"My doctor told me..."

TriciaJ, RN · Oct 28, 2018

"I have hypoglycemia so my doctor told me to eat lots of sugar." My favourite one was relayed to me via a third party. A woman being treated for cancer was asked why she was still smoking. Her response: the cancer wasn't in her lungs and stress and cancer don't mix so her doctor gave her the go-ahead to keep smoking. Uh, yeah, sure.

MunoRN, RN · Oct 28, 2018

I don't think I'm making it clear. He was using straight bleach, not diluted in any way, right out of the bottle onto his wound not the actual Dakin's solution.

Of our Docs that still prescribe 'Dakins', all but one prescribes it as undiluted bleach, since commercially available bleach has anywhere between 1% and 5% sodium hypochlorite (amazingly there is no requirement that bleach manufacturers get any more specific than that in terms of sodium hypochlorite concentration).

DowntheRiver · Oct 28, 2018

My son had a port, and you can bet we used it only for chemo. The first two got infected and had to be removed. They aren't cheap, even with insurance. I try to avoid using anyone's chemo port for simple blood draws and such, for this reason. Even at the cancer center, the staff used a peripheral site for blood draws, instead of the port.

I am an Oncology nurse and a cancer survivor who had a port ten years ago. My port was used for anything and everything with no issue.

The ports we put in at our cancer center have no issue. It is the ports we see that are put in outside of our cancer center that have issues. Typically it is those patients who tell us the doctor told them not to use it. Where I work we use them for everything, including PET scans and blood draws. Where I work we are part of the infusion staff so we just access and leave accessed for infusion after doctor's appointments. Our patients also typically have limb restrictions as we see a lot of breast and cutaneous patients. No point in sticking patients multiple times when they have a perfectly good port to use.

amoLucia · Oct 29, 2018

"My Doctor told me I can have a donut a day. And if I miss a day, I can have 2 the next day".

So said my aunt, a Type 2 diabetic on BID large dose insulin injections.

"I take so many meds. I take one for my hypertension and one for my high BP". So said my aunt again.

me: "Aunt, hypertension and high BP are the same illness".

"Oh no. My Doctor specifically told me one for hypertension and one for high BP".

There was NO chance of reasoning with her.

jaderook01, BSN, RN · Oct 29, 2018

I've have a weird week this week with some weird information that patients have said their doctors told them. It cracks me up because they either have the worst doctors I've ever known or they completely misunderstood what their doctor told them.
Example: Pt with a large abscess that's open and swelling. Abscesses don't usually swell more once open, so I was curious.
ME: How have you been treating it?
Pt: My doctor told me to clean with dawn dish soap and bleach. (He cut it open with a bleached knife and washed it with more bleach and dish soap)
What the doctor probably said: Clean with soap and water.
(Hey, bleach cleans stuff, right?)
another patient: Brought in five antibiotics from various dates some different kinds.
Me: Do you take all of these?
Pt: no, I just take them when I need them.
Me: Tell me what that means because that's actually dangerous.
Pt: Since I get lots of infections (from IV drugs) my doctor told me to take them whenever I feel an abscess coming on and stop as soon it goes away. (Queue my almost having an aneurysm.)
Me: Educated pt on the dangers and pointed out that each bottle says to make to take all medications and they would have received the same teaching from the pharmacy.
Pt: I don't think you're right. How do they even know how long to take an antibiotic? They're just guessing (I'm seeing stars in front of my eyes).
Me: tried to explain how they know how long to take antibiotics.
Pt: I think my doctor knows more than you since he's a DOCTOR and you're not, so I'll do what he says.
What the doctor probably: Do I even need to say it?
Please chime in with interesting "my doctor told me (input misinformation here)" I need a laugh before I go insane.

Oh, my word. Having been present when doctors talk to patients, I'm going with they misunderstood what the doctor told them.

amoLucia · Oct 29, 2018

To be realistic, there is the possibility that REAL miscommunication may have occurred. Many practitioners do speak with heavy accents, and while their English is correct and their information is also correct, pt age, hearing and ethnicity may be a real obstacle to good communication.

