Need advice for overcoming or manageing gag reflex.

Nurses General Nursing

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My wife will be graduating in December and wants to work in critical care/ICU. However, she has a very sensitive "gag" reflex that is activated primarily by smell (meaning looking at gross stuff doesn't really bother her, but combined with or by themselves noxious smells tend to make her gag). She fears that she will gag in front of a patient and be disiplined, and or fired (she said that she has just been lucky to this point in nursing school). Thus, far I have only been able to offer Vic's Vapor rub as a way of dealing with her problem. This helps, but it is difficult to apply in a time efficient manner, and you don't always know when a "gag" incident will occur (and it is effective for only a relatively short period of time). She says this occurs much more often in the morning when her sinuses/allergies are more active. Do you have any other advice? I have thought of behaviorally, based counseling as a long term solution. Are there any safe drugs that lower the sense of smell or lower the gag reflex (in the same way that certain medications help with motion sickness)? Are there any other "tricks of the trade" that might help keep her from gagging or at least from getting in trouble if she does? Is there anything similiar (but longer acting, and or more powerful) than Vic's which might be topically applied? I once suggested having her olefactory nerve clipped, but that seemed an unpopular suggestion (although I would like such a procedure myself to help with weight loss, since no smell= no taste which might equal weight loss).

Specializes in Oncology/Haemetology/HIV.

Roland,

You have a habit of coming on line to ask questions for the benefit of your wife. You have also expressed in previous threads that she does not like you spending time online.

My suggestion is for you to let her come here and ask the question instead of relaying this information.

For two reasons:

First you misinterpreted one poster's "dab of perfume under the nose" as putting perfume on the roof of the mouth. That isn't good. Therefore you may also misinterpret our posts in ways that might harm her, or not help with the gagging problem.

Second, when your SO has indicated a dislike in you spending alot of time on the Internet, and you use the excuse, " Oh, I'm doing it to help you, honey"...it proceeds to annoy them more. It is also manipulative behavior and generally leads to major relationship problems. She is a grownup and can ask the question of us herself, and we can discuss it more appropriately with her. That way she can give us her personal input in this matter and we can better tailor a solution for HER needs.

I don't believe anyone can "get inot trouble" or be fired for gagging....Fretting over this is going to make it harder for her to control....When confronted with a really smelly situation she has to concentrate on not THINKING about exactly what she is breathing-some people say to breathe through the open mouth but that makes me gag...yuck-I imagine I can taste it.....anyway-No need to blow this out of proportion-even the most experienced of us have a problem from time to time.....

I'm glad I'm not the only one. I've heard many people suggest this as well and even just the thought of it grosses me out to no end. If I don't want the smell up my nose, I FOR SURE don't want it in my mouth...ewwww...

Roland,

You have a habit of coming on line to ask questions for the benefit of your wife. You have also expressed in previous threads that she does not like you spending time online.

My suggestion is for you to let her come here and ask the question instead of relaying this information.

For two reasons:

First you misinterpreted one poster's "dab of perfume under the nose" as putting perfume on the roof of the mouth. That isn't good. Therefore you may also misinterpret our posts in ways that might harm her, or not help with the gagging problem.

Second, when your SO has indicated a dislike in you spending alot of time on the Internet, and you use the excuse, " Oh, I'm doing it to help you, honey"...it proceeds to annoy them more. It is also manipulative behavior and generally leads to major relationship problems. She is a grownup and can ask the question of us herself, and we can discuss it more appropriately with her. That way she can give us her personal input in this matter and we can better tailor a solution for HER needs.

C. Belle, no offense, but please mind your own business. I apologize for misinterpreting the advice to put the perfume under the nose rather than in the mouth. As for my spending time online you are correct in that she doesn't like me to spend time on this forum primarily because she fears that I will say something that will have ramifications at our nursing schools (imagine that). However, she has learned that I tend to say the same exact things (for the most part) in school. Thus, her fear about posting has been put in some perspective.

