Biting Your Tongue

by Ruby Vee | 17,324 Views | 62 Comments

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!

  1. 35

    Biting Your Tongue

    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 itís 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 heís 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 managerís 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 youíre expecting her to sleep in this sleep chair? Whatís 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!
    Last edit by Joe V on Jun 16
    tkelly1990, SLHLPN, uRNmyway, and 32 others like this.
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    About Ruby Vee

    Ruby Vee has '38' year(s) of experience and specializes in 'ICU/CCU'. From 'the Midwest'; Joined Jun '02; Posts: 8,547; Likes: 30,870.

    Read more articles from Ruby Vee

    62 Comments so far...

  3. 8
    Here's an older thread along the same line with quite a few gems in it if I remember correctly:
    http://allnurses.com/nurse-colleague...ve-267763.html

    Things I'd like to be able to tell my patients:

    Put the cigarettes down. We just did your heart surgery. Keep smoking and you'll need another, provided you can find a surgeon to do redo heart surgery on an active smoker. (Someone who refused smoking cessation counseling after a CABG x8)

    No, of course you don't need to stop smoking. Each time you get a tumor, we'll just cut it out. Of course, at some point you won't have enough lung left to live or it'll spread to other areas. (Another smoking cessation counseling refusal who openly stated he was going to keep smoking, s/p lobectomy)

    Yep, I work with cardiothoracic patients. Yes, some have been dealt a nasty hand by genetics or workplaces before we knew what we know now (asbestos -> mesothelioma), but not all.
    Last edit by Rose_Queen on Jun 14 : Reason: grammar policing myself
    ICUman, canoehead, bluenurse85, and 5 others like this.
  4. 14
    Coworker called ambulance for their grown daughter who "just tipped over for no reason" (narcotic overdose) and insists that there is something medically wrong as this has happened several times before. But no doctor will tell them anything or do anything about it because the pt tells everyone to lockdown their information!

    bite tongue, bite tongue... And btw- they are in pain, can they please have something?
    SLHLPN, uRNmyway, maelstrom143, and 11 others like this.
  5. 33
    If you don't agree with the MD's plan of treatment, refuse the meds ordered for you Mom, disagree with how the nurses do things and basically are unhappy with all the care provided, you are free to take Mom home and do it all yourself. There are 15 pts in ER waiting for beds. The door is that-a-way and don't let the door hit ya where the good Lord split ya!

    I wish.
    emjay:), SLHLPN, DBK99, and 30 others like this.
  6. 15
    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.
    Anna S, RN, lorirn58, 1feistymama, and 12 others like this.
  7. 8
    Quote from Susie2310
    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.
    Yes, you're right. It totally reflects a disconnect with reality from how it is to really do nursing -- not just learn it. If they're so in fear of losing their intellectual muscle, they are more than welcome to use their abilities to find some way to reach greater levels with their practice. Whether it's being more efficient in what they do or doing independent research or pursuing additional schooling, there are ample opportunities. I wonder if this is a lack of having real world job experience -- I see it in my current line of work, too. People are "bored" and wasting themselves while there are plenty of things around them that are calling out for them to apply their critical thinking skills. I think it might be due to a severe lack of innate drive and the "training" so many people have that causes them to need to have their hands held and be told directly to do something instead of taking initiative. Hmmm....
    Anna S, RN, bluenurse85, TriciaJ, and 5 others like this.
  8. 11
    Confused, combative resident was yelling loudly to the point other residents were getting out of their rooms and telling said resident to SETTLE DOWN. Attempted calm theraputic communication and redirection several ways/times. Plan of care stated to call daughter when said resident becomes agitated. Daughter called and stated she would be there 'in about an hour'. Behaviors persisted, im ativan given per dr order. When the daughter FINALLY mosied in (long after the storm had cleared, of course) she DEMANDED to know all medications that were given during the prior med pass. I named them all off. Colace was one of em. So, she says: Well, THAT'S why my (family member) was agitated!!!! YOU GAVE THEM A SUPPOSITORY!! {"No, ma'am. Colace isn't a suppository"---wanted to add 'how much blame are we gonna get for your family member's dementia? We, the nurses and the doctor try our best to #1 take good care of your parent and #2 cater to your every whim!'} That's the best I have. Just starting out in LTC.
    uRNmyway, Anna S, RN, newhospicern, and 8 others like this.
  9. 9
    Quote from Susie2310
    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.
    Did you mean this for another thread?
    jalyc RN, VivaLasViejas, TriciaJ, and 6 others like this.
  10. 7
    Quote from Esme12
    Did you mean this for another thread?

    Esme, I interpreted the title of the thread "Biting Your Tongue" to mean things one bites one's tongue about.
  11. 1
    "Come on, play the man!" Yeah that wouldn't go over well.
    imintrouble likes this.


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