Note: That was NOT the problem with my aunt.

allnurses Guide · Oct 29, 2018

I used my port for everything, including the week in hospital with flu/cellulitis. Double maste, no way was I letting anybody stick me when I didn't have to. I did however have to teach some of the nurses how to draw my labs with sterile procedure (some were former students of mine anyway :) ) since I wasn't on an oncology floor.

Hoosier_RN, MSN · Oct 29, 2018

I have a several patients tell me that their doctor told them that their port can only be used for chemo. By this they mean we can't take labs from it (even though we verify a return for chemo, etc.), use it to give blood, fluids, or even scans (contrast).

not sure if this is the same, but in dialysis, we tell pt not to let anyone use their cath (or access site) other than dialysis staff. If a cath gets clotted off, they may lose the only access that they have, regardless of how much someone knows how to maintain it. With a regular access, much damage and or bleeding can occur. And still, lab techs and others try to use these all the time. Please don't. I'm not sure if chemo port is the same ballpark though

allnurses Guide · Oct 29, 2018

Some patients who need MRSA skin decontamination cannot afford chlorhexidine wipes and shampoo. One common solution is 3/4 cup of household bleach/every 5 gallons of water for bathing.
Also, our all-familiar Peridex is 0.12% chlorhexidine. There is also OTC mouth wash made of 0.1% chlorhexidine for people who cannot use Listerine for whatever reason.
Re. the subject - I had enough of it to write a book. From glucose 800, sodium 110/comatose one who "drank a lot of fluids, just as doctor told!" (8 x 64 oz. of Coke within couple hours in a hot humid day). To a guy who was apparently told by two physicians, one of them was naturopath, that garlic and salty water were somehow good for healing infected wounds. After that, he was treating himself for a good few weeks by pasting his gangrenous leg with mix of garlic and salt twice a day. The following surgery was a grisly one, but, as surgeon put it, the meat was already pickled and brined.
I wonder what could be legal implications of correct and appropriate teaching "understood" wrongly. Like another smart one I once cared for who "figured out" that if he was told he could have "something I could see through" (meaning clear liquids) included doughnuts. That one was caught just in time before making it to operation table, but what if that was missed and the guy aspirated and suffered consequences?

Assessment of the patient for literacy is pretty key and then doing teach-back for the most important points. We focus a lot on patient literacy, which can mean unable to read or doesn't read very well OR it can refer to difficulties in comprehension or executive thought processes.

DowntheRiver · Oct 29, 2018

not sure if this is the same, but in dialysis, we tell pt not to let anyone use their cath (or access site) other than dialysis staff. If a cath gets clotted off, they may lose the only access that they have, regardless of how much someone knows how to maintain it. With a regular access, much damage and or bleeding can occur. And still, lab techs and others try to use these all the time. Please don't. I'm not sure if chemo port is the same ballpark though

I should clarify -

These patients are saying not to get blood from their port or put anything other than chemo in their port at a big name cancer center. Only nurses access ports and with sterile technique. We are an extension of Infusion, where the same qualified nurse would access the port.

Now, I have a lot of nurses tell me when they go to a hospital no one will access their port as no one is capable of doing so, which is fine. I don't want someone accessing a central line that they are not used to for patient safety reasons.

No, these patients won't even let an Oncology nurse working at a big name cancer center get blood from the port.

But, I understand what you're saying with dialysis caths. I wouldn't want to touch one of those - not my area!

morte, LPN, LVN · Oct 30, 2018

Assessment of the patient for literacy is pretty key and then doing teach-back for the most important points. We focus a lot on patient literacy, which can mean unable to read or doesn't read very well OR it can refer to difficulties in comprehension or executive thought processes.

need to make sure they can here you, first.

KelRN215, BSN, RN · Nov 3, 2018

"I have hypoglycemia so my doctor told me to eat lots of sugar." My favourite one was relayed to me via a third party. A woman being treated for cancer was asked why she was still smoking. Her response: the cancer wasn't in her lungs and stress and cancer don't mix so her doctor gave her the go-ahead to keep smoking. Uh, yeah, sure.

Someone I know told me once that her doctor told her it was fine to smoke during pregnancy. I told her that didn't happen.