Innapropriate comment at CODE?

[Dinith88]

I recently participated in a code-blue situation in which a doctor was having a difficult time intubating. At least 2 people (including the doc) remarked that the patient had a huge tongue. A comment was made by a male-nurse that : "I hear he was popular with the ladies..." A few people (including myself) laughed out loud to this comment.

There were probably 8 people in the room, 5 of whom were women.

If you were at bedside during this code, how would you have reacted? If at all?

[thatoneguy]

inappropriate, no it was not. i think the fact that it was a guy dose have a big affect on how it was perceived though. if a girl said the commit i would think it would be percieved in a more inappropriate matter. following guide lines and performing the procedures correctly has nothing to do with a one line commit. in fact the commit made here, IMO helps the others on the team by putting the current issue of the pt's tonge being big on the "top" of their heads. IMO this would get others on the team to think, if we cant get the pt intubated what can we do "trach or other" and be prepared to preform whatever needs that come up. IMO if we simply follow guidelines and focus on the steps we lose the critical thinking aspect of our job, which is what makes all the difference IMO. not that we should not use the guidelines to guide us, but we should not fall into the "routine" and just go though the motions. the commit made is not only a way to deal with the stress, but also a way to get everyone thinking of needed "adjustments" in our routine for a given situation.

[rcpals]

I would politely ask if you feel other sexual inuendo (SP?) are also acceptable. What about a reference to a large or small phallus? or Breasts. Is that also appropriate .

How would legal and administration look at your statement? Would they tell you good job, way to communicate. Do you think any of your legal nurses or dept managers would approve of such a crude statement? Please come in the to the 90's. This in not 20 years ago. You just can't make statements like that with out pissing someone off. Is that reasonable? You would be wise not to communicate in that manner. Someone will get you. Eventually.

At least look at it in a legal administrative view. Please answer this question. Why does anyone, man or woman have to make sexual jokes or inuendos at a code blue. What does that add to our team effort??? I definitly know a few nurses (men and women) that would write you up for that offense.

If you honestly think he was trying to warn us that we might have a difficult intubation, he could have said "lets prepare a rescue airway (LMA,Combitube,COPA etc...) in case he cant get it in next time. If you want to inform the staff of an impending problem just speak in clear medical terms that we all can understand.

In terms of following simple guidelines, we pray that you do. Please read the latest issue of CC Magazine and the article by Max Harry Weil MD a noted scholar and researcher with hundreds of articles. His biggest problem is that few people really follow the "simple guidelines. If we could follow the simple guidelines that would be a great start. There is lots of room for improvement. We do like and encourage critical thinking. Yes, of course. No cookie cutter medicine, but the guidelines are there for a reason.

Good luck and control the tongue

[Antikigirl, ASN, RN]

Okay..did the code go okay? That..despite words is the most important part! All other things can be forgotten or dealt with dependant on the battles you choose to take on (we have hundreds a day...so I always say to take them on as you so deem fit).

I have heard worse..and have giggled at worse! The humor in stressful situations is a protective mech for people..and if you find it inappropriate...then you have the right to say so in person to the person that said it.

Heck..one day when I was on my first day as a nurse at a local hospital said something most would laugh at..but one nurse had a probelm. I understood her probelm with it..but reported me directly to the superiors instead of talking to me which I would have gladly appologized for!

It was cleaning a man who just died of cancer...I had to remove his catheter, and the other nurse was doing basically nothing! I assumed it was my 'initiation' and did it perfectly. She screamed...I am telling you screamed at me "you did deflate the balloon didn't you". Being a little ticked since she was watching me like a vulture and had to have seen that I did indeed do this...I said "why? Did he jump?"....

Needless to say other nurses laughed because they knew that nurse, knew I was new..and knew in a way it was humor I needed (my first clean up of a corpse!) to set my abilities in a way she wouldn't forget....

In the end...the Nursing Administration, in giggles..said to not say that again..which I never have...and added about three or four phrases of their own they would have used! LOL!

We are human folks...but yes..you must be careful of what you do say..it is one thing to say what I did vs a sexual inudendo like that..but not uncommon! (I would have laughed and said....ummmm ewwwwww!)....

