How are you judgemental? - page 9

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   Ruby Vee
    Quote from cookiecuc
    i think that being in the nursing profession, you should not judge or stereotype anyone. as a nurse, you should look at everyone as an "unique" indivdual and that everyone has a reason for being the way they are and that you should acknowledge their differences and resolve the problem based on their situation.
    [font="comic sans ms"]nurses are human, and humans sometimes cannot help judging some things. and some people. no we "should not." but we do. it's good to be aware of our blind spots. it's also good to be accepting of one another. peronally, the person who is "holier than thou" is one of my pet peeves!

  2. by   Ruby Vee
    Quote from agoodusername
    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,"
    [font="comic sans ms"]personally, whenever i get a report like that, i know the patient is going to be a total pain in the a$$ -- just my luck, it seems! only thing is, most of the nrses i work with say the exact same thing. if the nurse giving you report tells you how sweet your patient is, you know you're going to have a miserable shift with a foul-mouthed, complaining patient!
  3. by   Tweety
    Quote from Daytonite
    Teaching patients can be done very objectively without injecting personal criticism and subjectivity into the conversation. All it takes is some exercise of control. If I berate a patient or take some criticizing pot shots at them for their health behaviors and practices, then what have I accomplished other than to make myself feel a little bit more superior over that person for that moment of time. That's a right thing to do? Not to my way of thinking. It's also not humane, compassionate, respectful, or nice. Crazy people will come back with guns and shoot you.

    I certainly wasn't advocating berating a patient as a way of teaching them. That misses the point entirely and I apologize for not being clear. I totally agree with what you say.

    I was merely speaking against keeping our mouth shut when there are teachable moments to drug addicts, obese patients, and smokers who are feeling the effects of their lifestyles.

    I highlighted your statement "all it takes is some exercise of control" because does presume something is going on with the teacher that needs control - his/her personal feelings and judgements. I find it best to acknowledge it's there, rather than live in a bliss of denial that "I'm a nurse, therefore I have no judgements or opinions whatsoever about a person's lifestyle". For some of us, myself included, it's usually a subconscious process, but as I indicated, being human, I have my moments that do need to, as you point out, exercise some control. It's not that hard.
    Last edit by Tweety on Dec 13, '06
  4. by   Ruby Vee
    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.
    [font="comic sans ms"]honey, if you have opinions, you're judging! i really don't see how anyone can say they never judge. is it just me, or aren't most of those who say they never judge patients judging the rest of us who admit that we do?

  5. by   GardenDove
    Ruby, I was kind of thinking that myself. But, there are a few saints that are quietly living ordinary lives. But, they probably don't go on internet sites proclaiming their virtues to a bunch of judgemental nurses.
  6. by   meme_911
    thank gad am not judgemental :smiley_aa ,i hate to be around people like that :smiley_ab cause they make me nurves:selfbonk:
  7. by   cardiacRN2006
    Quote from mjlrn97

    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. .
    We call this phenomenon "acute Hospitalitis", where suddenly after being admitted they can no longer care for themselves. They are unable to walk to the bathroom, unable to wipe themselves, or pick up their own glass of water, but have no problems going outside to smoke or visit in the waiting room with all their family members for hours on end. This was when I worked a tele floor.

    As I read this thread as a new nurse, I can't help but laugh at the student's responses (or is it students' responses"?) Boy, are they in for a suprise when they get into the real world! So idealistic and naive.
  8. by   Cattitude
    Quote from tweety
    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.
    :icon_smile: i guess i must have a big fat mouth that can't stay shut because most of the time i do talk to my patients about weight, drugs, smoking, etc. but, it is easier for me to do so as i work in home health and have a little more bonding time with them. when i did hospital nursing, those teaching sessions were much fewer and farther between.

    as far as being judgmental: working in home health i get frustrated at seeing the amt. of care people get who have never ever worked a day in their lives. yet, people who have worked, including some of my pt's and family, cannot get stuff they need and can't qualify for medicaid. here in ny, you can be dirt poor, receive medicaid and live in the million dollar home of your son who is a doctor. and your care costs the taxpayers about $6,000 a month. we have one of the highest cost mediciaid programs in the country. i could go on and on... just venting.....

    beez
  9. by   teeituptom
    I am extremely judgmental
    I always keep it to myself at work
    Because what I think doesnt matter
    In a 100 years no one will care anyway

    so go play golf, something that does matter
  10. by   twotrees2
    Quote from GardenDove
    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, when he gave it up. He had abused recreational drugs. He previously had smoked 4 pks a day, but now was down to 1/2 pack a day. He still occasionally indulged in pot, was married for 30+ years, had had stents, was not overweight, had early COPD, and was just about to get on disablity for his multiple problems. He also had had some esophegeal surgery secondary to his previous ETOH dependence.

