How are you judgemental? - page 3

I was reporting off this morning on a rule out chest pain pt. He was a 49 yr old guy who had an extensive family cardiac risk hx, he had had a CABG in his 30's, had been an alcoholic until 8 yrs ago,... Read More

  1. by   Quickbeam
    Quote:
    Originally Posted by Quickbeam
    When I was a work comp case manager (RN), I developed a hard heart towards malingerers and WC cheats. People claiming total disability from a questionable injury yet were able to reroof their house or drop a new engine into their truck (on surveillance). They'd always need OxyContin, could never work but managed to mow the lawn alright. There was so much outright fraud, I couldn't believe it.
    because you mow your lawn twice a week, doesnt mean you can hold a 40 hour a week job....and maybe you couldnt even do the lawn without the oxy.....hm droppng an engine is usually done with a hoist.....not sure how much work is really involved there......guess what, YOU just hit one of MY buttons,lol........ until you have walked a mile,.......
    I was referring to people claiming total disability and refusing all light duty work....yet are able to do things like reroofing the house, play full court basketball or yes, drop an engine. It's outright fraud. And I am disabled. I work full time.
    Last edit by Quickbeam on Dec 11, '06
  2. by   Tweety
    Quote from morte
    because you mow your lawn twice a week, doesnt mean you can hold a 40 hour a week job....and maybe you couldnt even do the lawn without the oxy.....hm droppng an engine is usually done with a hoist.....not sure how much work is really involved there......guess what, YOU just hit one of MY buttons,lol........ until you have walked a mile,.......


    I think that poster was talking about people who fraud the system, not judging the people who truly need diability. Best not to read too much into the post with the examples given.

    Not that you're wrong, because you make a good point. We shouldn't make snap judgements on appearances.

    I don't know, someone who climbs up on a roof and reroofs doesn't sound like they need total disability to me.
  3. by   GardenDove
    Quote from RazorbackRN
    I guess I could say that I'm judgemental against people who judge nurses for being judgemental until they've walked a mile in our shoes.

    Just because nurses tend to be judgemental after seeing the same behavior patterns time after time doesn't mean that we think our pt's don't "deserve respect, and good, unbiased, un-stereotyped care". We didn't say it was OK to be judgemental, however, nurses are human too, thus it happens.

    Do this...post back after you've been a nurse for 6 months, and then tell us that you still don't have times where you've been judgemental in some aspect. Whether it be in re: to the pt family, meds request, sheer laziness, or non-compliance, I'll bet you'll understand a little bit better.
    I agree with this post. I started this thread not to trash the pts, but just an acknowledgement that every nurse has a pet peeve pt, and it's nice to share. This is how nurses generally cope. It's also nice to let your collegues at work spout off without getting all huffy and calling them judgemental.

    As I explained in my opening post, the gal I was reporting off to does occasionally have her self rightous moments when another nurse complains about a pt. She has been very protective of a few of our more demanding and aggravating frequent flyers. So I did find it interesting that she was so instantly judgemental of my pt that I had had, without even meeting him. I really like this particular co-worker, incidentally, she's a great nurse and a wonderful person.

    So give your co-workers a break and let them vent in a safe enviornment, and acknowledge that what pushes their buttons may not push yours. Also remember that we are not all Mother Teresa of Calcutta, and actually I've heard that she had her opinions too.
  4. by   Tweety
    Quote from agoodusername
    I really don't appreciate this thread. Aren't we perpetuating stereotypes by highlighting them in a discussion? This is exactly how "drug seekers" and "complainers" are created, marked, studied and pegged -- before we ever even experience them!


    Excellent post and you certainly are right in theory. But seriously some of us in the trenches for year after year have a different experience than you the student. Most of us are kind and compassionate professionals, but we have our buttons that are pushed and we get a bit weary sometimes.

    Aren't you as a student being a little judgemental of us?

    Labeling a patient can be dangerous. I get a red flag when I hear someone is a whiner, drug seeking complainer. I can right off the bat think of three such patients, one had a bowel rupture, one had a torn bile duct and one had compartment syndrome............it's so dangerous to presume the worst about a person without adeuately assessing and listening to the patient.
    Last edit by Tweety on Dec 11, '06
  5. by   Tweety
    My take on all of this is like someone above, I have to acknowledge that I'm human.