[fergus51]

Okay..did the code go okay? That..despite words is the most important part! All other things can be forgotten or dealt with dependant on the battles you choose to take on (we have hundreds a day...so I always say to take them on as you so deem fit).

I have heard worse..and have giggled at worse! The humor in stressful situations is a protective mech for people..and if you find it inappropriate...then you have the right to say so in person to the person that said it.

Heck..one day when I was on my first day as a nurse at a local hospital said something most would laugh at..but one nurse had a probelm. I understood her probelm with it..but reported me directly to the superiors instead of talking to me which I would have gladly appologized for!

It was cleaning a man who just died of cancer...I had to remove his catheter, and the other nurse was doing basically nothing! I assumed it was my 'initiation' and did it perfectly. She screamed...I am telling you screamed at me "you did deflate the balloon didn't you". Being a little ticked since she was watching me like a vulture and had to have seen that I did indeed do this...I said "why? Did he jump?"....

Needless to say other nurses laughed because they knew that nurse, knew I was new..and knew in a way it was humor I needed (my first clean up of a corpse!) to set my abilities in a way she wouldn't forget....

In the end...the Nursing Administration, in giggles..said to not say that again..which I never have...and added about three or four phrases of their own they would have used! LOL!

We are human folks...but yes..you must be careful of what you do say..it is one thing to say what I did vs a sexual inudendo like that..but not uncommon! (I would have laughed and said....ummmm ewwwwww!)....

Couldn't agree more. If someone has a problem with a comment a coworker makes, they should say so. Personally, I wouldn't have been offended. Being able to laugh at strange things is what keeps me sane in my job, it's just blowing off some steam. Others may cope differently... I don't care.

[ZASHAGALKA, RN]

How would legal and administration look at your statement? Would they tell you good job . . .

Without commenting on the rest of the thread, if I stopped and examined how administration would view the way I do my job, I couldn't do my job.

Or, as a nurse here made famous, "Being a good nurse is not always the same thing as being a good employee'.

Which runs similar to what I used to always say, "Do you want a nurse, or some bureaucrat? Because I can be both sometimes, but only one sometimes, and so the question is, when push comes to shove, would you rather me be a nurse?"

Regarding the thread itself: The comment was inappropriate because of its sexual overture. I would probably have laughed, at the embarrassment of the comment. But would I tar and feather the guy? Let some bureaucrat do that, I'm a nurse.

~faith,

Timothy.

[thatoneguy]

I would politely ask if you feel other sexual inuendo (SP?) are also acceptable. What about a reference to a large or small phallus? or Breasts. Is that also appropriate .

i dont think that would never come up in a code, but if it did so what. on a code team the last thing you should be thinking about is if the nurse next to you gets upset and reports your meaningless words. if the family is present thats different, but we should not have to worry about people on our own team. it was not a extreme sexual commit, more of a suddle one. maybe if he always said such things it could be an issue, but one time come on. if it really bothers you talk to him about it dont report it.

How would legal and administration look at your statement? Would they tell you good job, way to communicate. Do you think any of your legal nurses or dept managers would approve of such a crude statement? Please come in the to the 90's. This in not 20 years ago. You just can't make statements like that with out pissing someone off. Is that reasonable? You would be wise not to communicate in that manner. Someone will get you. Eventually.

dont take it like this was a way to communicate. never meant to say it was a good way to say lets try something else. just it might act as a catalyst for others to put on their thinking caps. the commit made seemed to me to be more of a commit on the size of his tonge rather than a sexual commit. the sex referance just seemed to be a way to punctuate the point. perhaps something else should have been said but still no reason to get upset. to me its more of a shock that a nurse would focus on this and take it so personal. if he had said that looks like it would please you, sure take offense but it was not. by the way we are well past the 90's so come into the new melenium, careful there are sex referances everywhere, just put the TV on or log on to the net, turn on your radio and try not to take offense.

