digital stimulation!!!

rn/writer, RN · Jul 3, 2008

Why arent terms like "quad personality" edited out?

Because you have to name the concept in order to discuss it.

As Karen pointed out, what is being called "quad personality" could easily apply to other kinds of patients. The common denominators are people who are (or can be) medically fragile, those who are dependent on others for even basic survival needs, and those who have had too many run-ins with medical or other caregivers who do not listen and therefore place the patients at great risk.

I have a grandson with spina bifida (L 4-5, S 1-2) who is now eleven years old. The only reason that he has made it this far is that his mother is extremely vigilant and does not back down when she knows his needs are not being met. She and I are considering writing a book about their experiences, including a chapter on how to be the squeaky wheel and how to get past some of the communication barriers that sidetrack proper care. Our little guy has come close to dying more than once and his mom has saved his life by getting the necessary medfolk to understand that she wasn't just being difficult (SB personality?) for the fun of it, but had legitimate concerns that absolutely had to be addressed for him to be okay.

To her credit, she has used these opportunities to kindly but firmly instruct the residents (he goes to a teaching hospital) and even the attendings that they need to listen to their patients and the patients' families. She has been apologized to and thanked many times after the fact, but she takes greatest satisfaction in thinking that maybe the practitioners will take future patients more seriously because they finally made the connection with her and her son.

Noryn · Jul 3, 2008

I am not trying to be difficult but I am having a hard time understanding why no one else sees that there is a problem with this.

That concept is bogus. It is a false generalization. That is a derogatory term used for patients with SCI. It could apply to other patients but it doesnt because of the term "quad."

On the CRRN examination how much attention is dedicated to "quad personality?"

Dolce, RN · Jul 3, 2008

I would like to, once again, apologize to everyone that I may have offended by using the term "quad personality." This is certainly not a term or a condition that I made up. Nor does it apply to all persons with SCI. Rather, it is a set of behaviors that I have seen in some patients with SCI. I have also seen the same behaviors in others that have a long history of hospitalization. Once again I apologize and if the moderators feel it is necessary to regain the calm I am more than happy to have all of my posts deleted.

Home Health Columnist / Guide · Jul 3, 2008

We are leaving the term here as a learning opporunity for others to think about how they phrase things, discuss thoughts/concerns and educate others that words/ slang terms can be considered offensive to the disabled community.... and that through networking, education and research can prevent unintentional harm to patients/each other.

**canoehead, BSN, RN** · Jul 3, 2008

By explaining how important bowel care was I think it allowed me to also to challenge the views that "there are control issues" and that they somehow get enjoyment out of this. As someone who has taken care of patients with SCI injury those views are really off base.

For every patient, not just SCI patients, there are control issues, I don't think anyone would be offbase in assuming that someone dependant on other for care has control issues. I would go so far as to say I'd be concerned about the patient if we didn't have to chat frankly about their needs vrs nursing care needs at some point, and find a balance.

Patients getting sexual enjoyment from nursing care isn't an issue we deal with every day, but when I worked MS certainly it came up every few months, and in the ER it's every few days, especially when alcohol is involved.

When the term "quad personality" was used I knew what was being talked about, but sure don't think it has a thing to do with SCI. Some people have been exposed to the deaf ear of healthcare so long that they feel they need to shout. I think the same syndrome afflicts docs and nurses who suddenly have to take on a patient role. We've seen the mistakes, and get much more controlling and mouthy because we know what can go wrong.

Bringing up those points and discussing them makes the thread helpful for me, and I hope we continue to discuss them.

Tweety, BSN, RN · Jul 3, 2008

I am not trying to be difficult but I am having a hard time understanding why no one else sees that there is a problem with this.
That concept is bogus. It is a false generalization. That is a derogatory term used for patients with SCI. It could apply to other patients but it doesnt because of the term "quad."
On the CRRN examination how much attention is dedicated to "quad personality?"

You are not being difficult at all. You're stating an opinion and educating us about it. We have no problem with that at all.

As far as allowing the term, if someone said to you personally...you're being so difficult...oh yeah because you have a quad personality that's why. We'd be all over them as moderators.

Also however, if someone talked about a patient with a quad personality and you came back with "you're such an idiot for thinking that, don't you know there isn't such as thing as a quad personality", then you have just committed a TOS violation.

It gets tricky. Yes, sometimes we catch one's violation and not another. There have been a few times I've dinged someone for a TOS violation and they said "what about so and so" and I've said "yes, you're right about that...I missed it."

About that other site, I probably shouldn't judge it so quickly, a 2nd look and it seems very informative, but I was really turned off by some of the language in the first thread I read, with the f-bombs flowing freely. Just not me and that's definitely not us. Often people who are used to such freespeaking have difficulty here, and it's understandable.

By the way, I totally agree with you about the "quad personality". For nurses to judge an entire group of people like that is wrong.

Carrry on.

Noryn · Jul 3, 2008

I would like to, once again, apologize to everyone that I may have offended by using the term "quad personality." This is certainly not a term or a condition that I made up. Nor does it apply to all persons with SCI. Rather, it is a set of behaviors that I have seen in some patients with SCI. I have also seen the same behaviors in others that have a long history of hospitalization. Once again I apologize and if the moderators feel it is necessary to regain the calm I am more than happy to have all of my posts deleted.

My main point is that you are defining and using a term that is highly offensive and gives the implication of a personality disorder exclusive to patients who are quadriplegics. Furthermore, this term should not be used to describe a set of behaviors even in patients without SCI because it is a bogus or made up term. It doesnt exist in the medical or mental health community.

As a nurse I feel you have to be careful in giving legitimacy to such terms even if you in fact did not make them up . If you google "quad personality" this post is the fourth most relevant and only one in the first 5 pages that comes up (that relates to how you are using this term).

Noryn · Jul 3, 2008

For every patient, not just SCI patients, there are control issues, I don't think anyone would be offbase in assuming that someone dependant on other for care has control issues. I would go so far as to say I'd be concerned about the patient if we didn't have to chat frankly about their needs vrs nursing care needs at some point, and find a balance.
Patients getting sexual enjoyment from nursing care isn't an issue we deal with every day, but when I worked MS certainly it came up every few months, and in the ER it's every few days, especially when alcohol is involved.
When the term "quad personality" was used I knew what was being talked about, but sure don't think it has a thing to do with SCI. Some people have been exposed to the deaf ear of healthcare so long that they feel they need to shout. I think the same syndrome afflicts docs and nurses who suddenly have to take on a patient role. We've seen the mistakes, and get much more controlling and mouthy because we know what can go wrong.
Bringing up those points and discussing them makes the thread helpful for me, and I hope we continue to discuss them.

Anytime there is a major loss whether it is a loved one or loss of function there can be a wide range of emotions--anger, depression, denial, etc. I really never felt that all of my patients had control issues. I do understand how loss of control may be a problem but again I never thought this was a problem in all of my patients.

I also dont feel someone dependent on care necessarily has control issues. Some may consider it "control issues" but generally (especially if they have dealt with their injury for a long time) the patient knows their body best and knows what works for them. It isnt about being in control as much as it is doing the right thing.

Bowel programs are often difficult, time consuming, painful and humiliating for SCI patients to have to go through. A good number get colostomies to avoid this. So to automatically assume they get pleasure or sexual stimulation from this is mind boggling and very frustrating for the SCI patients who read this.