    For example, I recently took care of a drug dealer who was shot during a deal gone bad. I am probably the most compassionate person you will find when it comes to setting aside someone's lifestyle and taking care of them. This man was not abusive, but just foul-mouthed, angry, impatient and ugly. Being the human I am I had to think "it's no wonder you got shot".

    Also, the ones whose lifes revolve around their next pain shot can be draining after 12 hours. I do try to look at the whole picture and usually they don't get to me, and I'm understanding.....usually, but sometimes.........

    I need to be self-aware of my feelings and honest with myself. Just because the ideal that I strive for is total nonjudgementalism, doesn't mean I should stuff my feelings and sugar coat them when they are truly there.
    Last edit by Tweety on Dec 11, '06
  6. by   nurse4theplanet
    I think some people are confusing the natural human tendency to find fault with other's behavoir that does not match our own values with being outright judgemental/bias/prejudice. Every person on this earth is judgemental: whether they act upon it, speak about it with others, or simply think about it to themselves. You can be skeptical of someone, annoyed by their actions, or even judgemental of their lifestyle choices and still be completely able to separate those feelings and provide safe, competent, and equal care. That is the foundation of what you are taught in nursing school: not to be non-judgemental, that is humanly impossible, but to provide non-judgemental care. There is a difference.
  7. by   Tweety
    Quote from asoldierswife05
    I think some people are confusing the natural human tendency to find fault with other's behavoir that does not match our own values with being outright judgemental/bias/prejudice. Every person on this earth is judgemental: whether they act upon it, speak about it with others, or simply think about it to themselves. You can be skeptical of someone, annoyed by their actions, or even judgemental of their lifestyle choices and still be completely able to separate those feelings and provide safe, competent, and equal care. That is the foundation of what you are taught in nursing school: not to be non-judgemental, that is humanly impossible, but to provide non-judgemental care. There is a difference.


    I totally agree, very well put. Thanks.
  8. by   rach_nc_03
    patients or family members who want to talk partisan politics. for some reason, I ran across these types a lot- in the neuro ICU, it was the SAH or MG patients who were totally alert, but stuck in their beds- I refused to engage, and tried to diplomatically change the subject, but this type just gets more riled up when you do that. (And I'm talking about conservatives *and* liberals- regardless of how I feel, I'm not going there at work!) I usually found myself wanting to get in and out of their rooms at lightning speed- name calling is name calling, but people (patients or not!) somehow think using the terms democrat, liberal, republican and conservative as pejoratives is totally acceptable. no thanks.

    oh, and family members who don't want the terminally ill patient, who is clearly near the end of the line, to receive pain meds because they 'might overdose them'. Huh?? Sometimes this is cleared up with a little education, but I've seen plenty of family members (sadly, a lot of parents) refuse to allow us to make the patient comfortable. It hurts me to see someone suffer needlessly like this.
  9. by   *RubySlippers*
    Quote from agoodusername
    I really don't appreciate this thread. Aren't we perpetuating stereotypes by highlighting them in a discussion? This is exactly how "drug seekers" and "complainers" are created, marked, studied and pegged -- before we ever even experience them!

    I'm in nursing school, and I remember the first time I heard a nurse give me report on my very first patient. "She's got these open abcesses on her thighs that are really painful, she says. But if she's in so much pain, why is she still going downstairs to smoke every hour?" This made sense to me, a naiive, inexperienced nursing student, and so, before I even got a chance to begin my career in my own way of thought, I walked into my patient's room with a stereotype blocking my entire field of view. Because of this, the first thing I noticed about her was that she was sleeping with her cigarettes in her breast pocket (of course), and the first thing I assumed was that she would be crabby and want to smoke as soon as she woke up (of course), and that she really wasn't in all that much pain (of course not).

    I'm really thankful that I took the time to try and get to know her, because I learned a lot about how wrong that nurse was. I learned that my patient was missing her son's first day of kindergarten, and that she had been diagnosed with Crohn's a decade ago with no end in sight. She really was in pain, which I could clearly see without years of experience under my belt, and yes, she smoked. But it made me realize: why wouldn't she? She had nothing else to get her through the day!

    Stereotyping is really a huge issue with nurses, especially in the realm of report. You can make or break a nurse's DAY depending on how you describe your patient at end of shift. Think about it -- the outlook for your day can be completely different depending on the report you get: "This patient is really great. She's sweet, she doesn't really complain, and she definitely knows how to get up and go to the bathroom by herself. Really easy," versus, "Oh my gosh. What a nervous nancy. This lady shakes, and she's a smoker, but she's not allowed off the monitor so she just bugs you all the time about going downstairs. She always asks for pain medicine, but when you walk in she's asleep, and she has been incontinent three times. It's not going to be a good night for you." Everyone knows how each of these reports gives you a totally different outlook for your shift, and how you treat your patient.