    The guy was actually very nice and really above board and honest. He had been a traveling worker who had worked on railroads. He had made the effort to quit drinking for 8 years, had cut back to 1/2 pack a day, was not pestering me for morphine, and was really nice.

    So, one of the nurses in report was pretty judgemental. Let me just say that this nurse tends to give a pass to all the out of control diabetics who are 100 punds overweight, and is a only too eager to point out how judgemental I am if I comment on that.

    This all made me realize how each of us has something that makes us judge our pts. For some reason, this guy seemed up front and honest. He didn't mind my remarks like "How in the world did you manage to smoke 4 pks a day!?". I saw him as someone who WAS making an effort. Yes, I think that whiny, overweight pts who have complications from their food overindulgences bug me.

    So, what is it that particularly sets you off about your pts? For me it's the overeating, abdominal chronic pain pts, they really aggravate me.
    that my work place has turned my dementia unit into a psyc ward and the abusive braindamaged people they are bringing in to me( when they belong in a psyc ward not a nursing home!!) are due to drugs and alcohol in their 40's to 50's and one on particular makes me cringe as she has kids my age and they will grow up not knowing mom - why they do that to themselves is just beyond my belief ( even though i know and have history in my family with alchol abuse - bad enough to cause brain damage is even more beyond my comprehension than anything ) and having to call the police to chapter 51 them cause we cant give them the things they need due to nursing home rules and the hospital just sending em back after shooting them up with haldol - like that is gonna helpp my girls deal with em in a day - HA - right.
  11. by   twotrees2
    Quote from earle58
    i have a different take on it.
    i can pretty successfully tune-out pts' demands, idiocyncrasies, etc., and not get bothered.

    in an interview long ago, i was asked what my weakest point was.
    i was forthright in answering "my standards are too high".
    and sometimes i think i may be right, since i get easily muddled by other nurses' shabby work ethics.
    or the gossips who thrive on creating a toxic work atmosphere.
    or the nurse who looks the other way when noticing a pt doing something unsafe, or just independently, when they still need assist....because it's not their pt.
    the list could go on but my point is, i have little patience with experienced and seasoned nurses who lack certain key qualities and maturity, that are required in order to become something they should aspire to be.

    i have no patience with this workgroup.
    and we all know who they are.

    leslie
    oh yeah have toagree with this one- yep yep yep. sad they even are there. or the new grad ( and i had this happen often with one particular grad lately) who tell youthey ont know how to do something then try to get you to do it witthout being willing to go in with you to learn whatever it is ( like trach care) - i know its scary but come on ya gotta learn and your not gonna unless you see it and then practice it. even had one i made come in to watch and told her ok now sat ( next time we were working together) i would go witha nd she woul be talked through it yet do it herself and so she just didnt come to work! the last 2 weeks she has called in saying her daughter is sick in hospital every night i am on as charge nurse but when others who dont make her do stuff just do it for ,her she comes in those days between. tsk tsk.
  12. by   twotrees2
    Quote from Quickbeam
    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.
    around here disability is pretty strict -or used to be could be different now..... you have to take that light duty if they find you one and they will and they will also use thier docs as second opinions at least they use to - i know - my mother fought to get disability for 5 yrs- she was unable to do ANY work due to blackouts that happened at any time , noone wold hire her even places they sent her too due to the blackouts - well they refused her it for over 5 yrs- then had the balls to try to ask my father to settle with a pittance of what she should have had coming in all those yrs cause she dropped dead within those over 5 yrs and when dad took it to full jury they had to back pay him all her back denied benefits - i am sure other states are different. by the way i too could probably get disability - however working part time brings me as much as disability would and allows me to work /rest up good / work/ rest up etc - until i cant move i hope i always want to do something - dont think i could sit and do nothing on disability.
  13. by   twotrees2
    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.
    know what you mean - few weeks ago had a woman with would vac needed and she had diarrhea - the would wsa so low on her cocyx that no matter what we did that wound vac dressing ended up with a leak at the bottom and we just couldnt get it - tried for half hour giggling before we finally gave up emailed doc and said it wasnt happening due to diarrhea - we gave it our best shot though lol.

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