Can't Smell-Can I be a Nurse?

[Nurse Beth, MSN]

Dear Nurse Beth,

When I was in my teens, I suffered a concussion and since then I have not had a sense of smell. While many people have told me nursing is great field for someone who can't smell (since you're bound to encounter tons of bad smells along the way...), I've been getting worried that it might hinder me from performing well (i.e. recognizing foul odors from a wound), or that it might limit my options as to where I can work. Is this something I need to let my clinical instructors and professors and/or my future employers know about? Do you feel this will limit me in any way?

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Dear Worried,

Congrats on your recovery and readiness to embark on a career.

It's true you will be missing some olfactory cues.

Some organisms have distinctive odors but there are generally many other clues to a patient's condition. For example, it is not necessary to recognize the distinctive smell of a GI bleed to identify a GI bleed. Likewise, you will recognize an infected wound by the appearance.

I can think of only one time when odor was the only abnormal observation. Years ago, I had a patient in ICU with a foul odor. I washed her and changed her linen, and the odor persisted. I cleaned the entire room. Still kept getting whiffs of odor. Finally towards the end of my shift, I thought to do a lady partsl exam, gloved up, and discovered the problem- a hard, entrenched foreign object. I called her doctor, who called in a gyn consult. They were unable to remove the object (turns out it was a vase) at bedside, and by the time I went home, they were taking her to surgery.

I'm using the example to show how highly unusual it is to have no other clues but an odor, and I wouldn't base a career decision on one such event.

If a job description does not specify sense of smell as a qualification, I would not volunteer the information as it's not required for the job. Many nurses have allergies that impede their sense of smell. Others may be hard of hearing but have found ways to compensate.

To answer your question Do you feel it will limit me in any way?”- yes, it is a limitation but not a deal-breaker, depending on how badly you want to succeed and your willingness to work around your limitation. For example, you could always ask a colleague to help you assess for odor if needed. Detecting an odor is not likely to constitute an emergency situation.

I'd like to hear what the community of nurses here has to say to help you make your decision.

Best wishes,

Nurse Beth

Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!

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[brownbook]

My nursing instructor had the exact same "defect" cause by a concussion as a teenager. I can't even remember why she told us, but I am certain it was NOT to say she couldn't do floor nursing because of it!

I never had the greatest sense of smell. Can't think of anytime it has caused a problem for me as a nurse. I guess if a wound was "going bad" or an object was where it shouldn't be, as Nurse Beth noted, it would be useful. But the patient would be cared for by other nurses, CNA's, doctors, etc., who would notice the foul order even if you missed it.

Raising kids and grand-kids, it is helpful when checking if a baby or toddler's diaper is poopy. Maybe if you worked in a skilled nursing facility it would be useful to know when incontinent adults needed changing? But it isn't that hard to simply peek under the diaper.

[cinlou, BSN, MSN, RN]

I have had peers with same issue, one had and then lost it, and she said she did not miss it except when she ate. She did not feel it impaired her ability to be a good nurse, because she learned how to compensate for the loss. Some nurses can smell ketones on the breath, some can not for example, it doesn't mean you wouldn't recognize the other aspects of say DKA.

[retiredmednurse]

I also do not have much of a sense of smell. I never found it to be a hindrance, and as brownbook stated above, there will be other health professionals taking care of the patient to pick up on any strong odors. I usually found having no sense of smell to be helpful. If I could smell it, I knew the odor was BAD. Usually strength of odor also correlated with the amount and type of purulent drainage from draining wounds. So, taking care of these wounds just made my job easier. PLEASE don't let a lack of sensing smell to stop you from being a nurse. If in doubt, if there is a smell, I have asked co-workers to discreetly sniff for me (and I say discreetly so as not to embarrass or alarm the patient).

[Dafabb, LPN]

All I can say is you are lucky you can't smell but I can't think of a time when I just couldn't look and know there was a problem with infection or something wrong.

[she244]

I was in a MVA and had a skull fracture and concussion. I lost my smell. 2 areas I have not been able to work in are the Burn Unit and Pediatrics. I had floated to all of those areas while in Nursing School and working as a CNA at that Hospital. When I interviewed in those areas for to be a Nurse I told them up front I could not smell. The Burn Unit Director let me know that smelling an infection in a burn victim is important. Also in Pediatrics I was asked how would I know the child's diaper needed changing. I said I would have to check frequently to see if their diaper needed changing. The Director stated "these are sick children and could not be disturbed frequently to check a diaper. I ended up working in Neurosurgery and then the Emergency Room. Which as the other's have stated having no smell at times is beneficial. I am now a College Health Nurse. So not having a smell should not keep you from becoming a Nurse. I just felt is was best to be honest since in my personal life I knew what not having a smell meant. Good Luck!

[3ringnursing, BSN]

Nice assessment on the pt with the vase Beth! Poor woman, was probably too embarrassed to ask for help. Most pt's don't realize there is nothing so embarrassing that warrants losing one's life over - and eventually we've seen most things anyway, therefore don't even blink an eye. You likely saved her life. Although I agree, lack of smell should not be a deterrent to becoming a nurse if that is your desire.

[FranEMTnurse, CNA, LPN, EMT-I]

I have no sense of smell of foul odors, because I have COPD, but I am able to smell heavy fragrances such as perfume that chokes me.. I have no idea why, but many people are in the same category as myself. I get embarrassed if I pas gas and someone makes a remark about it. I am a nurse, but was only able to assist a patient for another healthcare professional before becoming disabled. I don't know if this has any relevance to your issue or not, but I thought I'd give some input.