How are you judgemental? - page 6

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   scrmblr
    Quote from critterlover
    there can be a difference between laughing at a patient and laughing at the situation.

    this weekend, we had a very drunk man come in with c/o change in mental status. his etoh level was 0.433 (43% alcohol), so he was going to get several liters of fluid. his poor elederly mother (he was in his 50's) stayed in the room with him to hold his arm down so he could get the fluid. otherwise, he kept bending his arm. after a little while, we decided to restart his iv somewhere other than the ac so his mamma didn't have to stand there. (by the way, no one asked her to do this, she did it herself, with the door shut, so we really wern't sure of what was going on until we went in to check on him. he had a seizure when he first arrived, so he had gotten some ativan, so he should have been out cold -- and he was, other than bending that arm). so three of us go in there, two to hold and one to stick. we get the iv restarted, and notice that he was just soaked. too soaked to just change the bed. so we decided it would be best for him just to change out the stretcher.

    well, lets just say that he was heavier than he looked. we managed to get him into a dry gown, but getting him from the wet stretcher to the dry stretcher, without getting the new stretcher wet.......well it was quite a bit tougher than it looked. add to that, he started peeing again all over the place, in great volumes. at one point, the three of us were giggling like little girls.

    from all appearances, we were laughing at our very drunk, completly soaked, patient. but we wern't. we were laughing at the situation, and our ineptness at doing a seemingly simple task.
    we had a similar situation last week involving a "code brown" and believe me we weren't really laughing at the pt!
  2. by   Tweety
    Quote from razorbackrn
    well, here in the good ole usa, we spell that word realize.:smilecoffeecup:
    it's funny that the british and aussies spell realize differently isn't it. i read a lot and the first time i saw a it spelled with an "s" i thought the publisher had made a typo.

    since it's "english" perhaps americans are spelling it wrong.

    i'm not necessarily a bad speller, but a fast typist and i make a lot of mistakes. i hope it irritates people.
  3. by   morte
    spelling correctly is a gift, just like being good at math.......nothing to do with intellect.....and if you cant, you arent going to know that it is wrong....
  4. by   ElvishDNP
    I work in OB/GYN/nursery and it REALLY irks me when I see pregnant women going down to smoke, or having a drug screen +cocaine (or any other illegal substance). Screw around with your own life, that's your business; screw around with another, that wins you a call to CPS as soon as you deliver. (assuming, of course, that CPS will actually DO something about it.)

    We had an antepartum whose drug screen was +cocaine (and continued to be positive throughout her stay with us...what does that tell you....) tell one of us "I had to quit my hairdressing job when I found out I was pregnant because of all the chemicals." BS.
  5. by   DizzyLizard
    I am a recent graduate and don't have much nursing experience but as a EMT I can say it is hard at times not to be judgemental of patients. I am usually very tolerant of people and accept them for who they are. My attitude is for every choice you make you accept its consequence (whatever it may be). The toughest assignments for me are the child abuse and neglect cases. Children don't deserve the treatment they sometimes get. What could a 2 year old child possibly do that is so bad to cause Mom to break 42 bones in her body???? And, to boot, Mom got a slap on the wrist with a $500 fine and 120 days in jail. I don't know where the child is now but it will grow up disabled and disfigured thanks to her mother.
  6. by   dmarie (GA)
    Quote from DizzyLizard
    The toughest assignments for me are the child abuse and neglect cases. Children don't deserve the treatment they sometimes get. What could a 2 year old child possibly do that is so bad to cause Mom to break 42 bones in her body???? And, to boot, Mom got a slap on the wrist with a $500 fine and 120 days in jail. I don't know where the child is now but it will grow up disabled and disfigured thanks to her mother.
    I agree DizzyLizard.
  7. by   Spidey's mom
    :imbar Hope the spelling comment was taken in stride as I make all kinds of mistakes myself when typing away . . . . no one's perfect. :angel2:

    Yes, the English language can be frustrating since it is a conglomeration of so many other languages and rules . . . you can say " I before E except after C" to help remind you of how to spell some words like "receive" but the rule breaks down for other words.

    Back to the topic - child abuse, as I mentioned, is probably the one thing I have a very hard time with. In school we were encouraged to do some soul-searching to find those areas where we might have problems and then be aware of that beforehand. That part of my education was priceless for me.

    Personally I have siblings who are addicts (one who stole oxycontin from her son when he was being treated for cancer so she could sell it for meth) and I have purposely educated myself on all aspects of addiction so I could at least intellectually understand even if emotionally I want to throttle someone.

    This would be a great thread for nursing students . . .

    steph
  8. by   Daytonite
    I'm with the few handful that have been able to say that they don't judge. Part of the challenge of working as a nurse is maintaining that professional image and keeping my mouth shut about any opinion I might have about the patient's lifestyle or his/her actions. Many people talk about freedom for all, but don't really want to practice that either. None of us, not one, is perfect. If we were, we wouldn't even be here on this earth to be discussing this.
  9. by   Tweety
    Quote from Daytonite
    I'm with the few handful that have been able to say that they don't judge. Part of the challenge of working as a nurse is maintaining that professional image and keeping my mouth shut about any opinion I might have about the patient's lifestyle or his/her actions. Many people talk about freedom for all, but don't really want to practice that either. None of us, not one, is perfect. If we were, we wouldn't even be here on this earth to be discussing this.

    Hmmmmm..........what I'm thinking is do we have to keep our mouths shut? I know there is a time to keep my mouth shut, and 99.9% of the time I do with the patient population I have, whose traumas are largely drug and alcohol induced.

    I think sometimes however we let those "teachable moments" pass us by.