Also, have you considered that she doesn't like these forums period. Therefore, if I didn't ask the questions she would have no way from benefitting from any advice offered (some of which may be quite helpful). What if I was Islamic or some other faith that often didn't permit wives to participate in forums such as these (my cousins for instance are Southern Baptists and their wives are all but forbidden to participate in online activities). Would you criticise my religious/ethnic perspective? If not what makes our personal relationship (and the mores, values, and social contracts which guide it) any different?

Furthermore, this is a big enough issue (her fear of gagging) that she came to me last week and said that she may not be able to hack it as an ICU nurse (in fact she was considering something like school nursing where gagging wouldn't be an issue). Since the primary reason that we gave up our mortgage/appraisal business (and six figure income) was to go to nursing school, become ICU nurses and then CRNA's (at which time we should be able to replace that income and add medical benefits, plus some occassional time off to raise our son rather than working seven days a week, which our business didn't offer) this is obviously a big deal to me.

Your concern and opinion are noted, but I've noticed that you've posted in several recent threads of mine with posts that are non-responsive to the subject at hand (and have instead focused on me instead). I would suggest that if you find my posts, to be offensive, banal, insipid or otherwise non rewarding that you simply skip them, or use the "ignore" feature that will remove them from your view entirely.

Totally off-topic, but I can't get past this part...

What if I was Islamic or some other faith that often didn't permit wives to participate in forums such as these (my cousins for instance are Southern Baptists and their wives are all but forbidden to participate in online activities).

What on earth does being Southern Baptist have to do with going online and participating in forums??

You lost me, dude.

Specializes in Oncology/Haemetology/HIV.

The point is, as I originally stated, that we can best assist (and that you can best assist her) by letting her have her voice. I repeat, she is a grownup and needs to deal with us (her future coworkers) if she is to be successful as a nurse. And that is very pertinent to the subject at hand.

As Muslim men forbid their wives access to the Internet, chances are that they probably not let them become nurses, either. Therefore that point is somewhat moot. But if any spouse was to continually come on line, against their spouse's express wishes, asking the same sort of of second hand questions, I would (and have) responded the same way. When a patient's spouse approach me in the hall about issues that concern the patient, I go to include the patient in the discussion, because not to do so would be rude and a violation of their rights, in most cases. That it is rude to your wife (why she would want advice from a source that she does not want you spending time with, is beyond me) and that the best way for you to get her to appreciate these forums is for her to access them herself. And it is her right to do so.

Trying to help your wife through you online is somewhat akin to an MD/nurse trying to assess/diagnose a patient's needs by speaking to the spouse without seeing or even speaking to the patient. It would be malpractice to say the least. There are so many factors that cause gagging, that there are many solutions that can be offered. Tiger Balm/Vick's Vapor Rub/ pre shift antiemetics/ keeping the stomach settled (nibbling on crackers, warm herb tea). But what would probably help is less stress. Worries over business future, and making every thing "perfect", the most important school, best grades etc., things that you keep reinforcing on the BB. Just relaxing and using mental imagery could help immensely, but not if she is continually stressed out from her lover (friend/SO/helpmate/spouse) continually going on about the best grades/best schools/we gave up our business for this. And spending a lot of time seeking advice from a source she dislikes, isn't likely to help her stress level.

The fact that anyone would consider cutting a nerve to impair the sense of smell as an option, is pretty far beyond the pale. Smell is a major diagnostic tool, and to lose it, an impairment to her ability to function as an excellent nurse

And as previously said, she needs to discuss with us, herself, how and whether these will work for her particular needs. An intermediary just impairs communication as already demonstrated.

And I know of no one that ever completely gets over gagging, and I know of no one that has ever been fired for gagging. But then, there are areas of nursing that do not require exposure to large amounts of grossness. But I don't know whether they would fit into the plans that you have for her.

