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.
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!
I'm in nursing school, and I remember the first time I heard a nurse give me report on my very first patient. "She's got these open abcesses on her thighs that are really painful, she says. But if she's in so much pain, why is she still going downstairs to smoke every hour?" This made sense to me, a naiive, inexperienced nursing student, and so, before I even got a chance to begin my career in my own way of thought, I walked into my patient's room with a stereotype blocking my entire field of view. Because of this, the first thing I noticed about her was that she was sleeping with her cigarettes in her breast pocket (of course), and the first thing I assumed was that she would be crabby and want to smoke as soon as she woke up (of course), and that she really wasn't in all that much pain (of course not).
I'm really thankful that I took the time to try and get to know her, because I learned a lot about how wrong that nurse was. I learned that my patient was missing her son's first day of kindergarten, and that she had been diagnosed with Crohn's a decade ago with no end in sight. She really was in pain, which I could clearly see without years of experience under my belt, and yes, she smoked. But it made me realize: why wouldn't she? She had nothing else to get her through the day!
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," versus, "Oh my gosh. What a nervous nancy. This lady shakes, and she's a smoker, but she's not allowed off the monitor so she just bugs you all the time about going downstairs. She always asks for pain medicine, but when you walk in she's asleep, and she has been incontinent three times. It's not going to be a good night for you." Everyone knows how each of these reports gives you a totally different outlook for your shift, and how you treat your patient.
This is my argument: both examples are wrong. Both examples of report put an idea into the receiving nurses mind, and immediately create a stereotype that molds and alters the rest of the shift and every dealing with the patient. I think that report should STRICTLY be confined to report -- medical, objective information that is PERTINENT and important to nursing care, NOT nurse opinion.
Stereotyping is a HUGE problem in nursing. Let's STOP glorifying it by giving petty examples of people who bother us. Our patients are sick, and regardless of what they are sick with or how sick they are, they deserve respect, and good, unbiased, un-stereotyped care.
Just keep doing your own thing. Some people are just bitter, jealous, unhappy people. Or maybe they're just human and are irked by this or that. What bothers me is two-facedness.
At the risk of sounding a little nutty, one of the things that drives me up a wall is gum chewing. I can't stand to see a nurse chomping and popping away while caring for patients. Looks so unprofessional. As for patients, I have problems dealing with the attention-seekers (we all know who they are) and the somehow functioning addicts. Give me a down and out addict anyday, at least there seems some honesty there. Its the professional appearing, manipulative-type addicts that drive me crazy. They lie and manipulate (all the while you know exactly what the score is,) but you can't call them on it, you have to just smile and act like you buy their story; hook, line, and sinker.
I can't believe they had to drop the e in judgmental! English spelling rules are absolutely exasperating. Did anyone see the movie Spellbound? People who can spell that well are total freaks of nature!
It just doesn't make a bit of sense to drop that E. [evil]I protest[/evil]
Oh...I guess I did spell judgmental correctly! See, all this spelling talk has me sooo confused. It doesn't take much to get me confused!!
Where's that fish......?? I'm going to hit myself with it....:trout:
haha.. that's my other one, people who can't spell. i just don't understand it, since an incorrect words just looks incorrect to me. but i realise it's just not important to some people.
well, here in the good ole usa, we spell that word realize.:smilecoffeecup:
there can be a difference between laughing at a patient and laughing at the situation.
this weekend, we had a very drunk man come in with c/o change in mental status. his etoh level was 0.433 (43% alcohol), so he was going to get several liters of fluid. his poor elederly mother (he was in his 50's) stayed in the room with him to hold his arm down so he could get the fluid. otherwise, he kept bending his arm. after a little while, we decided to restart his iv somewhere other than the ac so his mamma didn't have to stand there. (by the way, no one asked her to do this, she did it herself, with the door shut, so we really wern't sure of what was going on until we went in to check on him. he had a seizure when he first arrived, so he had gotten some ativan, so he should have been out cold -- and he was, other than bending that arm). so three of us go in there, two to hold and one to stick. we get the iv restarted, and notice that he was just soaked. too soaked to just change the bed. so we decided it would be best for him just to change out the stretcher.
well, lets just say that he was heavier than he looked. we managed to get him into a dry gown, but getting him from the wet stretcher to the dry stretcher, without getting the new stretcher wet.......well it was quite a bit tougher than it looked. add to that, he started peeing again all over the place, in great volumes. at one point, the three of us were giggling like little girls.
from all appearances, we were laughing at our very drunk, completly soaked, patient. but we wern't. we were laughing at the situation, and our ineptness at doing a seemingly simple task.
we had a similar situation last week involving a "code brown" and believe me we weren't really laughing at the pt!
well, here in the good ole usa, we spell that word realize.:smilecoffeecup:
it's funny that the british and aussies spell realize differently isn't it. i read a lot and the first time i saw a it spelled with an "s" i thought the publisher had made a typo.
since it's "english" perhaps americans are spelling it wrong.
i'm not necessarily a bad speller, but a fast typist and i make a lot of mistakes. i hope it irritates people.
spelling correctly is a gift, just like being good at math.......nothing to do with intellect.....and if you cant, you arent going to know that it is wrong....
I work in OB/GYN/nursery and it REALLY irks me when I see pregnant women going down to smoke, or having a drug screen +cocaine (or any other illegal substance). Screw around with your own life, that's your business; screw around with another, that wins you a call to CPS as soon as you deliver. (assuming, of course, that CPS will actually DO something about it.)
We had an antepartum whose drug screen was +cocaine (and continued to be positive throughout her stay with us...what does that tell you....) tell one of us "I had to quit my hairdressing job when I found out I was pregnant because of all the chemicals." BS.
I am a recent graduate and don't have much nursing experience but as a EMT I can say it is hard at times not to be judgemental of patients. I am usually very tolerant of people and accept them for who they are. My attitude is for every choice you make you accept its consequence (whatever it may be). The toughest assignments for me are the child abuse and neglect cases. Children don't deserve the treatment they sometimes get. What could a 2 year old child possibly do that is so bad to cause Mom to break 42 bones in her body???? And, to boot, Mom got a slap on the wrist with a $500 fine and 120 days in jail. I don't know where the child is now but it will grow up disabled and disfigured thanks to her mother.
The toughest assignments for me are the child abuse and neglect cases. Children don't deserve the treatment they sometimes get. What could a 2 year old child possibly do that is so bad to cause Mom to break 42 bones in her body???? And, to boot, Mom got a slap on the wrist with a $500 fine and 120 days in jail. I don't know where the child is now but it will grow up disabled and disfigured thanks to her mother.
:imbar Hope the spelling comment was taken in stride as I make all kinds of mistakes myself when typing away . . . . no one's perfect.
Yes, the English language can be frustrating since it is a conglomeration of so many other languages and rules . . . you can say " I before E except after C" to help remind you of how to spell some words like "receive" but the rule breaks down for other words.
Back to the topic - child abuse, as I mentioned, is probably the one thing I have a very hard time with. In school we were encouraged to do some soul-searching to find those areas where we might have problems and then be aware of that beforehand. That part of my education was priceless for me.
Personally I have siblings who are addicts (one who stole oxycontin from her son when he was being treated for cancer so she could sell it for meth) and I have purposely educated myself on all aspects of addiction so I could at least intellectually understand even if emotionally I want to throttle someone.
This would be a great thread for nursing students . . .
TrudyRN
1,343 Posts
Just keep doing your own thing. Some people are just bitter, jealous, unhappy people. Or maybe they're just human and are irked by this or that. What bothers me is two-facedness.