Self injury scars on arms and patient questions. - page 2

by dirtyhippiegirl

5,745 Views | 25 Comments

Just curious as to whether anyone else on here who is also a former self-injurer has ever had to deal with questions from patients about your scars? What do you say? I work mostly with adults and thus don't feel obligated to... Read More


  1. 0
    Quote from Indy
    I have to politely disagree that personal stories are not what we do in nursing. Seriously, storytelling is how our civilization keeps itself sane and informed. I have found that being aloof and "therapeutic" as we learned it in school, is a load of hogwash unless I just don't like the patient. People sometimes have problems that they want to get outside of, and they might like to know the nurse is human, not some therapeutic robot. My way is not everyone's way, but I have found that it works for me and my patients.

    Once I had a patient struggling with pain after her breast cancer returned, and she was in new A-fib, and she had a fight with her husband, who was at home sulking or something. Somehow she asked enough questions about death and pain that I told her the only stories I had, involving my only two experiences to date with the subject. I told her how hard it was to learn to speak to dying people at all, how much I regretted the first case where I didn't know how to help or to try harder, and so on. She got something out of that, what, I don't know. She called her hubby, who came to see her. She died that week. So basically if I feel like saying something, I will say it. I know when it's time to open up and that I will regret it if I don't.
    I guess my issue with opening up r/t my extensive psych history is that there is such a huge stigma attached to people who have psychiatric issues that is definitely not applied to people who have battled cancer, lost a loved one, etc. Self-harm, in particular, seems to invoke such a viscerally negative reaction with many people.

    Went to the local scrub store and bought a few different long-sleeved undergarments. With my luck, I'll be wearing long sleeves on my first night and be stuck tanking a burn for 1-2 hours. (Humid, 98+ degree heat in full waterproof gown, gloves, mask, and hat.)
  2. 0
    Quote from jadelpn
    "Are your scars from burns?"
    "No, they are not"
    Then onto their assessment.....
    Yep, that's about all we can do, unless, I would say, somebody had similar scars, and you connected in such a way that sharing your story would be helpful. I remember my first psych hospitalization, the psych tech shared w/ me about being in AA, and she knew that my issues involved alcohol. I didn't quite know it at the time but her doing that helped me consider it. It also made it less of a big deal for me to open up about it. I could also see that she was functioning well, so it gave me hope that someday I would be, too.

    Quote from dirtyhippiegirl
    I guess my issue with opening up r/t my extensive psych history is that there is such a huge stigma attached to people who have psychiatric issues that is definitely not applied to people who have battled cancer, lost a loved one, etc. Self-harm, in particular, seems to invoke such a viscerally negative reaction with many people.

    Went to the local scrub store and bought a few different long-sleeved undergarments. With my luck, I'll be wearing long sleeves on my first night and be stuck tanking a burn for 1-2 hours. (Humid, 98+ degree heat in full waterproof gown, gloves, mask, and hat.)
    I think probably you are going to have to deal with questions, then Otherwise you may end up passing out from the heat!

    It's a tough issue, for sure!
  3. 3
    I would say that if one is a nurse for people who are in various stages of disfigurement due to circumstances beyond their control, then to have conversation about self injury could add distress to an already distressful situation, and change the couse of care for the patient and the relationship between nurse and patient. Meaning that when someone has been burned, they are concerned with a number of things for certain, but they are also concerned with how the scarring and disfigument could/will affect them. To hear about self injury could provoke some pretty significant anger on the part of the patient.

    And to the pp re: theraputic robot comment-- Sorry, but I do not choose to share all of my personal horror stories with patients. That is not what either of us are there for. One can certainly say that a psych patient is not alone and can increase their function, but to start sharing details of one's own personal life takes focus off patient and onto nurse. That is not usually where we want to go when taking care of a patient.

