"We're Just Nurses" ..... Grrrrrrr!!!

[S.T.A.C.E.Y, LPN]

"We're Just Nurses, We're only looking at how cute his X-Ray is"

So yesterday I'm doing one of my last clinical shifts in emerg before I graduate (only a few more shifts to go!) and we have this septic baby come in. Lots of stuff was done for the baby, including chest x-rays. So we get the x-rays back, and I take them over to the light-box thing and look at them. In my head I'm trying to figure out what I should be seeing (if anything) fluid? consolidation? pneumonia? My nurse-partner comes over and starts to go through the x-ray with me, and explain what I'm seeing. Another nurse walks over and starts to go ga-ga over how cute his little chest is, and how cute his little teeny-tiny bones are. Mom and Dad hear her talking like this and come over to look at the x-ray too. Fair enough, I'd want to see it too. They ask if we see anything on it, and before me or the nurse I'm with has a chance to say anything, this other nurse replies: "We don't know, We're Just Nurses, We're only looking at how cute his X-Ray is"

I couldn't believe it.

I always try to read the x-rays with the docs, and have them explain to me what they see (or don't see), and have the nurses & docs explain to me what they're looking for......this lady left me speechless. I could feel the fire inside my head start to flame, and the nurse I was with was just as flabbergasted. Its attitudes like this about nursing that really made me second guess my decision when I first started school.

Sorry, I just had to get that off my chest.....How would you react to something like that?

[Jennifer, RN]

It can get complicated. I can interpret a lot of tests, but I did not go to medical school, so I never give my interpretation of test results to pts or anybody else. I love to look at xrays too, and always ask the docs what they show, but that is the extent of it. I never tell a pt, even if the doctor has already told me the diagnosis (unless I have specific instructions from the doctor to tell the pt) what is wrong with them, or what I think may be wrong with them. If a pt asks me about labs or xrays, I explain that I am the nurse and am not allowed to discuss results of xrays or labs, that the doctor would be in shortly to go over results. In your case, I would have probably told the parents that, "oh sorry, we are just looking at the xray to see if we could see anything, but I am really not sure what it shows, the doctor will have to explain results to you." I have seen ER docs get very upset at nurses for telling pts what might be wrong with them.

[morte, LPN, LVN]

indelicately, and inapproprately done; but it isnt within nursing scope of practice to discuss ...... so have a 'line' of your own ready if this happens again...with a little more class!

[tridil2000, MSN, RN]

It can get complicated. I can interpret a lot of tests, but I did not go to medical school, so I never give my interpretation of test results to pts or anybody else. I love to look at xrays too, and always ask the docs what they show, but that is the extent of it. I never tell a pt, even if the doctor has already told me the diagnosis (unless I have specific instructions from the doctor to tell the pt) what is wrong with them, or what I think may be wrong with them. If a pt asks me about labs or xrays, I explain that I am the nurse and am not allowed to discuss results of xrays or labs, that the doctor would be in shortly to go over results. In your case, I would have probably told the parents that, "oh sorry, we are just looking at the xray to see if we could see anything, but I am really not sure what it shows, the doctor will have to explain results to you." I have seen ER docs get very upset at nurses for telling pts what might be wrong with them.

ya, and god forbid we told the patients the results.... then the poor doc would have nothing to bill for:lol2:

[snowfreeze, BSN, RN]

I usually use the line, "there is nothing obvious" but then again I am not a ( ) fill in the blank. When I am looking at test results, x-rays, echo, angiogram, etc and a patient or family member asks me what I see. Keeps me from diagnosing and the patient not as anxious.

[Dinith88]

"We don't know, We're Just Nurses, We're only looking at how cute his X-Ray is" ?

OK. She was an idiot and is perpetuating an unfortunate stereo-type. Thats just the kind of nurse i'd like to take care of me when i come to an emergency room. '...i dont know nothin...i'm just a nurse...but dang stuff is cute...'

Personally, I review every x-ray i can. Yes, nurses usually arent given any formal training in cxr interpretation, (in school)...but after you see half-a-billion of them, you get fairly good at it.

Over the years, I've become fairly confident that i can read *obvious* abnormalities in Chest-films, and many times the more subtle stuff.

Here're 3 tricks that you can use to improve this skill:

1) pull a doc over and ask him. (this is the best way to start)

2) After you get more 'comfortable' with it, look at the film(without a doctor). When you come up with an 'interpretation', go to the formal report and compare notes. At first you may be way off...but you'll get better at it.

3) Repeat #2 as often as possible!!

Before you know it, you'll be able to look at a chest-film and know what it shows before ever hearing it from a doctor or seeing an official report.

-As an aside, (something that surprised me initially) was the ease of interpreting brain ct's (obviously the more subtle stuff isn't...but symptomatic structural brain pathology isn't too hard to see).

AT any rate...the point i'm making is that *some* (should be *most*) nurses can comprehend x-rays...but it's usually a matter of having the desire AND having access to the films. (forget about a nursing school!)

As far as "...but nurses can't diagnose...blah blah.." Consider that we're not allowed to diagnose MI, but we're expected to read/interpret EKG's and how to treat...('...i dont know cuz i'm just a nurse..but all these squiggly lines are sure cute...':angryfire )

[Jokerhill]

I was reviewing an x-ray about a year ago and call the resident to come and take a look at it. I work in the NICU so I see a lot of films and review them all. Well back to the resident I had a baby just for observation after delivery he had some tachypnea , tachycardia, and was acting fussy. So I got an order for a CXR I just thought it would be TTN. But when the X-ray came up to the unit I saw the problem right away and called the resident covering Peds as the baby was not admitted to our unit yet. He was very honest with me and said he could not read X-rays, I told him to come on up as I was sure he could read this one as the CXR just showed a bit of the Humerus and it was a transverse non-union fractured. Gave some pain meds, immobilized the arm and sent the baby back to mom. No problem with lungs or heart here just pain and no need to admit to an ICU. So it pays to look anyone could have seen it no special training needed.

[Jokerhill]

Oh, I forgot to add, WHAT AN ASS, poor nursing at its best. That nurse has yet to find out what nursing is all about and find the joy in it. I am always learning new things and look forward to learning more.

[tridil2000, MSN, RN]

I usually use the line, "there is nothing obvious" but then again I am not a ( ) fill in the blank. When I am looking at test results, x-rays, echo, angiogram, etc and a patient or family member asks me what I see. Keeps me from diagnosing and the patient not as anxious.

"regardless of my interpretation, the physician who ordered the xray is the one who is responsible to tell you the results. i am sure he or she will be in shortly."

[Gromit]

I'm with Morte. Not much class in her line -and it unfortunately perpetuates a pretty lousy stereotype -I dare anyone to be stupid enough to say "nurses are ditzy" or something similar to me. Have a classier line (please!) ready for when you need it.

Personally, I use the one I saw earlier: "A doctor will have to explain the results to you". Sure, maybe I CAN interpret that -but legally (and it would be stupid otherwise) I cannot discuss it with the family etc., I know when I DON'T have a certain level of training.

[fultzymom]

I understood why she did not want to offer the results of the x-ray but I think she could have offered a better explaination than that. It makes us look like a bunch of air heads!!

[nuangel1, BSN, RN]

yes i too like to look at xrays.i can see obvious issues and recognize them.i have dr explain what i see too.but i never tell the pt .its the dr that has the training and the responsibility to dx it and tell the pt.that nurse was an idiot.i would have said the dr will tell you the result he will be in shortly.