Whatever, Roland..remember there is always an "ignore" feature.

Specializes in NICU.
Furthermore, this is a big enough issue (her fear of gagging) that she came to me last week and said that she may not be able to hack it as an ICU nurse (in fact she was considering something like school nursing where gagging wouldn't be an issue).

Good idea! Because kids NEVER go to the school nurse's office with things like vomiting or diarrhea. :uhoh3:

But the bottom line is that she won't go on this forum. Thus, the only way she will probably be exposed to this information is by me asking it, and then sharing it with her. In addition, she has adjusted to the fact that I am going to participate in these forums because I consider them to be at least as educational as Nursing school itself and that I am a largely anti-social individual who would rather communicate in cyberspace that attend fuctions or events involving real people especially family and friends(in the same way that I have adjusted to the fact that she is going to talk on the phone with her school friends several hours each week about subject matter that drives me insane to even listen to).

In addition, it is not uncommon for Dr's to consult with other physicians over the phone or online over particularly difficult cases, and then to integrate that into the care of their patients. The same could of course be said of attorneys, tax preparers, and in my case real estate appraisers. Consider also how often parents ask other parents for advice on how to potty train their kids or deal with some other difficult aspect of child behavior.

As to cutting cranial nerve I, I'm not claiming it would be a perfect solution. Indeed, I was suggesting that it's greatest contribution might be in the area of weight loss rather than her specific case (although to paraphrase Jesus if "your eye causes you to sin then pluck it out", I would add "if your nose causes you to lose income especially income that your family is counting on and you can make it stop working then do so.") I wonder what the first fellow surgeons and nurses said to the person who first suggested gastric bypass surgery. Something makes me think that they didn't just say "that's a darn fine idea, start cutting people open and removing half their intestines tommorow." However, today it is a clinically accepted procedure for certain situations and people don't see it as terribly strange or abnormal.

I try to approach every issue without emotion, and without reflecting any preconceived biases or conditioning that I might posess on the issue. It is my "working hypothesis" that many ideas, and or courses of action are dismissed not because of their logical merit (or lack there of), but instead because people are shocked, offended, or otherwise uncomfortable with the subject matter. To paraphrase JFK, I seek to ask "why not" where others ask "why". Truthfully, how many of you had even [considered the notion of cutting (although I think it could be done in such as way as to not actually cut the nerve) CN 1 as a possible treatment for weight loss before it was mentioned here?

Furthermore, this is a big enough issue (her fear of gagging) that she came to me last week and said that she may not be able to hack it as an ICU nurse (in fact she was considering something like school nursing where gagging wouldn't be an issue). Since the primary reason that we gave up our mortgage/appraisal business (and six figure income) was to go to nursing school, become ICU nurses and then CRNA's (at which time we should be able to replace that income and add medical benefits, plus some occassional time off to raise our son rather than working seven days a week, which our business didn't offer) this is obviously a big deal to me.

Forgive my snippiness as I am a bit tired at the moment, but

THIS IS THE EXACT REASON WHY IT IS GENERALLY NOT ADVISABLE TO GO INTO NURSING JUST TO BECOME A CRNA!!!!!

Especially if it involves sacrifices such as those you speak of. Nursing is difficult enough when it is pursued as a life-long dream - don't believe me? Check out the student and new grad forums. To enter the field when it is not what you actually want to be doing only compounds that. There is no guarantee of entry into CRNA programs - you've been visiting the CRNA boards long enough to know that many people spend YEARS trying to gain entry, which in and of itself does not guarantee successful completion - imagine spending those years at a job that makes you unhappy (or your wife doing so). If being an ICU nurse does not make her happy - it will be a very long, miserable road for her (that may not end where you two want it to) and the result may not be worth it in the end. Just food for thought and just my opinion, so feel free to ignore it if you desire.

