How are you judgemental? - page 7

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   RN mom of 2
    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.
    You can't save people from themselves.

    As far as I know it's called being a nurse. It's what we signed up for.

    I can understand venting to others privately, but not in the workplace, or where there's a possibility a pt may hear you (including unconscious pts). It seems you'd even need to be careful on these boards, as you never know who may be lurking. I realize the probability is low, but you just can't be sure.
  2. by   dmarie (GA)
    From a spiritual point of view, we can recognize that instead of judging some of these patients, we can take pity on them. The obese person isn't always obese because of the extra piece of pie, the person with lung cancer isn't always a smoker, etc. etc.

    Maybe there's an opportunity for teaching in these frustrating situations? Maybe the mother who smokes while pregnant needs further teaching and opportunities for help quitting? Maybe the cranky lady in Room 1 needs someone to give her a hug and listen to her for a few minutes?

    Everybody's situation is unique.

    And thoughts, whether you realize it or not, do affect your behavior, albeit subtly at times, but manifest in behavior nonetheless.

    Some patients and people in general are frustrating, definitely, and I'm no saint. I just hope that when I'm sick one day, laying in the hospital, the nurse caring for me will have compassion and understanding for my limitations. We're all human after all.
    Last edit by dmarie (GA) on Dec 12, '06
  3. by   Spidey's mom
    Quote from 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...

    As I'm the instigator of that spelling lesson, I pardon Sir Tweety for his unintended error.


    "4. Venting/sharing judgments of patients is NOT appropriate in report. Hands down"

    I sooo agree with the above - report should be short, sweet and pertinent. I do get frustrated with folks who go on and on about personal judgments about whether a patient really has pain or is faking it because surely you can't be in pain if you are asleep, right? (and many other things too, not just pain).

    Just a little personal anecdote from the last three days - I've had the headache from hell. Not a migraine. I think a tension headache as it is mostly in the back of my head and down my neck. Nothing touches the pain - I took ibuprofen and acetominphen at work yesterday and last night resorted to my son's codeine w/phenergan cough syrup. But it still hurt - my husband started rubbing my neck and I was so tired of the darn headache I started crying a bit. I did end up falling asleep but woke up with the same intense pain. Plus I worked yesterday from 3 a.m. to 3 p.m. and we were very busy but unless I told someone, no one knew I had a headache.

    I truly think judging someone else's pain is just not fair.

    So, yes people can be in pain and still look normal.

    steph
  4. by   rach_nc_03
    Quote from SoulShine75
    I understand what you are saying, but at the same time that person may very well be in pain too. I was in the hospital several months ago with kidney stones and the pain was horrible. I was given demarol PO q 4hr prn and believe me those pills wore off in 3.5 and I was asking my nurse for my med because it hurt!!! I didn't think she minded because aside from my asking for my medicine I tried not to be a nagging patient. Well, on one of my rotations this semester I numerously heard some of the nurses call patients drug seekers because they wanted their pain med when it was due. It made me wonder if the nurses thought the same of me or if they secretly thought this of all pt's who request their medicine. I was really appalled by this because these people could very well be in pain like I was. I'm not saying that all nurses are this way, I worked with some wonderful women who treated their patients with so much respect and never judged. We aren't perfect, but I have learned a lesson....I will never judge someone's pain. It isn't my pain to judge.
    Amen. Read my recent post about having hip surgery, a failed epidural, and NOT getting any pain meds for several hours post-op. And how my surgeon almost put me in a coma at hour 36 because nothing could touch my pain by then.

    The biggest problems we seem to have with being judgmental are pain, obesity, and alcohol/drug abuse. (and yes, I've had those same thoughts.) In a perfect world, we'd all see something of ourselves in our patients. If only!! Where's Ghandi when you need him? :wink2:
    Last edit by rach_nc_03 on Dec 12, '06 : Reason: ack! spelling!
  5. by   muffie
    I truly think judging someone else's pain is just not fair

    steph[/quote]

    here here
  6. by   GardenDove
    As far as so called "drug seekers", yes I sometimes have my doubts about people who say 10/10, while they blithly snack on a twinkie, but it never affects my care. If pain med is ordered and they want some, they get some. I figure, whatever they want, they get, and if they're not in physical pain, then it must be emotional pain that motivates them. I am there to please the pt.

    Pain is so utterly subjective, and who am I to be on a moral crusade? I like to make the pts happy. If they're still in pain, I document and never hesitate to call the doc. Yes, there are people who manipulate the system, but I'd rather err on the side of pain relief on my shift.
  7. by   KnoxWarEagle
    I get tired of patients who are dead set on having an antibiotic for their runny nose. Even worse, they don't want to come in to be seen. They want you to call it in for them. The doctor I work for was formally know to call an antibiotic in when asked. NO MORE! He doesn't say anything. I think he may be alittle scarred of me! :wink2:
  8. by   Tweety
    Quote from 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...


    There are some words my fingers are just going to spell incorrectly all the time, guess that's just one of them. I used to have it in my sig line something of the effect "please forgive misspellings and typos".

    Thanks for forgiving me.
  9. by   UM Review RN
    re: the spelling lesson.

    from definition of judgment - merriam-webster online dictionary

    judgment

    one entry found for judgment. main entry: judg-ment
    variant(s): or judge-ment /'j&j-m&nt/
    function: noun
    1 a : a formal utterance of an authoritative opinion b : an opinion so pronounced
    2 a : a formal decision given by a court b (1) : an obligation (as a debt) created by the decree of a court (2) : a certificate evidencing such a decree
    3 a capitalized : the final judging of humankind by god b : a divine sentence or decision; specifically : a calamity held to be sent by god
    4 a : the process of forming an opinion or evaluation by discerning and comparing b : an opinion or estimate so formed
    5 a : the capacity for judging : discernment b : the exercise of this capacity
    6 : a proposition stating something believed or asserted
    synonym see sense
  10. by   UM Review RN
    So either judgement or judgment is correct, ok?
  11. by   VickyRN
    I have difficulty with families who insist that "everything" be done for their 90+ relative with many comorbid conditions, dementia, etc. I have to stand back and think that I'm not just taking care of the patient, but the whole family and this is a process that many families require in letting their beloved relative "go." Of course, we do our best to educate in a sensitive manner. Often families just aren't ready to hear what we have to say. It is very sad to see a dying elder coded or put on a ventilator, multiple pressors, etc, while the family goes through this process.
  12. by   Tweety
    I agree whole heartedly that the long-winded gossipy reports are out of line.

    I also agree it's not fair to judge someone's pain. As I said before I've seen bad outcomes on those labled "whimps" when it was really a change in their condition.

    Again, we'd only be human to not be effected by some of what we witness in our careers and it always doesn't just slide off our backs, as long as it doesn't affect our care and professional care of the patient.
  13. by   Tweety
    Quote from Angie O'Plasty, RN
    So either judgement or judgment is correct, ok?


    Thank you! I was noticing the same thing in MSN Dictionary. So there...neener neener neener!

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