Learning sick vs. not sick

Specialties Emergency

Published

How the heck can you teach sick/ not sick without plain old time and experience? How do does one gain the ability to differentiate between the guy with a stubbed toe and is actually dying versus the woman with syncope and chest pain who is just fine? Have you ever taught someone this skill who wasn't getting it or learned it yourself?

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

You pay attention to what the patient LOOKS like, not just what they're saying. What color is their skin and mucus membranes-- pink or blue or grey? Yellow maybe? How fast are they breathing? Is it labored? Are they walking upright, more or less normally or are they stumbling around? Maybe they're sitting slumped over, or are they sitting up straight and meeting your eye? Someone who is complaining of dental pain but is ashen, nauseated and diaphoretic may be having atypical signs of an MI. The patient who is stumbling, slurring their speech and making very little sense may be drunk, have overdosed on pain meds from the knee replacement they just had (hence the cane) or have a glucose issue.

A lot of it comes with experience, a lot of it comes just with paying attention. Thinking about it enough to ask the question means you have a head start on figuring it out! Kudos!

Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

The first time I saw "sick," it was like, "Ohhhhh... So that's it!" I defibrillated that guy some minutes later out of v fib. He was a gnarly gray color when we got to him (this was when I was a paramedic), and I will never forget the look in his eyes - yep, that look of doom. Once you see it, you recognize it.

Specializes in Current: ER Past: Cardiac Tele.

I feel like I'm always getting stronger about being able to feel sick vs. not sick.

Another, helping factor another nurse taught me. Touch the patient. And I feel like it's so true. You just get more of an idea when you feel that cold clammy arm... Lol.

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