Just had a couple of dillies yesterday, and wondered if any of y'all run into this where you are.
1) LOL is on the table, having a heart cath. The doc tells her that we have to send her to a different hospital for further intervention, based on the results. The LOL tells the doc to print out pictures of the problem areas, go and show them to her husband, and he will decide whether or not she needs to go.
2) We call a lady to schedule an appointment after an abnormal test, and to advise her that she will likely need a cath (that was the purpose of the visit, to allow us to explain why). The first question out of her was "Well, how abnormal was it? I have plans tomorrow, and I am getting my preop done, I can't come. I really don't see why we have to jump right to another test just because one was a little funny."
"Ma'am, this test was abnormal to the point that we are pretty sure that you need a cath. We can tell that something's not right, but we can not be sure how not right it is untile we take a look at your arteries."
"Well, what is the doc's name? OK, I'll discuss this with my husband and let you know if I'll be there."
#1 did get transferred, and #2 did show up, but GOOD LORD!
Yes, I will discuss things with my DH, if it can wait to be discussed. But in the above instance, especially number one, my only comment to my hubby would be "Get my things, please, and meet us there. I love you."
Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.
It's worth asking ourselves: are most patients stupid? If so, nursing--or at least some particular area of nursing--may not be the best career choice. Is it only a few? What, if anything, do they have in common? How can I communicate more effectively?
If you look into theories about intellect in society, you will find that most people fall in the 80-90% range of average intellect.
Some of these people with average intellect are functioning in society with some education. They are able to grasp concepts if explained properly in laymen's terms. They question appropriately (if they are also of appropriate emotional capacity) and it may take a lot of patience to get through to them. It's 80% of my day. They are mostly nice, scared and very interested in knowing what to do next.
Then there is the 10% who aren't so nice, but belligerent and extremely ignorant.
There is no teaching them--because they not only do not have the intellectual capacity, but the emotional capacity as well. There is no changing them. I adjust to their style. I understand them, so they don't frustrate me.
Is this judgement? No, this is my own anecdotal evidence. They do not incapacitate me in any way, nor do I spend too much energy on their lack of faculties. It is what it is.
If you accept that, you will have a better understanding of the human race in general.
I don't consider myself stupid or clueless, but I certainly wouldn't be jumping at the opportunity to have a coronary angiogram or a PCI, unless I was actively having a STEMI. I've pulled enough sheaths to know this isn't just a walk in the park, and I might be one to say "Let me think about it", even if I knew I'd probably end up having it done anyway. The ladies in the original scenario most likely do not have the knowledge that we do, so I think it's understandable that they'd need to process all the information before making a decision.
I'm 40, and I can't imagine asking my husband for permission to undergo a potentially life saving procedure, but I understand that for many of the older ladies, this is not unusual. They grew up in an era where the men made the big decisions...at least, publicly. That's not to say that the women didn't tell them behind closed doors what they should decide. The phenomenon that women were really the decision makers but let the men think they were, is very real. I guess I'm rambling, but I'm really not surprised that two older women would defer a decision until after they had spoken with their husbands. I'm also not surprised that they did decide to go ahead with their procedures. In a way, it's a sort of ritual.
I think, just for future reference, keep in mind that you might encounter this with our older generations, and just do your best to arm them with as much information as possible so they can make an informed decision, and let them go through their ritual. More often than not, they'll probably decide to go ahead with the life saving procedure, they just need to confront it in the way that they know how.
I guess I don't see it as being clueless so much as a generational difference.
Now, on the subject of stupidity, do I think some patients are stupid? Yes, absolutely. Like the guy who had an MI that nearly killed him, then the same day he was discharged went out and smoked some crack and ended up right back in the hospital with chest pain. The interventional cardiologist who had saved his life ripped him a new one.
If they are sick enough to need a cath, they may not even have enough oxygen saturation to think clearly. Advanced cancer patients can be another sadly clueless bunch. Their equally addled loved ones just make it worse.
First of all, glad to see the common sense responses on this thread. Those with judgmental, negative attitudes -- you don't think patients can read you? You think you're such good actresses and actors that your inner, perhaps real feelings just go over patient heads? I'd suggest to you that these "stupid" patients know more than you think. Just because you don't say they're "stupid" -- many of them read your attitude. You really believe you're in such complete control of your facial expressions, eye blinks, ticks, body stances and movements? Kid yourself if it makes you feel better. Make believe that there's a firm, soild line between your venting here and what comes through to your patients. Then, if you so desire, read the research about the subtle signals we send each other, unconscious non verbal signals that are actually much more important and revealing than the words we say. This isn't to say people don't make bad decisions every day. They do, and will continue to. But try to look behind the action, behind the bad decision to see what's really motivating the person. It's like stupid questions. Even if it sounds stupid, people are asking something. What is it? Sometimes people have such a small knowledge base in a certain discipline that they can't even properly articulate a question. They don't have the vocabulary. And consider this -- sometimes a patients "stupid" decision may be based upon poor communication upon the part of the caregiver.
