Biting Your Tongue

Haven't we all had to bite our tongues at times in order NOT to say that which is desperately demanding to be said but probably wouldn't send Press-Gainey into swoons of delight? Here are a few of mine -- please share yours! Nurses Announcements Archive Article

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!

Specializes in Pediatrics, Emergency, Trauma.
I was helping a colleague reposition her recently extubated post op CABG x 3 patient when the woman began to complain and curse angrily at all her chest tubes. She was angry and did not want " all these (choice curse word) tubes" because they hurt and they got in her way. She had a history of smoking, obesity, HTN, DM....the usual cardiac arrest package. I don't know what came over me but I was in able to bite my tongue! I simple stated to her, "You are here because of you! You did this to yourself! You came to us to save your life and that's exactly what we did! So you remember that every time you get angry about having all these, in your words, (choice curse word) tubes!". Surprisingly I didn't get pulled into the managers office. In fact, after that, the patient was extremely appreciative. Do we really have to be that way for people to come outside do themselves and own up to what they do?

Short answer- :yes:

Specializes in NICU, ICU, PICU, Academia.

The mother who brought her 5-month-old to our ER with a fever of 105 and hadn't given her any Tylenol because she wanted us to see how high the child's fever could get.

You forgot "...wearing a blanket sleeper and wrapped in a quilt" :)

[COLOR=#003366]Quote from VivaLasViejas

"The mother who brought her 5-month-old to our ER with a fever of 105 and hadn't given her any Tylenol because she wanted us to see how high the child's fever could get."

To add to Meanmaryjean's answer about wearing a blanket sleeper and wrapped in a quilt: Just try and take those items off the child: "Oh nurse, don't do that; he will get cold and then he'll cry".

After a night with all ETOH or drug abuse related patients I was getting short on patience. One of my patient's flat out said if I didn't do what he wanted (wanted one of the Filipino nurses to "sit" on him) he was going to get up and beat the **** of me. I am a decent sized guy and was getting slightly overwhelmed with all of the shift's current BS so I just grinned and said" Get up and do it I would like to see you try". Even though it wasn't the right thing to say it shut him up. You can only deal with threats so much until you snap....and believe me I really wanted to see him try.

You can inject yourself with all the insulin you like, it doesn't mean you can eat whatever and how much you want. To answer your question mom, no we won't order him more food and he is not a 'growin boy' here on the adult unit.

You would think both of them would have realized this after not one, not three, but like 5+ amputation surgeries.

Also, exactly what about having diabetes causes severe pain?

To the little old ladies (sometimes young ones too) who don't want a male caregiver: "I notice all your doctors are men."

To the paraplegic who "just couldn't" do his own straight caths because "his fingers wouldn't work right" "Then how the h#ll can you dial & text on that cell phone?"

To all the pts. who order 8 things at once, then want something else as soon as you start the first one: "I'm too dang fat to fly!"

"No ma'am. I'm not wiping your ass. What do you mean you have your husband do it at home? HOW on earth could you find that appropriate? You're 45 and weigh 400 pounds! Lose some weight or invest in a bidet - but stop having other people wipe your ass!!"

"Well, I imagine your stomach does hurt. It would with all that McDonald's you had your (mother, grandma, sister, girlfriend) bring to you. Imagine that; you have chronic pancreatitis, celiac disease, and colitis and 3 Big Macs and fries made you hurt. Must be why you're on a liquid diet. You idiot."

Specializes in Transitional Nursing.

The nourishment room is right down the hall to the right. Help yourself, I am here for the patients, not the family members.

Why do family members ALWAYS want me to wait on THEM too? I know I am the CNA, but I'm not a slave or a maid. You want to stay overnight with your mom, that's fine. Don't ask me to fetch you things you can get for yourself if you see how incredibly busy I am.

Really, now!

Specializes in Emergency/Trauma/Critical Care Nursing.
You can inject yourself with all the insulin you like, it doesn't mean you can eat whatever and how much you want. To answer your question mom, no we won't order him more food and he is not a 'growin boy' here on the adult unit.

You would think both of them would have realized this after not one, not three, but like 5+ amputation surgeries.

Also, exactly what about having diabetes causes severe pain?

I wasn't sure if that was a rhetorical question or not, but if it wasn't, diabetic neuropathy is pretty painful. If it was rhetorical then I get what you mean, not every diabetic has neuropathy, nor do they all need to eat every 2hrs like I've heard them claim lol.

Specializes in SCI and Traumatic Brain Injury.

I have an idea...Why not assign "Ms critical -thinker new nurse" to the patient who wanted the Philipina nurse to "sit" on him. Or maybe, let her respond to the patient who, among a stream of other requests, wants her to hold his member while he voids.Would it be too cruel to assign her, in additionl, to the patient whose grown child demands his mother gets ibuprophen every 2 hours around the clock. The one who says (shouts) "I don't care if it makes her stomach hurt, my mother needs to be PAIN FREE, don't you understand that??!. Let her apply a little "critical thinking" to the guy who calls 911 because he's drunk.

Maybe it will help her understand that nobody is going to require her to cite "studies" regarding anything nor quote any experts...just do the job of a nurse. You may have to "bite your tongue" when she tells you about it.

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.

Susie - As a nursing student, starting this August, I applaud you for this post! haha. After pursuing a different degree and discovering that college only teaches you (maybe) 1/4 of what you need to know and the other 3/4 is learned on-the-job, it appalls me to think new grads will assume they know all. Granted, this is a 2nd career for me and I have some maturity under my belt. Life experiences have a way of humbling a person. I just wonder, for clarification purposes, if you're noticing this behavior primarily in the young new grads or do you also see it in the 2nd-career new grads? I believe we were all guilty - to a degree - of thinking we knew all when we were early 20s. I would hope we'd outgrow this notion eventually.

I was helping a colleague reposition her recently extubated post op CABG x 3 patient when the woman began to complain and curse angrily at all her chest tubes. She was angry and did not want " all these (choice curse word) tubes" because they hurt and they got in her way. She had a history of smoking, obesity, HTN, DM....the usual cardiac arrest package. I don't know what came over me but I was in able to bite my tongue! I simple stated to her, "You are here because of you! You did this to yourself! You came to us to save your life and that's exactly what we did! So you remember that every time you get angry about having all these, in your words, (choice curse word) tubes!". Surprisingly I didn't get pulled into the managers office. In fact, after that, the patient was extremely appreciative. Do we really have to be that way for people to come outside do themselves and own up to what they do?

Sometimes you have to call their bluff...fight mean with mean. Glad you didn't get called to the Principal's office over that one.