Is it okay for RN to ask recovery patients not to swear?

[SweetieBeeSandy]

Hi, I am an RN working in PACU. The other day, I received a male patient from OR, and as soon as he woke up from anesthesia he started complaining excruciating pain. Of course that's not unusual. But this man was constantly swearing. "Oh, G--D----- it hurts. Oh F--- it, Oh it F---ing hurts". While I was medicating him as much as possible he kept swearing so much to the point where I had to ask him to stop. "I understand you're in so much pain and I am doing everything I can for you to lower the pain. But it's very difficult to be here and hear you swear. I do not want to hear any more of swearing words". He heard me, and he tried so hard to hold it. "Oh f,fff, it hurts, ohhh fff... so painful!". After an hour medication kicked in and the pain became much better, and he started smiling. And before sending him to a unit, I said I appreciated that he stopped swearing.

Now I wonder, was what I did, asking a patient to stop swearing reasonable? Or is it unprofessional? I always thought it's okay for patients to cry and scream if they had to, because they're in so much pain, and I don't tell them not to. And while I do not use swearing words myself, I know there are people who use them on a regular basis. Then, he should've been allowed to say what he normally say considering it was not personal? Or do I have a right to refuse to hear dirty language(which I thought I did)?

Please let me know what you think.

[NOADLS]

Swearing serves a way of coping through pain.

If you can't handle a patient swearing in a completely acceptable context, I'd be worried about what you are able to handle. I would even go as far to argue that by asking a patient to stop swearing in this situation, you are showing a lack of empathy.

[Fiona59]

Swearing serves a way of coping through pain.

If you can't handle a patient swearing in a completely acceptable context, I'd be worried about what you are able to handle. I would even go as far to argue that by asking a patient to stop swearing in this situation, you are showing a lack of empathy.

erm, but what if they've interrupted your game of Candy Crush

[dudette10, MSN, RN]

Depending on the anesthesia used and the patients reaction to it, they may not have a lot of control. My son had two procedures within two years of each other, both under general anesthesia. After the first one, he was downright chipper., "Hi Mom! That wasn't so bad!" After the second one, he was a total monster, unable to follow directions for more than a minute AND swearing. He said, "I'm really angry...I don't know why!"

It it may have been a partial reaction to the drugs.

[OlivetheRN, ADN, BSN, RN]

Depending on the anesthesia used and the patients reaction to it, they may not have a lot of control. My son had two procedures within two years of each other, both under general anesthesia. After the first one, he was downright chipper., "Hi Mom! That wasn't so bad!" After the second one, he was a total monster, unable to follow directions for more than a minute AND swearing. He said, "I'm really angry...I don't know why!"

It it may have been a partial reaction to the drugs.

Someone who I know very well and who is normally very mild mannered came through our recovery room and when he woke up he behaved very similarly. Once he had been in the recovery room a little while longer and he came around some more, he was more himself, but still wasn't the guy that I know when he doesn't have anesthesia floating around his system. Anesthesia can do some not fun things to people.

OP, while his swearing may have just been his norm, it could have been the anesthesia, the pain, or a combination of all three. Regardless, as others have said, swearing can often be a (sometimes good) way for patients to deal with pain, as long as it's not directed towards you and isn't disruptive to other patients. I know when I had my last surgery I was definitely dropping a lot of F bombs, albeit quietly and mostly to myself (although, who knows what happened before I fully came around, and my co-workers just tell me I was a perfect angel…they also tell me that I didn't snore…I suspect I work with some slightly dishonest people ).

[canigraduate]

If it bothers you, sure, you can ask the patient to stop. No biggie.

If the patient isn't completely lucid and can't stop, I'm sure you don't hold that against them.

There are a lot of cultural pockets around the US where swearing is unacceptable behavior. It's like masturbating in front of someone, simply NOT DONE. (Bible belt, particularly.)

There are also a lot of cultural pockets where it is OK to let fly. Detroit, NY city, etc., it's part of the vocabulary. If you get one of these patients, it's kind of fun and awe-inspiring to hear them at their finest! LOL!

[klone, MSN, RN]

I remember using the f-bomb liberally during transition in labor (unmedicated). If my nurse had asked me not to swear, I may have hauled off and smacked her.

[Rose_Queen, BSN, MSN, RN]

I've seen many a patient in the PACU unleash some language only to apologize a few seconds later... and repeat the whole scenario a few minutes later. Not their norm, but anesthesia does affect some people's inhibitions. If it's not directed at you, let it slide. We do the same things with surgeons (who make a conscious decision) who curse at situations during surgery (but never when at a specific person). It's a way to release some of the stress over the situation, or in the case of the patient, it has been proven that swearing lessens the feeling of pain.

[quazar]

I work in L&D, so swearing is like a second language to me.

[TriciaJ, RN]

Meh, if you can't beat 'em, join 'em.

"Well, the g-d Fentanyl didn't do s***, let's try some ******* Dilaudid."

I love it.

[Hollybobs]

Meh, if you can't beat 'em, join 'em.

"Well, the g-d Fentanyl didn't do s***, let's try some ******* Dilaudid."

After an hour the pain relief kicked in?? I think better post-op pain control for your PACU patients would reduce the swearing you find so unpleasant.

It isn't really okay to ask him, no, not for the sole purposes of addressing your own comfort levels as you've reported. He wasn't swearing at you. Unless it was offending another patient or there was a child nearby, it's a small sacrifice to make. And interestingly, it seems it might help cope with pain as PP's have said.

Also, bear in mind the meds given peri-op can lower inhibitions, decrease ability to make decisions, temporarily change personalities and also cause loss of memory. As a PACU nurse you must have experienced patients telling you intimate details of their lives that perhaps they wouldn't usually? Similar sort of thing.

[Tenebrae, BSN, RN]

I had to have an incision and drainage of an axillary abscess 2 years ago. The anaethetist suggested using ketamine as conscious sedation as it would have meant I didn't need to be intubated during surgery and the recovery time would be easier.

I woke up from surgery thinking I was an 80 year old Mexican woman (I was 37 and european) on my way to market and had been stopped by red coat soldiers on my way to market. I could have sworn I was speaking spanish, the people around me were speaking spanish, i could see the buildings and the market place. Now if a pacu nurse had of told me to stop swearing, i think my brain would have simply interpreted it as another person trying to stop me from getting to the market.

My point, I feel you were being over sensitive. Now if the patient was saying "nurse you are a blanketity, blank blank, blanks" you would be well within your rights to ask him to stop swearing. However people often wake up in pain. They are also dealing with the impact of a general anaesthetic if it was about you, then no, not ok. If you were concerned that his swearing might be upsetting to the patients around him, fair call

[smartassmommy]

Had a L &D nurse tell me she didn't like my language when I was in labour. No drugs, fully dilated, and had been pushing and getting nowhere.

She then went to coffee.

Bloody awesome experience

Really, childbirth with no drugs is the most appropriate time to curse. My nurses in L&D didn't like my language either.