Self injury scars on arms and patient questions.

  1. 0 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 shape the truth into something less offensive. "I used to cut myself when I was a teenager" tends to end the conversation fairly quickly. But I wonder whether this explanation will eventually get me into trouble as TMI. I'm really good at smiling and nodding when I have that occasional patient who wants to save my soul upon learning of my past.

    I work on a burn unit -- thus wearing long sleeves isn't really an option most of the time?
  2. Visit  dirtyhippiegirl profile page

    About dirtyhippiegirl, BSN, RN

    dirtyhippiegirl has '4' year(s) of experience and specializes in 'PDN; Burn; Phone triage'. Joined Jul '11; Posts: 1,125; Likes: 2,817.

    25 Comments so far...

  3. Visit  jadelpn profile page
    5
    "What's wrong with your arms?"
    "I have scars"
    jds87, OCNRN63, dirtyhippiegirl, and 2 others like this.
  4. Visit  breezycna profile page
    1
    I wear long sleeves under my scrubs, but roll them up all the time during cares or if it's just way too hot in the facility. I've been asked about my visible self-injury scars and I just say, "Oh, they're just some scars from a long time ago," or "I got these when I was really sick" and that's usually enough for them.
    jds87 likes this.
  5. Visit  Liddle Noodnik profile page
    1
    "I used to cut myself when I was a teenager" should cut it off.

    I have prominent scars from a suicide att., one on each wrist. no one has ever asked and I'm glad! there is no way to cover them even w/ sleeves.

    ((((you guys)))) I never had the cutting desires but I have addiction issues. it must be hard xoxo
    VivaLasViejas likes this.
  6. Visit  dirtyhippiegirl profile page
    0
    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.
  7. Visit  Liddle Noodnik profile page
    2
    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.
    seems to me in nursing school (a hundred yrs ago) they encouraged us not to get into personal discussions of ANY kind, basically, "oh, we aren't here to talk about me, let's talk about you. What do you do in your spare time" or "how is that pain of yours?" or something. Outside of work people would not ask such questions unless they knew you - it would be almost rude to ask. So diverting the conversation like that is basically a polite way of saying "none of your business" but diverting back to them. Usually they are happy to do so.

    There are those who will persist of course. like the burn pt, I have no idea how you would answer that. to say "no" would invite more questions, to say yes is lying (unless you just say, "I don't want to discuss it right now," (and not answer) and then revert to the "We're here to talk about you. so ... " etc...

    there are times tho, I think, where it could be theraputic to talk about it a little, or, use it to help the person deal with their OWN scars, etc. ie the burn person, "how is it for YOU to have scars..." etc.

    well I don't know if any of that is helpful ... hope so.
    jds87 and VivaLasViejas like this.
  8. Visit  Indy profile page
    2
    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.
    jds87 and VivaLasViejas like this.
  9. Visit  Liddle Noodnik profile page
    0
    Quote from Indy
    I have to politely disagree that personal stories are not what we do in nursing.
    Well my point was, none of us HAS to answer personal questions. In fact it is discouraged in nursing school. But of course we do use our own judgment and use our own experience if it's theraputic, which I also brought up in my post.

    But we can do that to excess sometimes. And, we are not obligated to do so.
  10. Visit  Indy profile page
    0
    You're right, Liddle. It takes something out of you to continually talk about yourself, plus you miss things if you aren't listening. I will say there are things I would not dream of opening up to a patient about, that are personal, and I just don't allow that part of me to exist or be seen when I am at work. I have no idea what I'd say if directly questioned about a couple of topics.
  11. Visit  jadelpn profile page
    3
    "Are your scars from burns?"
    "No, they are not"
    Then onto their assessment.....
  12. Visit  dirtyhippiegirl profile page
    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.)
  13. Visit  Liddle Noodnik profile page
    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!
  14. Visit  jadelpn profile page
    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.


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