Is a nurse in the ER joking to a patient like this appropriate?!?

Specialties Emergency

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I (a nursing student close to graduation) took my dad to the ER for chest pain last night. (He suffered a MI). He was immediately treated by a group of very pleasant doctors. The male nurse who was caring for my father quickly got too comfortable because my dad is a very calm and friendly patient. He rubbed me the wrong way when he quickly started advising my dad how he should eat, work out etc (as if my father was not already educated from this long standing condition and already taking very good care of his health to the best he could.) The male nurse then made a JOKE I did NOT think was funny: "I guess you were just born with bad genes!" my dad takes everything lightly and didn't get upset but I do NOT. Is this appropriate in the context of a joke from the "Nurse?" I seriously am developing ANGER towards this nurse today as my dad is still in the hospital. Should I let this go or report this? Also, he was sloppy when he inserted the IV and there was blood everywhere!!

Specializes in Critical Care; Cardiac; Professional Development.

It sounds to me like the nurse was fantastic to take educating your father into the equation. The nurse has no way to know how much your father does or doesn't know and whether he is actually implementing what he knows. Even if he knows all this already there are tons of people out there with conditions long term that they are not self managing appropriately and reinforcement of education during times of crisis can be the push needed to get them to take that step. The comment about his having bad genes was probably an awkward attempt to keep from sounding like he is placing all the blame on your father's behavior for his medical condition.

IVs bleed. Sometimes they bleed a lot. Especially if the nurse is newer and not particularly quick or adept or low on platelets, on anticoagulants, etc. Definitely not a reportable issue.

Honestly? I think you are upset about your father being ill and finding an easy place to put that anger. I don't see anything here that is worth this level of angst.

I am so very sorry your father is in the hospital. I hope he gets great care and is back to his usual life very very soon. Big hugs for the stress you all are under.

it's the nurse's job to educate. you went straight from making the point that the nurse was educating your dad on exercise, nutrition, etc. to the "joke" he made without mentioning what your dad said in between.

it seems to me (and i'm making an assumption) that a nurse who went from educating to saying "i guess you were born with bad genes" was met with something like, "oh, i eat perfectly healthy and work out five days a week." if that's the case....i can think of responses much worse than "i guess you just have bad genes."

maybe he should have said nothing. maybe he should've pointed out the obvious. he chose to make light of it and move on. if it offended you then maybe you should've said something. did the IV infiltrate? is your dad on a blood thinner? i don't think that "blood being everywhere" is a good reason to report someone.

I am so very sorry your father is in the hospital. I hope gets great care and is back to his usual life very very soon. Big hugs for the stress you all are under.

Thank you very much :) I'm just too close to the picture to judge logically on this one. He did tell my dad some good tips on exercise, such as staying away from weights. Hugs are appreciated and help! :~}

Specializes in Critical Care.

No, nurses must be strait-faced robots and not attempt to build any rapport or do anything that may suggest normal human interaction.

Oh, and IVs will only produce maybe 1 or 2 gtts of blood for every venipuncture - anything more is being incompetent and the nurse should just hand over their license to the BON and flagellate themselves at home.

:)

But in all seriousness, sometimes joking - even if you don't think it funny - is good for a patient in an emergent situation and can help calm the atmosphere, even if but temporarily. If your father reacted and took it well, why bother complaining?

Specializes in Psych ICU, addictions.

First, I'm sorry that your dad is in the hospital.

Second, the nurse was right in instructing your father about what he should be doing; he should never assume that because you dad had a chronic condition that he knew all about it, that he was actually doing everything he should have been, or didn't need a refresher course on it. Better to educate again and cover all bases, even if the patient says, "I know that already."

You stated that you were a nursing student, and so I say this with the utmost respect...but are you miffed over the instruction itself or the fact that it wasn't you that was doing the teaching? Did you feel the fact that the nurse teaching your dad somehow reflected poorly upon you as a nurse-to-be/daughter? I am very serious: I have seen similar reactions happen with patients whose families happen to have healthcare professionals in them. And I've felt that way myself with my own family at times.

