Biting Your Tongue

[Ruby Vee]

Things I'd like to say to patients (or their families) and get away with:

"I'm so sorry no one told you that drinking a liter of hard liquor a day could cause heart problems. This must be a complete shock to you, having alcohol-induced cardiomyopathy. But did you honestly think drinking that much daily would be GOOD for your health?" Clenched my teeth, bit my tongue and didn't say anything when the patient was going all "Woe is Me!" because of his cardiomyopathy and how unfair life is that this happened to him just when he was . . . .

"I don't know the anesthesiologist who promised you that you would have NO pain post-operatively. But I can assure you that it's not unusual for heart surgery to hurt."

This to the patient and family who wanted the patient to be drugged into oblivion until "he's all better." They never did understand why he had to be "awake and miserable" to do his pulmonary toilet, physical therapy or eat.

"No, ma'am. The surgery didn't make your husband this way. I'm pretty sure he had some memory issues BEFORE he had the surgery. That would be why he was taking Namendia and possibly why he was living in a memory care unit instead of at home with you." Didn't say it, but I was thinking it pretty loudly!

"Yes, Ma'am. I sure he lived through the night. I'm looking at him right now, and he's eating breakfast. I'm sure he'll forgive you for selling all of his things and using the money to buy that Birkin bag you've always wanted. He did look pretty sick last night, what with that not breathing and all."

"Of course you can stay all night, Ma'am. But that pillow you've got under your arm is the one we just took out from under his left side; and we're going to put it under his right side momentarily. If you MUST lie down RIGHT NOW, please go ask the unit secretary for guest linens and don't take the stuff we need here" OK, I have said that, or something similar. But I didn't get away with it. I had to sit in the manager's office and explain all about how I was thinking that the wife might be less comfortable trying to sleep with all the drainage from his wound right under her cheek.

"You're HOW old? And you had to have your Mommy stay overnight? She's 80 and using a walker, and you're expecting her to sleep in this sleep chair? What's the matter with you?"

"You're here to visit your mother? Really? And you can't tell me her last name? I don't care how many times she got married, if you're close enough to be visiting her when she's in the ICU, you're close enough to know her last name!"

"Sir, if that were a service dog -- which I doubt, because I've never heard of a Service PitBill -- you'd be able to tell me what service he provides. And he'd have a service dog vest, not a spiked collar. I'm sorry, but "Spike" isn't allowed to visit, and neither are you until you come back without him." Now if I HAD said something like that (which I would have had I seen them coming before they actually got into the room), it would have prevented all sorts of drama when "Spike" attacked Dad's nurse and pinned him up against the wall.

I'm sure I'm not the only one who has nearly exploded from the strain of trying NOT to say that which is desperately DEMANDING to be said . . . please share!

[Ruby Vee, BSN]

It boggles my mind when I hear people who are new to the field say they feel they fear their intellectual abilities will not be sufficiently challenged in nursing. If that is the case, it is one's own fault, not the fault of the profession.

If one isn't using one's intellectual abilities or critical thinking skills at the bedside, one isn't doing it right.

[Esme12, ASN, BSN, RN]

Esme, I interpreted the title of the thread "Biting Your Tongue" to mean things one bites one's tongue about.

I get it....LOL I thought maybe you had a few windows open and posted on the wrong thread..I've done it. LOL

There are so many my dearest wish is that I would win the lottery and pay the hospital for one week to sit in triage and say what I really mean....

"Well...if it hurts for 2 weeks when you stand on your head then another 3 hours won't hurt...will it?"

"No...your IVF toddler that you tried for YEARS to conceive will NOT die from her chin lac"

" Be a parent hold your kid down and give the freaking Tylenol...I don't negotiate with 3 years olds".

"If you think you are pregnant, stop smoking, stop drinking and buy your own pregnancy test"

and to all the wimpy Emmy winning patients with a stubbed toe..."Buck up Buttercup!"

I can go on and on....

[nurse3131, RN]

Pleaseeee!! don't bring your whole family into the doctors office to get a pap smear! ( 4 kids, husband, mother) And please tell your husband I am asking YOU the questions not him! he does not need to answer when your last menstrual period was! Stop coming in for STD checks every other month and wear condoms! oh and one more thing...do not ask me prices I am a nurse I do not do billing!!! thank you

[nurseprnRN, BSN, RN]

I am trying to say this while causing as little offense as possible. In the last few years I have read a number of posts by a) pre-nursing students b) new/recent grads, who express how disappointed they are to find that a) nurses do not value intellectual inquiry and that b) their research/critical inquiry abilities i.e. referring to various studies, etc., are not valued by the nursing school environment/classmates/instructors, and that they expect they may have to continue on to become an APRN or try very hard to find a niche in nursing where they can use their critical thinking abilities. I would like to ask pre-nursing students, students, and new/recent grads to hold your opinions about how much intellectualism and critical thinking is utilized in the profession until you have participated in it. Participating means practicing as a nurse. Nursing school takes you to the beginning of nursing practice; the beginning of the journey. Did you learn about the Nursing Process in nursing school? You will be using the Nursing Process, the nurse's critical thinking process, for the rest of your career. Practicing as a nurse will give you more opportunities to use critical thinking and research than you will ever dream of.