Specializes in LTC, med-surg, critial care.
But the bottom line is that she won't go on this forum. Thus, the only way she will probably be exposed to this information is by me asking it, and then sharing it with her.
If she won't visit this forum there are other ways for her to get the information she needs without your help. She can ask an ICU nurse at her clinical site "So, how do you handle strong odors while at work?" While she's at it she can also inquire if it's possible to get fired for gagging.

Or she can ask her instructors for any tips. After all, they are/were floor nurses and you are paying them to teach her what she needs to know. I believe this falls in that category.

Or she can ask a fellow student. Maybe someone in her class has had a patient with a GI bleed or C-diff. She could ask them how they handled it.

What if I was Islamic or some other faith that often didn't permit wives to participate in forums such as these (my cousins for instance are Southern Baptists and their wives are all but forbidden to participate in online activities).

So what does this have to do with the price of rice in China?

Roland~

I personally think it is nice of you to try and find some way to help your wife, some men are not so nice when it comes to stuff like this. That being said, I have nearly the same issue and have dealt with it for years. some people have very sensitive gag reflexes. sometimes very strong perfume will cause me to want to gag. that is bad. how i deal with it clinicals (we are in a nursing home right now, so poop duty is hourly!!!!) i do vicks in the nose or peppermint oil, very strong gum (think altoids gum), and breathe through the mouth. This seems to work well only had a couple of times where it didn't and them i employ the cough/gag method. Bottom line is I understand the severity of this problem. it is embarassing for yourself and the patient. and if you do it all the time co-workers will think you can't handle things. where my sister works, a couple of nurses with the same problem actually go wrote up because it effected the way they worked. they would just run out the room to bathroom and somebody else would help the patient. so it can be come a serious problem. your co-workers won't like you very much if you are always asking them to do your poop/vomit duty.

that being said now onto the CRNA thing. Do you actually have an interest in Nursing?? what is your interest in being a CRNA? My opinion is if you like nursing then cool but if you find what CRNAs doing interesting and exciting then why stay a nurse go for the gold. but don't do it just because you will make alot of money. My sitiuation is I am a career changer with a husband, mortgage, and car payments. but I want to be a nurse. so I took a private loan, quit my job and started LPN school. why? because it is only a year program, so then i can go back to work while I do the transition program at my school which is a year. do I want to nurse? yes i want to be an RN. do I want to be an LPN? heck no. in may area LPNs make 12 dollars at the hospital. so the only place to make good money is passing meds to 50 patients per shift and nothing else. so i am doing what i need to do to get to my goal. i wouldn't let a couple of women on these boards get you. sometimes people on these boards have a knack for be a little to quick to judge others. that is why i am very selective about the threads I read which is a shame but I really don't care to crabbiness that goes on. sorry for rant but I had some stuff to say!!!!!!!!!!!!!! tell your wife good luck for me.

ps. by the way, I got your idea on islam on southern baptist, very true

Kris

The point was that our relationship and whatever mores/values/ and social contracts that govern it were not relevent to my question which involved ways to manage the gag reflex. I was responding to C.ladyBelle's assertion that this wasn't a question that I should be asking (in other words that my wife should instead), and that I shouldn't even be posting (because my wife was averse to the idea). My point was even if those things were true, that they were not relevent in this context. However, if it makes the principals more comfortable I will restate the facts to make myself the key. For the purposes of this question assume that I am the one with the gag reflex problem (and if that's a "flip flop" perhaps it means that I am qualified to run for President).

As for the poster above who indicated that going into nursing for "money" was a bad idea. Please understand that I come from a conservative, libertarian perspective that basically believes that all career choices should be motivated by these concerns. I have defended this perspective at length in the past and will do so again if someone desires me to do so. However, I appreciate that others may not subscribe to this rationale and respect their right to disagree. It's like Ralph Nader or Rush Limbaugh you may disagree with their perspectives, but you shouldn't question the sincerity, and or depth of their convictions.

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