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.

[TheCommuter, BSN, RN]

do I have a right to refuse to hear dirty language(which I thought I did)?

As others have mentioned, consider the source of the swearing and profanity. If a patient's cognition is temporarily altered by anesthesia, I would not make any demands to stop swearing.

[benegesserit]

OP, I guess you're lucky I wasn't your patient. I've had numerous surgeries & after all but one, I came out of anesthesia swinging my fists. The first time it happened I caught one nurse in the jaw. After that, there was a large note on my chart to warn everyone.

This is my husband, too. He now warns them to keep him in restraints until he's fully alert. We've been together 15 years, and I've never seen him be violent towards anyone.

I feel that the question represents a dangerous lack of understanding about the effects of anesthesia - I can easily see this turning into a situation where the patient becomes violent. While I certainly wouldn't begrudge anyone in severe pain the right to swear about it, it goes beyond that. A person coming out of anesthesia is not rational. Making unnecessary demands of them, especially for your own comfort, is not appropriate.

[Spidey's mom, ADN, BSN, RN]

While it's "ok" to ask, you won't get what you want.

Why does it bother you so much?

Personally, it was the way I was raised. I've mentioned before that my Grannie had a sign in her kitchen that said "Profanity is ignorance made audible". :)

The older I've gotten, the more easy it is for me to swear but it doesn't pepper my language and the "F" word is still very very hard to say, for me. Even during labor.

As a nurse, I let this stuff go unless as others have mentioned, it was directed at staff in a threatening way.

Also, the OP has written a very nice subsequent post thanking everyone for their opinions and has decided that she was wrong to ask the patient to stop swearing. Sometimes if we don't read the entire thread, we miss important pieces of the conversation.

As an aside, I've always thought it interesting that a random definition to a random series of letters ends up being a cuss word. What if the "F" word we use had instead been the word for love and love had been the "F" word? Can you just imagine, being in terrible pain, and saying "LOVE, LOVE, LOVE, LOVE, LOVE".

Or maybe just "phooey".

[benegesserit]

Also the OP has written a very nice subsequent post thanking everyone for their opinions and has decided that she was wrong to ask the patient to stop swearing. Sometimes if we don't read the entire thread, we miss important pieces of the conversation. [/quote']

I did read this post, and agree that it was very nice and well-considered.

However, it included no acknowledgement that anesthesia can make people literally not in control of themselves in a way that goes beyond attempting to manage severe pain, and I feel that this is something absolutely crucial for a PACU nurse to understand. Hence my post.

(I'm a non-swearer, raised by non-swearers. To me, swearing even in someone's general direction is beyond the pale. My husband is many-generation Navy, and, well, swears like a sailor. It's a frequent argument. So I'm sympathetic. But it's simply irrelevant to the PACU setting.)

[ktwlpn, LPN]

Anesthesia,man,dig it.Sometimes I come out of it bawling like a baby.And I don't mean a cute baby.It's that ugly crying-my face gets all oogly and quivering and looks like it's trying to crawl away from my skull and I sob and sob and just have to let it out.The harder I try to control it the worse it gets.Didn't happen the last time,I was the life of the party.

[James W.]

Did it occur to the OP - to assess her patient for the reason why he was so distressed?

Maybe it was a sign of something wrong, that needed further investigation?

Having said that, I can recall recovering from an unpleasant burst appendix operation,

& although the pain was such - that I really felt that I would rather have died - than

suffer it - yet I was culturally conditioned to 'take it like a man', & not complain , or

ask for pain relief, so only my involuntary tachy/rapid shallow breathing - actually

gave my agony away.

Seems kinda silly now,

& maybe even a bit sorry for being openly critical of men (from non-staunch cultures),

- crying for their mother..

[lavenderskies, BSN]

I think his swearing was in context and a coping mechanism. Therefore I personally wouldn't have asked him to stop, I'd just focus on getting the pain under control. Now if he'd of been swearing at you or about you.....different story.

[meanmaryjean, DNP, RN]

"Or do I have a right to refuse to hear dirty language(which I thought I did)?

Please let me know what you think."

OP: What makes you think you have this 'right'? How was this 'right' granted to you? I find the interaction you described, as you described it, really high-and- mighty on your part, and really lacking in compassion. Do you make these kinds of demands on random strangers when you're out in public, or just the recently operated upon, vulnerable souls under your 'care'?

[James W.]

Especially forensics. The staff and patients curse non-stop. It can be shocking to outsiders.

Indeed..

While communicating honestly in synch with the patient idiom

is a realistic approach in such settings, nurses do need IMO,

to know how to delineate between casual use of 'taboo' words,

& specific usages which are in fact, demeaning/insults/threats.

Also, if the issue comes up as a disciplinary matter,

don't count on the Nurses Board accepting

that is acceptable for nurses to use 'taboo' words,

at work, under any circumstances, let alone habitually.

Actually, they'll likely perceive it as a violation of

professional propriety, regardless of any 'real world'

situation-based 'cultural norms' extenuation.

[applesxoranges, BSN, RN]

I'll say there are other kids in the rooms so please don't swear. If there are really young children, I will be very stern with them. Otherwise, I don't care.

[chacha82, ADN, BSN]

The only time I have heard of someone asking a pt to stop swearing was a doc to a pt as small children and families were nearby. Also it was swearing directly at the doc, which I am sure made him mad.

[Ellie G]

I don't curse but it doesn't bother me if a patient does. If they are cursing at me, I might take issue and gently ask them to stop. Also if they are bothering other patients then we might have to have a talk. In PACU when people are emerging from anesthesia and in pain, a few flying curse words are par for the course.