How do you tell someone they smell bad?

[Virgo_RN]

Not a patient, but a student? The other day I was getting report from the previous RN, and she had an LPN student with her that she was precepting, and the student smelled awful. It nearly knocked my socks off. It wasn't BO, like from working up a sweat from working hard, but more of a yeasty skin fold smell. On the one hand, since she is an LPN student, she'll probably only be around for a few weeks, so I could just ignore it. But on the other hand, she probably smells like this wherever she goes, and I'm certain it leaves an impression. Would it be kinder to ignore it since she is temporary, or mention it in some kind sort of way, so that she knows and can address it? Maybe I should mention it to her preceptor, but it's hard to imagine that her preceptor hasn't noticed.

[krltdy]

There is a medical condition referred to as fish odour syndrome, Trimethylaminuria. I worked with a girl who suffered from this and management could not do anything about it. Some of my coworkers were mean and would call her fishy and it was so sad.

I would not want to be in the position to tell someone they smell bad. I would not know how to go about it. I don't think there is anything you could say and not embarass someone.

I saw this on Medical Mysteries (My fav!) They said high protein foods add to the smell, especially eggs.

[jazz_is_my_game]

If I can stand lower GI bleeds, I can stand a little BO. It could even get funny. We could rate our pts' BO by the number of coffee filters with a pack of coffee apiece in 'em left under the bed. A little humor goes a long way in promoting tolerance.

Your patients? That's not funny IMO.

[chicookie, BSN, RN]

Here have some good smelling lotion. Now rub it everywhere.

[AOx1]

They should be told politely. Even if it is cultural, I think many people would want to know and correct the problem if possible. As someone who lived in another country for a brief time period, I was doing something offensive. The people there stood much closer to you than here, and I would naturally back up as someone entered my personal space. Then they would step closer, and so on. I was grateful when someone told me it made me appear unapproachable. I didn't know until someone was kind enough to tell me. I was still uncomfortable with the close contact, but tried to change my behavior enough to not offend. I would think if the student is smelly, he or she would certainly want to know. It could hinder their future career possibilities. I think many employers would be reluctant to hire a nurse who smells unpleasant. I would tell the instructor or preceptr, as the instructor or preceptor deals with the student more regularly and is in a better position to know whether or not this is a regular occurrence or an isolated incident.

[NurseKitten, MSN, RN]

If it happens again, pull her aside and say much of what's been said up here. All good suggestions, save a few.

We had a unit secretary once that was just plain nasty. It was awful. I knew she had been taught better, 'cause I knew her mother, and how they lived...anyway, since she was the first thing people saw coming into the unit, it had to be addressed. It was around Christmas, and one of the assistant NM's took her into the office and talked to her...then, since I was a friend, and she knew I wasn't being nasty, my Christmas gift to her was a beautiful set of Victoria's Secret bath stuff.

(Heck, *I* would have loved to get that gift!!!)

The problem wasn't completely solved, but it did get better.

[buransic]

I think Batman24 hit the nail on the head. Batman24's description is part of the process commonly used in Crucial Conversations. You can open the dialogue with a contrasting statement, something like, "This is not a personal attack on you and I'm not trying to make you uncomfortable. Your body odor is noticeable and I'm concerned that if I notice it that others do and that it may have an adverse effect on your work with others." As long as the conversation can be sustained, you have a chance at educating the student, and correcting a problem. Good luck!

[Vito Andolini]

I think the best way to deal with this is directly. In a very nice way, just tell the young lady that you do not wish to embarrass her or hurt her feelings in any way, shape, or form but that you have noticed that she does not usually smell very clean and that you are concerned about it. You let her know that she might possibly need medication for yeast/fungal infection under her breasts, inside her legs, under her arms, wherever, let her know that you wish no harm at all to her whatsoever and that you are so very, very sorry to bring it up but that it is something that makes it unpleasant to be around her and that she will probably not be able to find or keep a job if the problem doesn't get corrected and that you would like to help her.

If you preface it with enough "schmaltz", if you let her know you are not trying to be mean, if you can help her see you as a friend and someone who wants to help her, she should, hopefully, take it well and do something to clear up the problem.

Be brave. how would you like to be the stinky one and no one would tell you the truth? Stop making it such a big deal, stop waiting for someone else to do the deed, and just do it.