    I know from these boards when we talk about obesity and smoking among our profession, it's always "how dare you judge, none of us are perfect". Sad that we treat the diabetic foot on the 300 pound patient, the COPD in the smoker, the cocaine snorting anetpartum patient and the consequences but feel we have to keep our mouths shut lest we be judgemental.
    Last edit by Tweety on Dec 12, '06
  10. by   TrudyRN
    Quote from morte
    spelling correctly is a gift, just like being good at math.......nothing to do with intellect.....and if you cant, you arent going to know that it is wrong....
    Morte, I thought it was more a matter of learning. I know that some subjects come to a person more easily than another but the ones that are harder can still be mastered if a person wants to. :smilecoffeecup:

    Words that I see misspelled here all the time include

    consistant (consistent is correct)
    dependant (dependent is correct)
    There are more that do not come to mind right now.
  11. by   agoodusername
    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.

    A few things in response to my previous post:

    1. I in no way want to get across the message that I am perfect and never judge. Clearly, when I said that my very FIRST patient was an example of following a judgment and making it my own, I was hoping to get across the point that it is easy to fall into and something that I have struggled with. You're right -- it is IMPOSSIBLE to get through a day without judging, and it is impossible not to want to spout off to your co-workers about frustrating patients, etc. I've done it, we've all done it and that's life.

    2. Despite the fact that it happens, I don't think it has to. And despite the fact that I'm still a student, does not mean that I haven't felt the effects of the horrible situation nurses are in because of the shortage and the strain of working 40+ hours a week on the unit. I may be just beginning my journey, but in nursing, every step is JAM PACKED with hard times, so please give me the benefit of the doubt -- as another poster said -- just because we're students, doesn't mean we don't have brains or experience.

    3. What I do want to get across is that being judgmental is a huge problem on units, which CAN be stopped. In an externship experience this summer, where I worked for 5 week rotations on two units, I experienced a unit withOUT gossipy judgment, and a unit WITH it. The nurses on the first unit simply did not talk badly about their patients -- or talk about their patients at all. Most of our conversations were about each other, our lives and our families -- not bitter gossip about patients that might have bothered us. Because of this expectation on the unit, people worked together, helped each other out and appreciated the patients for who they were as PEOPLE. The attitude of the unit was happy and exciting and yes, there were stressful time and yes, people got grumpy, but for the majority, the unit was progressive, exciting, fun to be on and really beneficial, regardless of what role you filled. The second 5 weeks of the summer, I worked on a floor where all the nurses did was complain. They complained about the patients, about the hospital, about the staff members, about the shortage, about the schedule. They complained behind the patient's backs, in front of the patients, with faculty, etc, etc. People rarely helped each other out, everyone was always stressed and the unit was very disorganized and not fun to be on. Report went for over an hour because of gossip, and was full of stereotyping, slander about patients and useless information. And you know what happened? Within two weeks, I saw my positive, proactive, purposeful attitude, which I had learned, and gained on the first unit, turn sour. I began to complain, I began to give my patients derogatory nicknames, and most of all, I really dreaded coming to work because I had no idea what my co-workers were saying to me behind my back. NOT a fun place to work.

    4. Venting/sharing judgments of patients is NOT appropriate in report. Hands down. It's easy to do -- I've done it, I've seen tons of nurses do it, and I hate it every time. As I said before, and I will continue to say, I HAVE to choose to be a nurse that DOES NOT contribute to this, even if it is only by giving objective, non-biased report on a patient. Yes, the oncoming nurse needs to know how her night/day will look, but not through personal judgments. It is always refreshing to receive report that is unbiased, clean, short and full of pertinent information.

    All in all, what I'm trying to say now, and what I was trying to say in my previous post, is that judging patients is a huge problem that we can change. Yes, you need to let things out and yes you need stress release, and yes, sometimes you need to get in your car at the end of the day, call someone who is completely unrelated to your job and vent (or come onto a website like this and vent - I understand the purpose of this now, thank you for making that clear). But too many units are CONSUMED with this slanderous, gossipy talk and it RUINS nurses, nursing students, assistive personnel and progress in general. It is NOT FUN to be around and it is SO EASY to get sucked into. That's all I'm saying. There is a time and place for venting, but when it consumes and controls the attitude of the unit so much so that everyone hates work...that's not cool.

    Nursing is a hard job, and any job that deals with people has its serious downsides, but I think we have a choice to make: we can either continue to propagate emotionally-charged workplaces that compromise the quality of care and attitude of the unit, or we can choose to stop. I know I'm just getting into this world of nursing, and I know there will be times when I feel burnt out -- there already have been -- but I HAVE to make this choice now, or else I'll never be able to. I HAVE to go into this deciding how I'm going to act, and what I'm going to participate in. I HAVE to remind myself daily that my patients are HUMANS, and of how it would make me feel if I was the one sitting in the bed, and just happened overhear my nurse complain about me in the hallway or call me a name.

    It's hard to be positive, and many days I DO NOT meet my own expectations, but I have to go back to the old adage: life is 10% what gets served to you and 90% what you do with it. I think that's really true - in terms of nursing, in terms of everything.
  12. by   GardenDove
    I'm pleased to see we have some living saints amongst us who never judge others. I hope they are able to bear the rest of us flawed humans, I wish I were so perfect but I'm not. Meanwhile, for the rest of you, carry on!
  13. by   GardenDove
    Er, Tweety, I see you misspelled judgmental Did you miss the spelling lesson?

    Regarding spelling, I definately think that some have an inate ability to visualize words in their heads, and I'm not one of them. No, I don't take the gentle correction personally, it was done with good humor...

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