I realize today that some students do not get as many clinical opportunities as students did in the past, but it seems to me that I am hearing people speaking who have graduated from nursing school and seem to have no student clinical experience at all, who appear to be speaking from a completely idealistic point of view. Of course nursing practice is evidence based practice - this isn't new, as the experienced nurses on this site will tell you. You will find research incorporated in nursing policies and procedures and in the standards of practice. Please, hold off on your comments about how nursing falls/may fall short as an intellectual field when you haven't even begun your practice. There are so many different specialties in nursing, opportunities for specialty certification, and nursing and medicine are constantly changing. Just trying to keep up with the changes is a huge undertaking in itself. It boggles my mind when I hear people who are new to the field say they feel they fear their intellectual abilities will not be sufficiently challenged in nursing. If that is the case, it is one's own fault, not the fault of the profession.

I hear you, I agree with you ... but what does this have to do with this thread about biting your tongue? Would you like to ask the mods to move it to the "anti-intellectualism in nursing" or some other related thread, perhaps in the student forum?

[LadyFree28, BSN, LPN, RN]

I hear you, I agree with you ... but what does this have to do with this thread about biting your tongue? Would you like to ask the mods to move it to the "anti-intellectualism in nursing" or some other related thread, perhaps in the student forum?

Agree...I say don't bite the tongue on this one!

[Selfie]

To patients and co-workers: To those that say, "guess how old I am?" or, "I'm 65, but I don't look that old." I'd like to say: "Yes, you really DO look that old."

[thenightnurse456]

To patients and co-workers: To those that say, "guess how old I am?" or, "I'm 65, but I don't look that old." I'd like to say: "Yes, you really DO look that old."

"Can you believe I have grown up children?"

Yes, yes I can...

[Hispanik RN]

We had a new graduate in our unit some time ago, she was kind of cocky, don't get me wrong, I can handle people like that, but It was a long, hard shift, so I was at my lunch time, and then this nurse came and ask me: where are the blunt cannulas that the hospital recently got? I told this new graduate: They haven't arrived yet, we only had the in service saying that it will be required to use it.

Then the new graduate said: There is a policy in the hospital saying there is implicit to use this cannulas when withdrawing medication.

Of course I just look at her and said Ok. Go and ask your preceptor what you can do.

But in my mind I was like: So you are not going to give medication because you don't have your damm cannula? Geez!!! you the one that always talk about critical thinking cannot figure it out how to take medication from a bottle? Get away from me and let me eat!!! And by the way!!! there is a bigger policy called... give your medications!!! .

Sorry I was so hungry and tired...

[thenightnurse456]

We had a new graduate in our unit some time ago, she was kind of cocky, don't get me wrong, I can handle people like that, but It was a long, hard shift, so I was at my lunch time, and then this nurse came and ask me: where are the blunt cannulas that the hospital recently got? I told this new graduate: They haven't arrived yet, we only had the in service saying that it will be required to use it.

Then the new graduate said: There is a policy in the hospital saying there is implicit to use this cannulas when withdrawing medication.

Of course I just look at her and said Ok. Go and ask your preceptor what you can do.

But in my mind I was like: So you are not going to give medication because you don't have your damm cannula? Geez!!! you the one that always talk about critical thinking cannot figure it out how to take medication from a bottle? Get away from me and let me eat!!! And by the way!!! there is a bigger policy called... give your medications!!! .

Sorry I was so hungry and tired...

Not much beats a cocky grad.. Except maybe the cocky student.

[ICURN3020]

"Who opens your pack of crackers / holds your cup while you drink / feeds you / moves your blankets an inch this or that way / holds your member while you urinate / turns the lights on or off / changes the channel for you AT HOME?!?

This is for those patients who seem to think just because they are in the hospital, you must do every little cotton-picking thing for them when they are full well and able to do it themselves!!!!!!

Just once I'd love to say to them "Are your hands/arms broken?

Drives me nuts!!!

[That Guy, BSN, RN, EMT-B]

How about things you SHOULD have bit your tongue to:

"You get nothing from me until you say please. You are the one who called 911 for being drunk, you don't get to be an ******* to me. When you ask nicely you can get a blanket" - Charge nurse jaw about hit the ground

"So why are you here then?" - In response to someone coming up to triage with a medical complaint list as long as a google search can provide.

"I'm just gonna leave then"

"Ok see if I care" - angry, you can't start an IV on me, draw labs, take my BP, tell me what to do pt

Sometimes my filter dies at about 0300....

Oh and telling a drunk that had been in several times in the past few nights that if I saw him again I'd give him one across the face. He laughed and said ok Guy you have a deal. Comes in 6 hours later completely torn up. He sees me and in front of the cops and everyone "OH NO HES GONNA HIT ME!" I never would but we all got a good laugh out of it.

[Irish_Mist, BSN, RN]

"Who opens your pack of crackers / holds your cup while you drink / feeds you / moves your blankets an inch this or that way / holds your member while you urinate

Holds your member while you urinate? What kind of barbarian would act like that? Wow!!!!!!!