When Nurses Feel Disgust: What grosses you out? Should this nurse feel guilty?

Dear Nurse Beth Advice Column - The following letter submitted anonymously in search for answers. Join the conversation!

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Dear Nurse Beth,

I've been out of clinical work for many years and in June of this year started doing pediatric home health care-an altogether new area for me. I worked with a 3 year old and enjoyed the work, and need to see a new patient.

I met with an 8 year old girl and her family and I cringed when I saw the patient. It was so difficult to be around her. Her mouth stayed open and she worked her jaw a lot. It was gross. And I feel horrible for feeling this way around this child! It was her mouth being open that got me.

I just need some encouragement and support that it's okay if I see a patient and don't want to work with her. I feel like I "should" be able to see beyond her oral — jaw? Problem. Home health and disabled children are new to me. I've worked with adults in neurotrauma, rehab, addictions, but this was so uncomfortable.

Part of me knows I don't have to work with her, but I've got a guilt complex. And I'm shocked at my own reaction. Thank you for this blog and website!! I graduated from nursing school in 1985!! This is great.

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Specializes in Tele, ICU, Staff Development.

Dear Shocked,

 Welcome to the site ?! There are hundreds of nurses here, from student nurses to new nurses to retired nurses. And we all get grossed out by something.

Sometimes people assume nurses are immune from being grossed out. Not true. If it were true, we'd be robots, not humans. We just know how to professionally mask our reactions, and protect our patients' dignity.

Pet Cringe

There's isn't a nurse out there who's not repulsed by something. We all have our triggers. Usually it's some bodily fluid or foul smell. While I'm that person who gets a certain satisfaction from seeing a pus-filled boil lanced, I'm squeamish about tracheal secretions. 

In addition to physical disgust, there's also moral disgust, such as feeling disgusted by a new mom who shoots heroin, or an obese patient who can't clean himself.

In your case, it's an open mouth and moving jaw that happened to be on an 8 year old girl. It took you by surprise because you haven't had much exposure to this population.

Should you feel guilty?

Do you feel guilty because it was a child that grossed you out? Would you feel as guilty if it were an adult?

Guilt should be reserved for when you've actually done something wrong. How to tell if you've done something wrong- did you do anything you need to apologize for? No, you did not.

Nurses And Feelings Of Disgust

Feelings aren't good or bad, right or wrong. They just are. Feelings of disgust are automatic and visceral. 

Nurses are not supposed to feel disgust. It's taboo. Feelings of disgust in nursing are typically not acknowledged. We don't even use the word "disgusted", we say "grossed out". We're certainly not taught how to cope with the feelings of disgust we'll inevitably experience, although over time, we learn to distance, normalize and to just get on with the task at hand.

You feel shocked (ashamed?) by your feelings of disgust towards an 8 year old girl. Again, it took you by surprise. Don't punish yourself for visceral feelings. Over time and with more exposure, your feelings would have changed.

As it was, you had the option to not work with this client and that's OK.  Patients can sometimes detect when caregivers feel disgust. Another clinician might be more therapeutic in this case. 

Finally, to accept this aspect of yourself, I turn it back to you and ask what you would you tell me if I asked you ? You are probably more forgiving to others than to yourself.

Treat yourself as kindly as you would others.

Best wishes,

Nurse Beth

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