    This is my argument: both examples are wrong. Both examples of report put an idea into the receiving nurses mind, and immediately create a stereotype that molds and alters the rest of the shift and every dealing with the patient. I think that report should STRICTLY be confined to report -- medical, objective information that is PERTINENT and important to nursing care, NOT nurse opinion.

    Stereotyping is a HUGE problem in nursing. Let's STOP glorifying it by giving petty examples of people who bother us. Our patients are sick, and regardless of what they are sick with or how sick they are, they deserve respect, and good, unbiased, un-stereotyped care.
    First off, I never read one nurse say they treated their patient unproffessional, in this thread. 2nd this is a way for Nurses to get things that bother them out in the open, which is good old Psych if you have had that yet. Next-what are you going to do when you experience this.....and you will one day, just wait???? Are you going to hold it in, not talk about it because you think it is wrong? You will be waiting for a Stroke, or to go off on a patient. This is good intervention for anxiety, stress, things that can lead to depression.:spin: I learned that is Psyh .


    And last, my pet peeve is patients who can bathe themselves, but say "I am going to let you do it honey"....... No you are not, you will do what you can, and I will help with what you can't. And I am thinking (Because, you can sure hit that call bell and change that TV station, and get up and go to the bathroom, and on and on). There are some very Lazy patients out there, that think they are in a SPA, when they are in the hospital????:smackingf What is wrong with these patients???? I would want to bathe myself
  10. by   sissyboo
    I really have a problem with patients who need a translator for their entire hospital stay, however, they can speak enough English to let you know they are going to smoke and to ask when their next dose of pain meds are due. I have no problem with translators, they are a very valuable resource to a hospital (especially in my area). I feel some pts take advantage of them to some degree. You can't get the patient admitted until the translator gets there, but nurses can give any pain med at any time with or without the translator there.
  11. by   VivaLasViejas
    Quote from asoldierswife05
    I think some people are confusing the natural human tendency to find fault with other's behavoir that does not match our own values with being outright judgemental/bias/prejudice. Every person on this earth is judgemental: whether they act upon it, speak about it with others, or simply think about it to themselves. You can be skeptical of someone, annoyed by their actions, or even judgemental of their lifestyle choices and still be completely able to separate those feelings and provide safe, competent, and equal care. That is the foundation of what you are taught in nursing school: not to be non-judgemental, that is humanly impossible, but to provide non-judgemental care. There is a difference.

    I couldn't agree more. Well said!

    Over the years I've been here at allnurses, I've had quite a bit to say on the subject of prejudice toward certain types of patients, with the general theme being "judge not, lest ye also be judged". A lot of that has to do with the fact that as a severely obese ex-smoker with a history of ETOH abuse who was on Medicaid in the past, I've BEEN one or another of those patients.

    However, as "undesirable" as I might have been as a patient, I wasn't dumb. I knew perfectly well what some doctors and nurses thought of me. It showed in the way they spoke to me, as if being poor also made me stupid. It showed in the way they dismissed my complaints, from migraines to carpal tunnel, as a result of being overweight and thus unworthy of treatment until I lost 100 pounds. It also showed in the way they would send me home from the ER, still in status asthmaticus after three hours of breathing treatments and a dose of Solu-Medrol brought my sats up from 75% to 90%, while the woman in the next cubicle with Blue Cross and a cough was ushered up to the medical floor within thirty minutes.

    So, yes, I disapprove of health professionals walking around with bad attitudes toward patients with certain problems. While I know almost everyone tries to treat all patients equally regardless of circumstances, I don't believe we succeed as well as we'd like to think. Something of the way we feel almost always comes across, and patients pick up on it. I know I personally disliked the frequent flyers---almost always females in their 30s and 40s---who would come in complaining of severe abdominal pain, nausea, and 'intractable' vomiting for which no cause was ever found, but that would respond only to massive doses of morphine, Phenergan, and Ativan. They also had a way of suddenly being completely incapable of reaching a water glass on the table a foot away, going to the bathroom by themselves, or using the built-in remote control to change the TV channel........but then you'd see them pushing their IV poles toward the elevator as they headed downstairs to the smoking area.