[Virgo_RN, BSN, RN]

I think if it were me, I'd feel humiliated no matter how nicely or respectfully someone told me. That's what makes it tough for me, I think. Plus I really dislike confrontation, especially when there is a risk of the person feeling hurt. I appreciate all of the feedback. I think I will speak with her preceptor, not to gossip or talk behind her back, but to discern whether the issue has already been addressed. Perhaps there is something I do not know. If the preceptor is feeling as awkward as I am, I will share some of the suggestions you all have shared with me.

[LEN-RN]

1. Vickks vapor rub under your nose.

2. Don't stand down wind to them.

3. Breathe through your mouth.

4. Chalk it up to cultural differences.

Those are good tips, but what about the poor patients? :)

I do respect cultural differences but body odor usually means not very good hygeine. So if they arent washing themselves, how are they doing with hand washing? Sorry but some things should not be excused and overlooked just because its a cultural difference.

[Vito Andolini]

If it happens again, pull her aside and say much of what's been said up here. All good suggestions, save a few.

We had a unit secretary once that was just plain nasty. It was awful. I knew she had been taught better, 'cause I knew her mother, and how they lived...anyway, since she was the first thing people saw coming into the unit, it had to be addressed. It was around Christmas, and one of the assistant NM's took her into the office and talked to her...then, since I was a friend, and she knew I wasn't being nasty, my Christmas gift to her was a beautiful set of Victoria's Secret bath stuff.

(Heck, *I* would have loved to get that gift!!!)

The problem wasn't completely solved, but it did get better.

What do you think was the reason for the trouble existing to begin with? Also, what do you think was the cause for it not being corrected fully?

Was the person angry, embarrassed, hurt, offended or did she seem grateful?

[Vito Andolini]

I think if it were me, I'd feel humiliated no matter how nicely or respectfully someone told me. That's what makes it tough for me, I think. Plus I really dislike confrontation, especially when there is a risk of the person feeling hurt. I appreciate all of the feedback. I think I will speak with her preceptor, not to gossip or talk behind her back, but to discern whether the issue has already been addressed. Perhaps there is something I do not know. If the preceptor is feeling as awkward as I am, I will share some of the suggestions you all have shared with me.

Would you rather be humiliated but grateful and clean or oblivious and stinky and talked about behind your back?

Sometimes, we do feel humiliated but we can correct the problem and move on. Yes, I know it's not always easy. But problems still have to be fixed, don't they? And haven't we all been on the receiving end of correction at some point in our lives? Of course we have.

I mean no harm but I really can't stand when people talk about each other "secretly" but will never go directly to the right party and see about getting the issue, whatever it it, resolved. This just really angers me, this "tell everyone but the involved party because I'm afraid to confront " mentality. It's leaving the hard, dangerous work to someone else, it's expecting others to rectify troubles when we ourselves are perfectly capable of doing it. I understand there is concern for who the best person is to tell her but what if there is no best person and someone just has to do it. I happen to agree that her instructor should probably do this and do it with the concern that I and others have expressed - that it will adversely affect her chances of finding and keeping a job. I apologize if I seem harsh.

You could invite the girl out for soda or coffee or a drink after work or ask her to have lunch with you or somehow run into her outside of work and just tell her.

There are many times in life when we must confront. If you see your friend or loved one going down the wrong path, you really should speak up. If they get mad or don't want to take good advice, their resultant troubles will not be on you. You have to find a kind way to say hard things. Be as nice and gentle as humanly possible. Or someone could get a big sack, fill it with deodorant, baking soda, soap, nice towels and wash cloths and give it to her anonymously, with a typed note saying to please wash more often and more carefully. Same with bad breath - give them toothbrush and paste, baking soda (the versatile little goody), floss, Listerine, and the name of a good dentist - all anonymously. They'll get the hint, hopefully.

[nerdtonurse?, BSN, RN]

We had a guy at work (back when I was a nerd) that we all hinted at that his breath was bad. In reality, it was beyond bad; I mean, OMG, to sit near him during a meeting could make the hair fall out of your nose. We tried gentle "hey, X, want some gum?" or "Want a TicTac" as you're passing them out. Never got it. Finally, we all chipped in a buck and each bought a "travel size" bottle of mouthwash. Guy comes back from lunch, and there's 20 little bottles of mouth wash on his desk with a 3x5 card that said, "use these, please. Signed, your coworkers". It finally dawned on him that he STANK, and he started using the mouthwash. He was PO'd but he used it.