Are patients more likely to be honest with the nurse or the doctor?

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Specializes in CVSICU, Cardiac Cath Lab.

I've had a patient all week (I'm on my second clinical rotation of an ABSN program) who gives everyone a different story about his alcohol consumption. Yesterday, he told me it was 8-9 shots/ night and a dozen beers. His intake said 18 oz and a dozen beers, but listed no time frame. This morning, the resident d/c Ativan because "pt does not drink daily."

With whom is the patient truthful? Nursing staff or resident MDs? Or, did the resident not really assess the patient and see the visible signs of withdrawal (hand tremors, confusion, and lack of pupil contriction) that my instructor and I both noted over the past few days?

Overall, do you think patients are more likely to be honest about social habits with nurses or docs?

Thanks!

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I think that many people are in denial of the situation, particularily when it comes to addicts. They may lie to others because in truth, they are lying to themselves. Addicts may also lie to others in order to further fuel their addiction.

For non-addicts, why do they lie? I think out of embarrasment...saying you had three drinks instead of 9 makes it seem like your decisions weren't as bad as they probably were.

I don't think that the distinction of honesty is so much connected with whether someone is a nurse or a doctor.

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Specializes in CVICU, Obs/Gyn, Derm, NICU.
I think that many people are in denial of the situation, particularily when it comes to addicts. They may lie to others because in truth, they are lying to themselves. Addicts may also lie to others in order to further fuel their addiction.

For non-addicts, why do they lie? I think out of embarrasment...saying you had three drinks instead of 9 makes it seem like your decisions weren't as bad as they probably were.

I don't think that the distinction of honesty is so much connected with whether someone is a nurse or a doctor.

In my experience, nurses are often better at establishing initial rapport with p'ts in the ED. Addicts usually provide accurate info re drinking and drug use to an experienced RN.

However, regarding general history....Docs have the advantage here. Amazing how many p'ts will omit parts of their history to the nurse. However this probably is because doctors IMHO are more skilled in history taking than nurses

Nurse - 'Have you got any surgical history' ?

Patient (with an appy scar) - 'No'

Better to ask - 'Have you ever been in hospital before'? And go from there

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I believe the patient will be more honest with the person they have communicated the most while in hospital.

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Specializes in ORTHOPAEDICS-CERTIFIED SINCE 89.

As far as ETOH consumption I was always told to multiply the response by at least 2 probably 3 to get an estimation. Patients get tired of being asked the same question multiple times and often save the final version for the doctor. If you've ever been admitted to a hospital you know what I mean.

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I think they will be MOST honest with whomever they feel more comfortable with. However, I don't ever expect complete honesty from any drug and/or alcohol abuser. They will tell you whatever suits them in the moment.

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.

Definitely nurses. They trust us, we don't intimidate them, they know we have no financial stake in whatever treatment they do or don't get.

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Specializes in Community, OB, Nursery.

I've seen it work both ways; some will tell the truth to the doc, some to the nurse. I think it depends on whom the patient trusts - or, whom they think they can fool most easily. I used to work in a community health center and the patients were sometimes more truthful w/ our lab tech than they were with either doctors or nurses.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

I would think that many patients would be more honest and forthcoming with nursing staff because there's far less professional distance between the nurse and the patient.

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keep in mind, with chronic and symptomatic alcoholism, there might be some brain damage...

literally rendering them unable to reliably respond to questions.

many of the alcoholics i've dealt with, were cognitively deficient...from mild to gross impairment.

nothing to do with trust.

leslie

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Specializes in Med/Surg.

Agreed with any kind of addict, their behavior is unpredictable. Especially as many have developed manipulative or passive-aggressive behaviors to try to justify and get away with their addictions. Also, I have been standing in the room doing a hx with a patient, doctor comes in says a few words, leaves and then dictates an entire hx and physical including heart, bowel, breath sounds. Maybe he has excellent hearing but :uhoh3:. Agree with the poster who said have several people ask at different times/days.

For example, was told in report pt A drinks 2 drinks a day but is in ETOH precautions, receiving ativan q2 due to withdrawls. I ask pt A, "So I can correctly dose your medication, I need to verify how much you drink a day." Pt A responds "2 drinks". Me - "What kind of drink?" Pt A "Vodka" Me - "By a drink do you mean a shot?" Pt A "No a bottle." :idea:

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Specializes in home health, dialysis, others.

I stopped asking how much they drink, and started asking if they drink a case of beer every day, or 2 fifths of whatever liquor. amost would have to stop for just a minute and answer with '2 cases in about 2-3 days', or 'one and a half bottles every day' I think I got closer to the truth most of the time.

Most people have a hard time estimating/admitting exactly how much they drink.

Same thing with meds - I stopped asking 'do you use any illegal/street drugs?' and changed to 'do you take anything at all that was not prescribed for you.'

Not 'how much do you smoke' but 'how many cartons a week?'

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