Uh-huh...and sometimes the patient's are just numb.
Guy comes in to the ER at 2AM with cough/cold symptoms, and says "I think I need an antibiotic." OK, so are you allergic to anything? "Yeah, last time I had a cold, they gave me some medicine, and it made me swell up like the Goodyear blimp. " and what was the name of that medicine? "I don't know...you could call my wife, my doctor keeps track of all that stuff."
STUPID. Let me list the ways...
So in 30 years when that guy has his first heart attack he'll be shocked, and frightened, and trying to ignore the whole thing, my heart goes out to him. You can bet he'll still be stupid too, and it will make our job to keep him alive that much harder, and that much more frustrating. My mother has been heel on wheels to keep a low fat diet for the past 5-6 years, but uses tablespoons worth of Becel on her meal. It's polyunsaturated, but it's still pure FAT. For some reason she's skipped over that fact in her logic. Yes, as a nurse, and as a daughter I think it's dumb. When she goes in with her heart attack her nurses are going to plant her right in the stupid category, and she's going to deserve it. I still think she'll get good care, great teaching, and she'll probably send the heart unit nurses a dozen doughnuts to thank them.
If they are sick enough to need a cath, they may not even have enough oxygen saturation to think clearly. Advanced cancer patients can be another sadly clueless bunch. Their equally addled loved ones just make it worse.
Most of my CAD patients saturate just fine. It's the coronary circulation that is affected by CAD. Often, people who undergo diagnostic caths aren't having severe symptoms. Though if the person has comorbidities like COPD, CHF, valve disease, carotid artery stenosis, etc., then sure, their brain may not be getting enough O2 and that could impair their thought processes.
It's worth asking ourselves: are most patients stupid? If so, nursing--or at least some particular area of nursing--may not be the best career choice. Is it only a few? What, if anything, do they have in common? How can I communicate more effectively?
If you look into theories about intellect in society, you will find that most people fall in the 80-90% range of average intellect.
Some of these people with average intellect are functioning in society with some education. They are able to grasp concepts if explained properly in laymen's terms. They question appropriately (if they are also of appropriate emotional capacity) and it may take a lot of patience to get through to them. It's 80% of my day. They are mostly nice, scared and very interested in knowing what to do next.
Then there is the 10% who aren't so nice, but belligerent and extremely ignorant.
There is no teaching them--because they not only do not have the intellectual capacity, but the emotional capacity as well. There is no changing them. I adjust to their style. I understand them, so they don't frustrate me.
Is this judgement? No, this is my own anecdotal evidence. They do not incapacitate me in any way, nor do I spend too much energy on their lack of faculties. It is what it is.
If you accept that, you will have a better understanding of the human race in general.
Not everyone is smart; that's the truth.
I don't think I'm following your point. I'll concede that not everyone is smart. Heck, I've made enough trips to the convenience store for cigarettes and a lottery ticket to convince me that not all smart people are always smart. But as I read your post, it seems like you are saying most people are below average in intelligence, or that average intelligence is low intelligence, or maybe both. My understanding of IQ is that it follows the classic bell curve, with the majority at or near average, and decreasing numbers at either extreme.
Now, I'm prepared to accept as likely that a relatively high proportion of nurses have above average IQs. I was in nursing school not so long ago, and it was hard. I can imagine some nursing students with average IQs make it through by working their butts off, but I doubt many with much below average intelligence graduate and pass NCLEX. So if I interact with patients with the assumption that they are all as smart as I am, I'm likely to spend a lot of time talking over their heads. Even among those with IQs as high as or higher than mine, I probably need to use laymens' language.
But I still contend that if I approach patients with the assumption that they are "clueless," or "stupid," I am not likely to be able to communicate effectively with many of them. My baseline assumption is that they are of about average intelligence and not well-informed about healthcare, and I revise that assumption as part of my ongoing assessment. What's important, I think, is that my estimate of someone's knowledge or intelligence is independent of my sense of their worth. Dumb people deserve respect,too. And, really, if most of your patients are stupid, most of them would probably rather have another nurse.
Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.
i don't think i'm following your point. i'll concede that not everyone is smart. heck, i've made enough trips to the convenience store for cigarettes and a lottery ticket to convince me that not all smart people are always smart. but as i read your post, it seems like you are saying most people are below average in intelligence, or that average intelligence is low intelligence, or maybe both. my understanding of iq is that it follows the classic bell curve, with the majority at or near average, and decreasing numbers at either extreme.
now, i'm prepared to accept as likely that a relatively high proportion of nurses have above average iqs. i was in nursing school not so long ago, and it was hard. i can imagine some nursing students with average iqs make it through by working their butts off, but i doubt many with much below average intelligence graduate and pass nclex. so if i interact with patients with the assumption that they are all as smart as i am, i'm likely to spend a lot of time talking over their heads. even among those with iqs as high as or higher than mine, i probably need to use laymens' language.