The fact that he joked with your father--and the fact that your father responded well to that humor--isn't necessarily a bad thing. And to be honest, sometimes it is genetics that is the cause of the problem.

As far as the IV...even the best nurses can have a messy IV--that doesn't necessarily reflect on the nurse's professionalism. And as others have said, there's a lot of other factors that weren't mentioned.

You're right, you are too invested in this to be entirely logical about it...and that's OK: it is your dad after all. However if you do have a concern, you should never hesitate to speak up about it. Better you do that and the concern is put to rest, than to not do it.

I hope he has a speedy recovery.

if it offended you then maybe you should've said something. did the IV infiltrate? is your dad on a blood thinner? i don't think that "blood being everywhere" is a good reason to report someone.

Thank you :) Yes, he was put on Lovenox, so that's where my concern stemmed from. I know I may be overly sensitive in this situation because it's my dad. I will def speak up if I am bothered next time. He does eat perfectly and exercises regularly, your assumptions are correct. It's a very frustrating situation.

Specializes in wound care.

whhewww over react some, , and people wondering why so many nurses get burned out and hate nursing... you cant ever win, if your unpersonable your rude and robotic. if your personable and try and lighten a tough situation your unprofessional. Welcome to the wonderfull world of nursing , enjoy :)

Sheesh. I'd better resign because the last IV I started was a hand gusher that dripped on the bed. The PATIENT made a joke about it, can I report her???

it seems to me (and i'm making an assumption) that a nurse who went from educating to saying "i guess you were born with bad genes" was met with something like, "oh, i eat perfectly healthy and work out five days a week." if that's the case....i can think of responses much worse than "i guess you just have bad genes."

I completely agree. When I tell people about their risk factors, and they insist that they "do everything right," I typically respond with "Oh...well, you just didn't read the fine print when you picked your parents." A joking way of saying "this is probably a genetic pre-disposition." So I guess I would have really ****** off the OP.

OP, I think you overreacted. It sounds like your Dad actually had a really good nurse. As far as IVs go, usually you can stem the flow of blood when you disconnect the catheter and reach to connect it with the IV tubing or with a hep lock, but sometimes you get a bleeder. It's still a small amount relatively speaking, and while not ideal, certainly not worthy of making a big stink over.

Hope your Dad is feeling better.

Are you miffed over the instruction itself or the fact that it wasn't you that was doing the teaching? Did you feel the fact that the nurse teaching your dad somehow reflected poorly upon you as a nurse-to-be/daughter? I am very serious: I have seen similar reactions happen with patients whose families happen to have healthcare professionals in them. And I've felt that way myself at times with my own family.

As far as the IV...even the best nurses can have a messy IV--that doesn't necessarily reflect on the nurse's unprofessionalism. And as others have said, there's a lot of other factors that weren't mentioned.

You're right, you are too invested in this to be entirely logical about it...and that's OK: it is your dad after all.

I hope he has a speedy recovery.

Thank you :) Your kindness is appreciated. I really do like my dad to receive useful and good advice from doctors/nurses because he will act on and listen to their advice rather than mine. It doesn't bother me because I know he sees me as his daughter and not nurse. As for the IV, I just wasn't sure because in nursing school they haven't let us insert IV's. I don't know if blood on the sheet and bed are "normal" after inserting a new IV.

:)

I'm sorry your dad is sick. I had 3 sick relatives while I was in school. I think it is great that the nurse educated your dad. I include all sorts of education information when taking care of patients in their care plans and discharge paperwork. Actually from my experience it is required especially for chronic diseases that the government says we have to educate patients about. As far as IV's I am messy so I always bring a couple towels when I start one. And I bring extra gauze or alcohol wipes to clean up the blood that is on the skin after I start an IV.

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