    Now, I did try my best to be as professional and non-judgmental as possible when dealing with this type of patient, but I'm sure I wasn't able to hide it completely..........I remember one lady who said to me one night, "None of you knows what this is like---you all look at me like I'm some sort of psych case." Well, she wasn't too far off the mark, but I was stung a little because I really had tried to be kind to her.

    The point I'm trying to make is, there is nothing wrong with FEELING a certain way towards patients with certain problems, and venting here is one of the safest ways of blowing off steam. If we can't safely talk here about our frustrations, they will surely manifest themselves in other ways, and acting out those frustrations might be one of them. We must take great care to separate how we feel from how we behave, and that is one of the hardest things on earth to do.

    Let's continue to have civilized discussions such as this, and students, please consider that when you have walked a few hundred miles in our worn-out nursing shoes, you may feel very differently. This does not relieve us of our duty to give EVERY patient our best efforts, of course, but we are human and we are subject to the same weaknesses as everyone else.
  12. by   ktliz
    Quote from agoodusername
    I really don't appreciate this thread. Aren't we perpetuating stereotypes by highlighting them in a discussion? This is exactly how "drug seekers" and "complainers" are created, marked, studied and pegged -- before we ever even experience them!

    I'm in nursing school, and I remember the first time I heard a nurse give me report on my very first patient. "She's got these open abcesses on her thighs that are really painful, she says. But if she's in so much pain, why is she still going downstairs to smoke every hour?" This made sense to me, a naiive, inexperienced nursing student, and so, before I even got a chance to begin my career in my own way of thought, I walked into my patient's room with a stereotype blocking my entire field of view. Because of this, the first thing I noticed about her was that she was sleeping with her cigarettes in her breast pocket (of course), and the first thing I assumed was that she would be crabby and want to smoke as soon as she woke up (of course), and that she really wasn't in all that much pain (of course not).

    I'm really thankful that I took the time to try and get to know her, because I learned a lot about how wrong that nurse was. I learned that my patient was missing her son's first day of kindergarten, and that she had been diagnosed with Crohn's a decade ago with no end in sight. She really was in pain, which I could clearly see without years of experience under my belt, and yes, she smoked. But it made me realize: why wouldn't she? She had nothing else to get her through the day!

    Stereotyping is really a huge issue with nurses, especially in the realm of report. You can make or break a nurse's DAY depending on how you describe your patient at end of shift. Think about it -- the outlook for your day can be completely different depending on the report you get: "This patient is really great. She's sweet, she doesn't really complain, and she definitely knows how to get up and go to the bathroom by herself. Really easy," versus, "Oh my gosh. What a nervous nancy. This lady shakes, and she's a smoker, but she's not allowed off the monitor so she just bugs you all the time about going downstairs. She always asks for pain medicine, but when you walk in she's asleep, and she has been incontinent three times. It's not going to be a good night for you." Everyone knows how each of these reports gives you a totally different outlook for your shift, and how you treat your patient.

    This is my argument: both examples are wrong. Both examples of report put an idea into the receiving nurses mind, and immediately create a stereotype that molds and alters the rest of the shift and every dealing with the patient. I think that report should STRICTLY be confined to report -- medical, objective information that is PERTINENT and important to nursing care, NOT nurse opinion.

    Stereotyping is a HUGE problem in nursing. Let's STOP glorifying it by giving petty examples of people who bother us. Our patients are sick, and regardless of what they are sick with or how sick they are, they deserve respect, and good, unbiased, un-stereotyped care.
    I think the big difference between your post and the nurses who have posted is that you are focused on pre-conceived notions, while the more experienced nurses are talking about specific behaviors they have witnessed time and time again. Yes, it is unfair to stereotype someone, of course!! But unfortunately negative stereotypes are perpetuated by the people who DO exhibit those behaviors, and those are the patients that nurses, I think, find themselves frustrated with.
  13. by   GardenDove
    Well put, Maria, exactly my sentiments! This thread supposed to be cathartic and confessional. We need to have an outlet, and it's also good for us to realize, yes, we are all judgemental in some way. One point of this thread it to point out that we should try to withhold our judgements on another nurse's pet peeves, since we all have one. We shouldn't get too high and mighty with one another, but try to be supportive and be good listeners.

    When I walk into a pt's room, however, I try to be the best actress in the world, who is playing the role of the angel of mercy. There's always something lovable in each person, we have to keep an open mind.

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