Posted on 02/15/2007 9:37:41 AM PST by 60Gunner
Language is the capital that drives the economy of human communication. Each social or professional culture presides over its own unique lexicon. The observer will also note further subdivisions related to slang or specific specialty.
Nurses and physicians often use abbreviated terms among ourselves. We do this for two reasons:
1: It saves time; 2: The other person knows what we are saying (as long as the speaker is not just making something up in order to sound cool, which happens from time to time).
But I was reminded this week about how easy it is to fall into the terminology rut in front of patients, and about how important it is to communicate clearly and understandably with my patients. It was a simple matter, really, and not life-threatening at all; but the misunderstanding between the patient and her nurse (yours truly) might not have happened had I been more careful, or had I said what I said somewhere else. Furthermore, I would not have become fodder for the comic enjoyment of my fellow nurses.
The patient came in during the "dinner rush" (between 6PM and 11PM) complaining of bilateral lower abdominal pain. She was well within childbearing age. She was also suffering from a self-care deficit which was related to her lifestyle choices. She had a poor grasp of basic concepts related to her health and hygeine (namely, bathing). Her ability to communicate her chief complaint and her history was poor. Her education level was poor.
The standard practice related to any woman of childbearing age who presents in the ER with a complaint of lower abdominal pain involves ruling out female disorders such as ovarian cysts, pelvic inflammatory disorders, and so on by means of a pelvic examination. (We also perform other tests and draw blood to rule out other possible differential diagnoses.) In my ER, we have many beds available than are designed to facilitate pelvic exams. Unfortunately, my patient was not on one of them. I finished my nursing assessment of the patient and I called an ER Tech over. Then I spoke the words that set the scene about which I now write.
I told the tech, "The patient needs a pelvic stretcher."
In front of the patient.
The patient's lack of understanding related to my terminology was evidenced by her sitting straight up in bed and bellowing, "THE H*** I DO! YOU AIN'T GONNA STRETCH MY PELVIS!
The following silence was oppressive. I heard a snicker from the nurse's station.
I turned to the patient and calmly explained to her what a pelvic stretcher was. She straightened her blankets, tossed her hair, and said, "Well, alright then."
I had a very hard time summoning the courage to exit the patient's room and walk red-faced to the nurse's desk, where I was greeted by hoots of laughter.
I don't know if this could have been avoided, but it reminds me that I need to be more careful about what I say in front of my patients. Very humbling, indeed.
ER Nursing Stories Ping.
Another good story though
It could have been worse. [Frantically trying to think of how]...
one certainly doesn't want to her the nurse say things like: "uh oh", "oops!", and "five second rule!"
one certainly doesn't want to her the nurse say things like: "uh oh", "oops!", and "five second rule!"
Old horselaugh, eh?
You made Happy Cows out of them, didn't you?
I believe there is/was a character on "Scrubs" (a doctor) who turns EVERYTHING into a sexual double entendre. If another doctor had requested a "pelvic stretcher" in front of him, he would have gladly volunteered for the job, with a leer.
I didn't volunteer.
As a technical trainer, one of the techniques I use to explain how communications protocols work is to use the example of people in the same room all speaking different languages.
Industrial or professional language such as that used by doctors, lawyers, engineers, etc., all equate to a different language similar to a foreign language. Before the patient leaped to her confusion (I use that word intentionally, here), she should have asked what a "pelvic stretcher" is first. This is the first problem when we don't understand something that someone says - we don't ask "who" or "what" questions to try to understand what was said.
Oh the irony of it all!
Rewriting all those words: She was obese and could have been pregnant.
Hard to really get out of the bad habit, isn't it. I sense a dollop of political correctness contributing to the subject of this thread.
Not from what I've read.
That’s a great story. My education not being so poor and I think my understanding of medicine as a lay person, not too bad…but I think I’d react much the same way she did! What did you say to calm her down?
Charley what are you doing? asked the doc.
Just following your ordrers says Charley.
What orders?
Why, to get a hot mama and be care free of course.
Charley, I said you have a heart murmur and to be CAREFULL.
My own personal experience with medicine runs the other way - be careful of the questions you ask. I recall asking the Doc who did my colonoscopy to show me what she intended to use. That's a question better delayed until after the procedure...
And the old guy who went right from the doc's office to the Cadillac dealership and bought himself the top of line Seville.
When his buddy asked him why, he answered "well, if I'm gonna be impo'tent, I's gonna look impo'tent."
ROTFLMAO
"complaining of bilateral lower abdominal pain. She was well within childbearing age. She was also suffering from a self-care deficit which was related to her lifestyle choices."
One can but guess
crack head with bad bowel gas? (errr, don't go there)
fat, stinky and not so well educated (I refuse to say stupid, ignorant, maybe)with PID
crack head with something 'lost' inside - nasty, but happens
poor woman with bad hygene and a raging infection (eeewwww, don't even go there - wuuf)
Working in the ER brings you into contact with so many different people whose idea of 'clean' and 'hygene' may not match yours.
Lucky you, I now mostly work on PCs/tech support, they don't yell at you, and I haven't been hit in a long time. Try that with a tweeker up for a week and snorting crack....with a dental problem (heh)
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