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.
I'm not saying a word
Thanks for translating that. I wondered what was being glossed over.
Actually, she was rather poorly-nourished secondary to drug and alcohol dependency.
I sense a dollop of political correctness contributing to the subject of this thread.
Not really. The patient's reaction was certainly beyond what I would have expected, but given her history of poly-substance abuse, it is not all that surprising. It just so happened that a completely innocuous phrase was taken to mean something completely different by the patient. That's probably more the patient's fault than mine in this case, but it underscores the necessity of carefully explaining what we plan to do before doing it, and then affirming the patient's understanding.
Nothing PC about that. That's just Common-Sense Patient Care 101.
I simply explained in these words: "I'm sorry that I was not more clear. A 'pelvic stretcher' is just a kind of bed that allows the doctor to do a pelvic exam. We call beds 'stretchers' here."
Old joke: The colonoscopy was going along just fine up to the point when the doctor cautioned the patient that he really should be flossing better. :=)
I suppose you could have asked her if she wanted to be a couple of inches taller...
Hey, we've sent guys off for a bucket of steam, a paper stretcher and a wire stretcher. Don't feel so bad.
Another good story. Keep them coming. What a positive way to vent frustrations after "one of those nights"
a few of the males like the way it sounds - of course I just mean they're (new) and in my assignment...
Heh. When I was a merchant seaman (AB), I'd send my ordinaries looking for a fathom of rhum line and five gallons of prop wash.
You know, after the initial mortification I was able to laugh at the whole thing, too. Eventually.
You know the female nurses at the nurse's station where "dying"when they heard that exchange.;)~
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