At least look at it in a legal administrative view. Please answer this question. Why does anyone, man or woman have to make sexual jokes or inuendos at a code blue. What does that add to our team effort??? I definitly know a few nurses (men and women) that would write you up for that offense.

look in the magical world of perfection and political correctness, your right. but in this same world a nurse should never get flustered at such commits. instead realize that sex was not the intent of his words. of course this commit would be something you could get a talk to about. but i live in the real world and know not to take things personaly or literally. i thought all nurses learned this. the commit i think helps the guy that said it more than anything. it also might help break the tension with the entire team or even alert others of the trouble. by helping himself stay "loose" he in effect helps the team. how would reporting it help the team effort?

If you honestly think he was trying to warn us that we might have a difficult intubation, he could have said "lets prepare a rescue airway (LMA,Combitube,COPA etc...) in case he cant get it in next time. If you want to inform the staff of an impending problem just speak in clear medical terms that we all can understand.

did not say that. just that it could be a catalyst for others to jump in. dont take it so literally.

In terms of following simple guidelines, we pray that you do. Please read the latest issue of CC Magazine and the article by Max Harry Weil MD a noted scholar and researcher with hundreds of articles. His biggest problem is that few people really follow the "simple guidelines. If we could follow the simple guidelines that would be a great start. There is lots of room for improvement. We do like and encourage critical thinking. Yes, of course. No cookie cutter medicine, but the guidelines are there for a reason.

Good luck and control the tongue

yeah but still following those guidelines has nothing to do with this commit made. you bring another point up, why should i be thinking more of how to and what to say so i dont affend you a co-worker rather than focussing on those very guidelines. perhaps this is one reason many are not simply following them, because they are worried more about the people blasting them for what they say intent of focussing on what their actions are. reporting a little thing like this is actually going to have a negitive effect on patient care and cut off communications between the staff. if i was to work with someone that might get mad and report me for something like this i will be less likely to jump in and help when they might need it, out of fear of getting into trouble. i think i would end up thinking of what not to say so i stay out of trouble rather than what can and needs to be done. reporting this would only hinder future comunications between those involved. not the best thing for that patient or future patients IMO. if this commit made the person that said it stay calm and focussed on what he was doing then so be it. i would rather he say the commit and perform his job than get fustrated. if he feels he can not release stress in a simple quick way and lets it build up inside, dont want that repressed one working on me, give me the crude guy that stays focussed and relaexed enough to think on his feet.

[Nemhain]

Inappropriate? Yes, but I don't think so much so that the person should get punished (to clarify the OP didn't state if any action was taken against the nurse who made the comment). Would I have laughed? Yes I think many times hospital humor is right on the edge of being inappropriate. We do have a unique sense of humor and I never get too worked up about it. I do speak up in I think someone is being cruel or highly insensitive and regarding the example given I don't think in was extremely inappropriate given some of the other things I've heard doctor's/nurses say. I do believe, however, that cracking a joke in a tense moment is okay to cut the tension; I would just like it to be made about the situation and not the patient.

[rcpals]

Hi All,

This is a cool thread. First let me say I am a totally open to all opinion's. I don't necessarily agree but thats cool. I have laughed at many,many things in code blues. I am not against a little levity in just about any situation. To me it did seem like a sexual inuendo, not a warning of a impending diffucult airway. I may be wrong. Lets not debate over the intention of the statement.

If it was sexual in nature it should just stay out of the ER or any workplace. Period. This is a very simple concept. We are just human, but should at least try to control our tongues.

It just seems logical that sexual referenced jokes at the patients expense is just plain wrong.

I agree with Nemhain post. "I never get too worked up about it. I do speak up in I think someone is being cruel or highly insensitive and regarding the example given I don't think in was extremely inappropriate given some of the other things I've heard doctor's/nurses say. I do believe, however, that cracking a joke in a tense moment is okay to cut the tension; I would just like it to be made about the situation and not the patient."

Is it really appropriate. Who knows. I always bring it to a personal level. Would you want your mother or father or baby resuscitated in that way? Is this the professionalism we are so desperately looking for?

What is the difference if the family is there or not. Do we run stop lights if the cops arent there? Can we act appropriate if even if someone isnt watching us?

What if your 21 yo daughter, new grad RN is working next to some guy who loves to say these things. Would you be ok with that?