    There's lots of self-help groups like AA, NA and many, many others where one can go and share personal stuggles and get feedback in return. I just don't think the bedside is one of them.
    dirtyhippiegirl, elkpark, and OCNRN63 like this.
  4. 0
    One of the nurses I work with wound up sharing a bit recently with his OD patient and a bonding of sorts ensued... I thought it was really brave of him to show that side and talk about it with someone who seemed to need some kindness. The outcome in the end wasn't good though, and the nurse is now pretty torn up about it. But I was going to point out that he doesn't wear anything to cover his scars. I never asked him, he just started talking about it one night.
  5. 0
    Quote from jadelpn
    I would say that if one is a nurse for people who are in various stages of disfigurement due to circumstances beyond their control, then to have conversation about self injury could add distress to an already distressful situation, and change the couse of care for the patient and the relationship between nurse and patient. Meaning that when someone has been burned, they are concerned with a number of things for certain, but they are also concerned with how the scarring and disfigument could/will affect them. To hear about self injury could provoke some pretty significant anger on the part of the patient.

    And to the pp re: theraputic robot comment-- Sorry, but I do not choose to share all of my personal horror stories with patients. That is not what either of us are there for. One can certainly say that a psych patient is not alone and can increase their function, but to start sharing details of one's own personal life takes focus off patient and onto nurse. That is not usually where we want to go when taking care of a patient.

    There's lots of self-help groups like AA, NA and many, many others where one can go and share personal stuggles and get feedback in return. I just don't think the bedside is one of them.
    I am sorry for the misunderstanding. What I meant by that comment is that I felt, in nursing school and afterwards, that the way therapeutic communication is taught, makes me feel like a therapeutic robot. It lacks a human touch.
  6. 0
    Quote from jadelpn
    "What's wrong with your arms?"
    "I have scars"
    BINGO!
  7. 0
    Quote from dirtyhippiegirl
    Yay, thanks for the reassurances/suggestions.

    I don't know what it is but it seems like my patient population doesn't take to the generalized answers -- "Oh, they're old" IS something that I use in most general settings and get away with it but not while I'm nursing. Just leads to more questions.

    My left arm is such a pulpy, disfigured mess of scar tissue that some of my burn patients specifically ask me if I've been burnt in the past. I almost feel obligated to explain the truth in that particular situation.
    I'm not sure why you can't pleasantly, but firmly, tell them that it's personal. We're nurses. We are not obligated to divulge private matters to patients.
  8. 0
    Quote from jadelpn
    "Are your scars from burns?"
    "No, they are not"
    Then onto their assessment.....
    I like this answer, but the problem is there are a lot of people out there who don't take a hint very well, or they're clueless clods; for them, that answer wouldn't be enough. OP needs to find a polite way to shut them down so she can feel comfortable.

    Many years ago, a visitor who was a farmer noticed that I walk with a limp. In front of a bunch of people, he called out "Hey, you're lame!" I just laughed then said, "I guess if I were your horse you'd shoot me." That shut him up fast.
  9. 0
    Quote from OCNRN63
    I like this answer, but the problem is there are a lot of people out there who don't take a hint very well, or they're clueless clods; for them, that answer wouldn't be enough. OP needs to find a polite way to shut them down so she can feel comfortable.

    Many years ago, a visitor who was a farmer noticed that I walk with a limp. In front of a bunch of people, he called out "Hey, you're lame!" I just laughed then said, "I guess if I were your horse you'd shoot me." That shut him up fast.
    Oh my goodness, that's horrible! I'm so sorry someone said that to you. It never ceases to amaze me how insensitive and rude people can be. To the OP, there are definitely patients that simply don't take hints. It is up to you how much you reveal, but if you want to put that boundary down and not discuss it, why not say something like, "They are old scars and I really don't discuss it." That closes the door on any further questions. There is definitely still a stigma with self harm and psych issues, and quite frankly, your past is no one's business.
  10. 0
    Is there a professional you ave had counseling from that you could ask or maybe a support group?


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