How are you judgemental?

[GardenDove]

I was reporting off this morning on a rule out chest pain pt. He was a 49 yr old guy who had an extensive family cardiac risk hx, he had had a CABG in his 30's, had been an alcoholic until 8 yrs ago, when he gave it up. He had abused recreational drugs. He previously had smoked 4 pks a day, but now was down to 1/2 pack a day. He still occasionally indulged in pot, was married for 30+ years, had had stents, was not overweight, had early COPD, and was just about to get on disablity for his multiple problems. He also had had some esophegeal surgery secondary to his previous ETOH dependence.

The guy was actually very nice and really above board and honest. He had been a traveling worker who had worked on railroads. He had made the effort to quit drinking for 8 years, had cut back to 1/2 pack a day, was not pestering me for morphine, and was really nice.

So, one of the nurses in report was pretty judgemental. Let me just say that this nurse tends to give a pass to all the out of control diabetics who are 100 punds overweight, and is a only too eager to point out how judgemental I am if I comment on that.

This all made me realize how each of us has something that makes us judge our pts. For some reason, this guy seemed up front and honest. He didn't mind my remarks like "How in the world did you manage to smoke 4 pks a day!?". I saw him as someone who WAS making an effort. Yes, I think that whiny, overweight pts who have complications from their food overindulgences bug me.

So, what is it that particularly sets you off about your pts? For me it's the overeating, abdominal chronic pain pts, they really aggravate me.

[wonderbee, BSN, RN]

Judgmental? Oh yeah. The trauma population can really raise some ire. With all the drama in trauma, it's pretty hard not to develop some attitude.

[Daytonite, BSN, RN]

I know from these boards when we talk about obesity it's always "how dare you judge". Sad that we treat the diabetic foot, the COPD, the cocaine snorting mother and the consequences but feel we have to keep our mouths shut lest we be judgmental.

Teaching patients can be done very objectively without injecting personal criticism and subjectivity into the conversation. All it takes is some exercise of control. If I berate a patient or take some criticizing pot shots at them for their health behaviors and practices, then what have I accomplished other than to make myself feel a little bit more superior over that person for that moment of time. That's a right thing to do? Not to my way of thinking. It's also not humane, compassionate, respectful, or nice. Crazy people will come back with guns and shoot you.

[ceecel.dee, MSN, RN]

I am not one of the saints...I disapprove (sp?) of the unwashed and odorous. It's just so unnecessary (sp?).

I make a conscious effort to maintain a neutral face and to discretely don the gloves to even touch their skin.:uhoh21:

[Elvish, BSN, DNP, RN, NP]

For the record, I did eventually develop a rapport with the cocaine snorting mom and while I continued NOT to agree with what she was doing, I was able to take care of her and her baby competently. I think it is perfectly possible to completely disagree and/or disapprove of what someone does (the action) while being able to have a therapeutic relationship with the person behind the action.

[angel337, MSN, RN]

I really don't appreciate this thread. Aren't we perpetuating stereotypes by highlighting them in a discussion? This is exactly how "drug seekers" and "complainers" are created, marked, studied and pegged -- before we ever even experience them!

please post again once you are actively working as a nurse and are completely responsible for multiple patients and their every little need. i GUARANTEE you will change your mind. i never treat my patients anthing but professional, but it does not stop me from being annoyed by certain things that they do.

[nurseinlimbo]

One of the things that shocked me the most coming out of nursing school, was HOW judgemental nurses are.

Maybe because we are burnt out, maybe because we no longer care (or maybe never did), maybe because we've missed Christmas for 10 years in a row and are resentful. Whatever it is, it is definitely a part of the nursing environment.

I have worked in Psych, and one of my ways of filling in the slow times at work was to read all the patient histories in their charts. It was unbelieveable what some of these people had been through, horrible abuses and life situations that would knock most of us. Yet they received very little understanding from their nurses if their coping skills included drugs or alcohol. That is just one example. I always try to look at the whole person, rather than just what they are doing now.

But I think that as nurses, we are probably most judgemental of EACHOTHER. How many times have you participated in Gossip? given someone the gears because they didn't pick up the phone for that extra shift? spread rumors about another nurse's competence? eaten your young?

And by the same token, how many times have you given a helping hand to a nurse who has just worked 14 shifts in a row and has been asked to stay late? or picked up Christmas for a young single mom so that she can be with her kids to open presents? or guided a new nurse and helped them to become better?