What do we teach our daughters and sons to say and do if someone is offending them.

Augustus said ~~ wrong is wrong even if everyone is doing it.

I look at it this way. I wouldnt have confronted this guy or even said one thing to him. I do not sweat the small stuff. I have MD,RN,RT,EMT friends that occasionally do those things in codes. I have have heard references to large apendages whether male or female. I have seen rns lifting up the pt gown to ogle at a large male appendage. There has to be some line we at least try not to cross. We are not calling for people to be written up for some levity. We know some people will be upset and offended. Why take a chance. Is it that important?

I dont think this person should have been written up, or fired or whatever. I never called for him to be written up. If it did bother someone that person should have told him face to face.

It is simply not ethical to make sexually referenced jokes at a patients expense.

It sure seems like a easy thing to do. I have never had the need to communicate that way but many people do. So it is a personal choice. Do you encourage this or try and discourge this. Its your choice. Don't complain if your written up. Would I write you up? No. Would I have said something to you, No. But someone else might.

"why should i be thinking more of how to and what to say so i dont affend you a co-worker rather than focussing on those very guidelines. perhaps this is one reason many are not simply following them, because they are worried more about the people blasting them for what they say intent of focussing on what their actions are. reporting a little thing like this is actually going to have a negitive effect on patient care and cut off communications between the staff. if i was to work with someone that might get mad and report me for something like this i will be less likely to jump in and help when they might need it, out of fear of getting into trouble."

Is potty talk so pervasive that we have a diffucult time speaking non-slang english in a emergency? Most I know do not have that problem. We just say "hey this is a difficult airway" Not. "This guy has a big tongue and Im sure he was very popular with the ladies" Maybe thats just me being politically correct. You be the judge.

Most people dont have to think about saying the wrong thing. Are you saying if we talk potty talk our patient care will be better?

I do enjoy your passion and I hope you take this in a good natured debate. No hard feelings OK...

I wouldnt freak out about this guy. I Just think some MDs/RNs/RTs push the line.

I promise you neither Max Harry Weil MD, nor I think the above is the reason people follow don't follow the guidelines. It is a great article by the way.

Good Luck.

[wildcherry]

Male or female...the comment was funny and I think humor should be expected during codes. Actually, I'd be a little afraid if the comment was made by a female. :roll

[carolinapooh, BSN, RN]

I am not a nurse yet, but I don't believe that person's comment about the man's tongue was inappropriate. I believe we live in a society that expects far too much self-censorship, which isn't healthy.

My dad has endured over 20 major surgeries during his lifetime, several of them emergencies. He has a staph infection that has almost killed him twice, for which he takes antibiotics every day to keep it suppressed. Luckily, he encouraged in his children a sense of humor that often veers into the irreverent, and this has sustained us through all of these ordeals.

If any medical personnel overheard some of the comments my siblings and I have made in jest as we cried and prayed in the emergency room or ICU for our father, they would think we were very cruel people, indeed. Luckily, Dad would never think that and would instead be grateful that even in the depths of stress and despair, we were able to find something to wisecrack about.

I imagine it's the same for medical personnel.

Same here. My dad was a hospital corpsman in the Navy for nearly 30 years, and I grew up with that black humor.

We've ripped a few good ones since Daddy passed away (and in the hospital at the time, all at his expense) - all of which he would greatly approve, and would have probably said himself if he'd been here!

My husband is British, and their sense of humor is COMPLETELY different from ours (they do not take themselves as seriously as we do). It takes some getting used to! Many times he's told me jokes that I know when I met him eight years ago I would have NEVER laughed at, but I've learned to accept the differences....and sometimes I'll say, "That's terrible", and I'll be trying so hard not to laugh. Sounds as though he's "training" me well....

[carolinapooh, BSN, RN]

Male or female...the comment was funny and I think humor should be expected during codes. Actually, I'd be a little afraid if the comment was made by a female. :roll

That would definitely tell me more than I needed to know.

[mebeafrn]

IMO tension relief is OK as long as only nsg. hears it. Humor puts things in a more "manageable" light.