but i still contend that if i approach patients with the assumption that they are "clueless," or "stupid," i am not likely to be able to communicate effectively with many of them. my baseline assumption is that they are of about average intelligence and not well-informed about healthcare, and i revise that assumption as part of my ongoing assessment. what's important, i think, is that my estimate of someone's knowledge or intelligence is independent of my sense of their worth. dumb people deserve respect,too. and, really, if most of your patients are stupid, most of them would probably rather have another nurse.
that's a strawman's response about "dumb people deserving respect."
there is no issue with people being dumb and not deserving respect. all people deserve respect.
my understanding of the op's original thought is that she is expressing her frustrations. that's it. but there is always one person on this forum who is quick to deny an op that--and that happens to be you.
the issue here is denying that dumb people exist. they are all out there and nurses here are venting about them.
what is at issue here is that this forum is the place to vent...let it all hang out about nurses and their stupid patients.
just because you feel that the op is judging, doesn't dismiss her own personal feelings. she has a right to them--and if she feels that she doesn't "get" the dumb people (yet)..so be it.
that's her personal experience.
all i'm adding to the equation is that dumb people do exist and that has been scientifically proven. whether you feel that they are less dumb because of your approach, well...have at it....
i am just being my pragmatic, and very logical..me.
Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.
I think saying a patient is stupid is extremely judgemental MAYBE if the doctor / nurse explained it in a manner that is relateable to the patient this would not occur . Fear and anxiety is mostly what a person experiences when they hear the life shattering news that will change there lives. Anybody that makes comments about patients intelligence is Jaded what a shame , I guess my opinion is harsh but I think healthcare professionals need to be sympathtic and treat the patient as whole mind ,body , and soul .
You are an "RN TO BE."
Let us know what you think when you graduate, get licensed, and have been doing this for a couple of years.
Without disrespect to you, I do not think you can have a truly valid opinion of what nurses do--until you have done this yourself.
Specializes in Emergency Dept. Trauma. Pediatrics.
Speaking only on the elder generation consulting husbands and stuff, I don't think it's limited to just the older generations. I would consult with my mom and husband before I made any major decisions. I wouldn't be getting permission but I would inform my Dr I was going to discuss things with my family first. I know I am not a stupid person but I also know I would need a little time and not want to feel rushed or pressured into something and even just talking with my family to let them know what was up would give me that time.
Now if it was an emergency situation and they were like, "ma'am we need to do this right this moment or you are going to die" then I wouldn't consult first.
In my case I would probably discuss with my mom over my husband though.
Specializes in med-surg, psych, ER, school nurse-CRNP.
Gee, AngelfireRN, drama club in school? Well, I guess there's nothing you need to learn about acting or commication. You "think" your patients can't read you. That's your perception. Sometimes the "way" you show something doesn't get to you, works for you -- but it's also quite recognizable to those around you as merely a strategy. Communication is a complex subject, and non verbal communication is even more complex. You seem pretty confident. Your strategies seem designed to make you feel good and keep you going. That's valid. But that has nothing to do with how your patients may perceive you.
Well, there's no need to get snippy. I never said that I had nothing left to learn. That was YOUR perception of my post.
Yes, I am pretty confident. You can not do what I do and not be confident, they'd eat you alive. And as far as how my patients percieve me, well, I haven't yet had one complain. Granted, they may when I leave, but I know I have their best interest at heart, and while I have yet to say, "Fine, Mrs. X, you can just go ahead and die, because that is what will happen if we don't help you", Lord knows I have wanted to. I have ticked a few off when they asked what they could do to get healthy, and my first answer is, "If you smoke, stop."
We try to save these patients on a daily basis, we know what we're doing, and to not be able to do it because they want to hem-haw around is maddening. If that makes me a bad NP, so be it.
I will agree, though, stupidity is rampant, and some of the folks coming through are eat up with it. If you work with the public, you can't avoid it.
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PostOpPrincess, BSN, RN
2,211 Posts
It's worth asking ourselves: are most patients stupid? If so, nursing--or at least some particular area of nursing--may not be the best career choice. Is it only a few? What, if anything, do they have in common? How can I communicate more effectively?
If you look into theories about intellect in society, you will find that most people fall in the 80-90% range of average intellect.
Some of these people with average intellect are functioning in society with some education. They are able to grasp concepts if explained properly in laymen's terms. They question appropriately (if they are also of appropriate emotional capacity) and it may take a lot of patience to get through to them. It's 80% of my day. They are mostly nice, scared and very interested in knowing what to do next.
Then there is the 10% who aren't so nice, but belligerent and extremely ignorant.
There is no teaching them--because they not only do not have the intellectual capacity, but the emotional capacity as well. There is no changing them. I adjust to their style. I understand them, so they don't frustrate me.
Is this judgement? No, this is my own anecdotal evidence. They do not incapacitate me in any way, nor do I spend too much energy on their lack of faculties. It is what it is.
If you accept that, you will have a better understanding of the human race in general.
Not everyone is smart; that's the truth.