disagrees with me that they hope a pt attacks me because I am cruel and assault my pts which is wrong.....whatever that rational means. To answer your questions, I have seen it used often by people with varying degrees and have used it myself! :D

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Specializes in Peds/outpatient FP,derm,allergy/private duty.
No offense taken, nursel56. I only found this question when I stumbled across it because I had a burn question. Maybe you'll get more varied and open minded opinions and experiences in the ER forum. I've posted alot there and never been told by someone who disagrees with me that they hope a pt attacks me because I am cruel and assault my pts which is wrong.....whatever that rational means. To answer your questions, I have seen it used often by people with varying degrees and have used it myself! :D

Oh, God, no. They'll have me for lunch! Just kiddin'. :D I've seen some of your posts, so I know you aren't some deviant lurking about the hallways. Happy Holidays! :cheers: (I do know holidays are pretty hairy for the Emergency Dept what you guys seeing the dark side of all the party animals and wacky family stuff)

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No offense taken, nursel56. I only found this question when I stumbled across it because I had a burn question. Maybe you'll get more varied and open minded opinions and experiences in the ER forum. I've posted alot there and never been told by someone who disagrees with me that they hope a pt attacks me because I am cruel and assault my pts which is wrong.....whatever that rational means. To answer your questions, I have seen it used often by people with varying degrees and have used it myself! :D

in mass. this would be battery, in ct assault......maybe you should stop and think about your use, of this absollutely unnecessary and abhorent "skill". always use the least invasive/dangerous/painful way to get the info you seek, and you have already admitted that that would be the "smelling salts".....as you sow so shall ye reap.

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Specializes in ER.

If someone is unresponsive the appropriate action is to check for response to voice, then pain. When the patient feigns unresponsiveness to voice they can expect the nurse to check responsiveness to pain. Fully assessing the patient makes him a good nurse, not cruel or sadistic. Now if he did it twice for good measure, yeah, that would just be revenge.

I agree that nipple twisting just isn't appropriate, there are ways to assess responsiveness that don't involve disrobing the patient, and can't be considered sexual acts.

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If someone is unresponsive the appropriate action is to check for response to voice, then pain. When the patient feigns unresponsiveness to voice they can expect the nurse to check responsiveness to pain. Fully assessing the patient makes him a good nurse, not cruel or sadistic. Now if he did it twice for good measure, yeah, that would just be revenge.

I agree that nipple twisting just isn't appropriate, there are ways to assess responsiveness that don't involve disrobing the patient, and can't be considered sexual acts.

BUT this IS what he insists he does....and usually in the case of a behavior issue, not even true neuro issues!!! this is assault....i used pain to assess level of consciousness today, I assure you i felt no need to be twisting anyones nipples!!!! and would have run the risk of arrest had i done so!

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