That is what nursing should be, but it isn't. I have worked numerous places, and encountered it everywhere. We have no regard for eachother, and especially those that are new to a group of established nurses, or new to nursing period.

If I had known that this would be what I would encounter when I got out of school, I would never have gone into nursing. Management allows it to occur and even encourages it. It may be a result of the nursing shortage but we all still have a choice in how we treat others.

[weirdRN, RN]

I have problems with being judgemental of people who are not willing to help themselves. There are so many people out there willing to help you up when you are down, Why stay in that hole when you can dance in the sunshine? Makes no sense to me.

I have difficulties understanding and relating to the person who smokes. I thought that the way to understand would be to take up that nasty habit. So, I barrowed a smoke from a friend and she made me swear to smoke it or give it back. I lit it. In the end I just couldn't make my self put my lips around that nasty habit. Yeck! I don't believe I have any unbreakable habits beyond breathing. Hopefully someday I will have an inkling of what it is like. I am even more judgemental of people who smoke but are on public assistance and not planning on bettering themselves or don't have the money for milk or medicine but can buy thier next smoke. And I have a way short temper with parents and families who smoke with children of any age around.

I used to not understand people who are non-functioning alcoholics, the overweight and obese people, and those who are depressed. Then I had an event and became depressed myself. From that depression I began to drink and then I gained weight. Eventually, I got over my event and through a lot of work, I am better. I relate and have a great deal more compassion today that I did before my event.

I used to pray for patience with small children and the grace to understand people who bring small kids to resturants and expect them to behave perfectly. I understand them and relate to them better now that I have a child of my own.

[muffie, RN]

you must walk a mile in the shoes of another to understand

[Ruby Vee, BSN]

i think that being in the nursing profession, you should not judge or stereotype anyone. as a nurse, you should look at everyone as an "unique" indivdual and that everyone has a reason for being the way they are and that you should acknowledge their differences and resolve the problem based on their situation.

nurses are human, and humans sometimes cannot help judging some things. and some people. no we "should not." but we do. it's good to be aware of our blind spots. it's also good to be accepting of one another. peronally, the person who is "holier than thou" is one of my pet peeves!

[Ruby Vee, BSN]

stereotyping is really a huge issue with nurses, especially in the realm of report. you can make or break a nurse's day depending on how you describe your patient at end of shift. think about it -- the outlook for your day can be completely different depending on the report you get: "this patient is really great. she's sweet, she doesn't really complain, and she definitely knows how to get up and go to the bathroom by herself. really easy,"

personally, whenever i get a report like that, i know the patient is going to be a total pain in the a$$ -- just my luck, it seems! only thing is, most of the nrses i work with say the exact same thing. if the nurse giving you report tells you how sweet your patient is, you know you're going to have a miserable shift with a foul-mouthed, complaining patient!

[Tweety, BSN, RN]

Teaching patients can be done very objectively without injecting personal criticism and subjectivity into the conversation. All it takes is some exercise of control. If I berate a patient or take some criticizing pot shots at them for their health behaviors and practices, then what have I accomplished other than to make myself feel a little bit more superior over that person for that moment of time. That's a right thing to do? Not to my way of thinking. It's also not humane, compassionate, respectful, or nice. Crazy people will come back with guns and shoot you.

I certainly wasn't advocating berating a patient as a way of teaching them. That misses the point entirely and I apologize for not being clear. I totally agree with what you say.

I was merely speaking against keeping our mouth shut when there are teachable moments to drug addicts, obese patients, and smokers who are feeling the effects of their lifestyles.

I highlighted your statement "all it takes is some exercise of control" because does presume something is going on with the teacher that needs control - his/her personal feelings and judgements. I find it best to acknowledge it's there, rather than live in a bliss of denial that "I'm a nurse, therefore I have no judgements or opinions whatsoever about a person's lifestyle". For some of us, myself included, it's usually a subconscious process, but as I indicated, being human, I have my moments that do need to, as you point out, exercise some control. It's not that hard.

[Ruby Vee, BSN]

i'm with the few handful that have been able to say that they don't judge. part of the challenge of working as a nurse is maintaining that professional image and keeping my mouth shut about any opinion i might have about the patient's lifestyle or his/her actions. many people talk about freedom for all, but don't really want to practice that either. none of us, not one, is perfect. if we were, we wouldn't even be here on this earth to be discussing this.

honey, if you have opinions, you're judging! i really don't see how anyone can say they never judge. is it just me, or aren't most of those who say they never judge patients judging the rest of us who admit that we do?