Self injury scars on arms and patient questions.

[dirtyhippiegirl]

Just curious as to whether anyone else on here who is also a former self-injurer has ever had to deal with questions from patients about your scars? What do you say?

I work mostly with adults and thus don't feel obligated to shape the truth into something less offensive. "I used to cut myself when I was a teenager" tends to end the conversation fairly quickly. But I wonder whether this explanation will eventually get me into trouble as TMI. I'm really good at smiling and nodding when I have that occasional patient who wants to save my soul upon learning of my past.

I work on a burn unit -- thus wearing long sleeves isn't really an option most of the time?

[jadelpn, LPN, EMT-B]

I would say that if one is a nurse for people who are in various stages of disfigurement due to circumstances beyond their control, then to have conversation about self injury could add distress to an already distressful situation, and change the couse of care for the patient and the relationship between nurse and patient. Meaning that when someone has been burned, they are concerned with a number of things for certain, but they are also concerned with how the scarring and disfigument could/will affect them. To hear about self injury could provoke some pretty significant anger on the part of the patient.

And to the pp re: theraputic robot comment-- Sorry, but I do not choose to share all of my personal horror stories with patients. That is not what either of us are there for. One can certainly say that a psych patient is not alone and can increase their function, but to start sharing details of one's own personal life takes focus off patient and onto nurse. That is not usually where we want to go when taking care of a patient.

There's lots of self-help groups like AA, NA and many, many others where one can go and share personal stuggles and get feedback in return. I just don't think the bedside is one of them.

[Indy, LPN, LVN]

One of the nurses I work with wound up sharing a bit recently with his OD patient and a bonding of sorts ensued... I thought it was really brave of him to show that side and talk about it with someone who seemed to need some kindness. The outcome in the end wasn't good though, and the nurse is now pretty torn up about it. But I was going to point out that he doesn't wear anything to cover his scars. I never asked him, he just started talking about it one night.

[Indy, LPN, LVN]

I would say that if one is a nurse for people who are in various stages of disfigurement due to circumstances beyond their control, then to have conversation about self injury could add distress to an already distressful situation, and change the couse of care for the patient and the relationship between nurse and patient. Meaning that when someone has been burned, they are concerned with a number of things for certain, but they are also concerned with how the scarring and disfigument could/will affect them. To hear about self injury could provoke some pretty significant anger on the part of the patient.

And to the pp re: theraputic robot comment-- Sorry, but I do not choose to share all of my personal horror stories with patients. That is not what either of us are there for. One can certainly say that a psych patient is not alone and can increase their function, but to start sharing details of one's own personal life takes focus off patient and onto nurse. That is not usually where we want to go when taking care of a patient.

There's lots of self-help groups like AA, NA and many, many others where one can go and share personal stuggles and get feedback in return. I just don't think the bedside is one of them.

I am sorry for the misunderstanding. What I meant by that comment is that I felt, in nursing school and afterwards, that the way therapeutic communication is taught, makes me feel like a therapeutic robot. It lacks a human touch.

[OCNRN63, RN]

"What's wrong with your arms?"

"I have scars"

BINGO!

[OCNRN63, RN]

Yay, thanks for the reassurances/suggestions. :)

I don't know what it is but it seems like my patient population doesn't take to the generalized answers -- "Oh, they're old" IS something that I use in most general settings and get away with it but not while I'm nursing. Just leads to more questions.

My left arm is such a pulpy, disfigured mess of scar tissue that some of my burn patients specifically ask me if I've been burnt in the past. I almost feel obligated to explain the truth in that particular situation.

I'm not sure why you can't pleasantly, but firmly, tell them that it's personal. We're nurses. We are not obligated to divulge private matters to patients.

[OCNRN63, RN]

"Are your scars from burns?"

"No, they are not"

Then onto their assessment.....

I like this answer, but the problem is there are a lot of people out there who don't take a hint very well, or they're clueless clods; for them, that answer wouldn't be enough. OP needs to find a polite way to shut them down so she can feel comfortable.

Many years ago, a visitor who was a farmer noticed that I walk with a limp. In front of a bunch of people, he called out "Hey, you're lame!" I just laughed then said, "I guess if I were your horse you'd shoot me." That shut him up fast.

[CarryThatWeight, BSN]

I like this answer, but the problem is there are a lot of people out there who don't take a hint very well, or they're clueless clods; for them, that answer wouldn't be enough. OP needs to find a polite way to shut them down so she can feel comfortable.

Many years ago, a visitor who was a farmer noticed that I walk with a limp. In front of a bunch of people, he called out "Hey, you're lame!" I just laughed then said, "I guess if I were your horse you'd shoot me." That shut him up fast.

Oh my goodness, that's horrible! I'm so sorry someone said that to you. It never ceases to amaze me how insensitive and rude people can be. To the OP, there are definitely patients that simply don't take hints. It is up to you how much you reveal, but if you want to put that boundary down and not discuss it, why not say something like, "They are old scars and I really don't discuss it." That closes the door on any further questions. There is definitely still a stigma with self harm and psych issues, and quite frankly, your past is no one's business.

[Ruas61, BSN, RN]

Is there a professional you ave had counseling from that you could ask or maybe a support group?

[traumaRUs, MSN, APRN]

I only have vision in one eye and to many people its quite visible. However, my job has nothing to do with my monocular vision. I choose not to answer questions at all - I just change the subject.

At work, the care is not about ME. If folks are persistent, then I redirect them with a "lets focus on YOU" and my pts are more than willing to talk about themselves.

[SuzieeQ]

I would simply tell them that "it is personal" or maybe "it's a very long story"... Hopefully they take the hint and do not probe any more.

[canned_bread]

I have the same problem, and questions from the general public have prepared me for it all. I just say "I was sad as a teenager and took it out on myself". If they probe further I say "it was the in the past and makes me feel uncomfortable to talk about it as I regret it now."

I do not wish to shock people or make them feel uncomfortable, and most people get the gist pretty quickly.

For me, I think it has limited my job opportunities as working on a ward such as a teenage mental health ward could lead to some awkward questions. So that is something you may want to think about. Some teens, especially ones with personality disorder, may view those things as "cool" or a competition.

You do have the option, legally, to wear long sleeves for religious or cultural reasons. This may be an option you may wish to take if you state to your employer it is for those reasons.

[brittykbritt]

I got attacked by a bear

I saved an infant from a rabid pit bull

During my last job at the butcher, my arm was caught in the meat grinder

Nicer ways to say its none of your business