I've had this conversation with a few different people recently and I'm going to try to put it in writing which may be difficult and I might be tempted to switch subjects in the middle of the post but the topic made me laugh in real life so I'm going to try it and I want to see how many of you were going to criticize my run-on sentence before I told you that I was doing it on purpose cause I didn't want to do the work of coming up with new sentences that still sounded interesting. Hehe.
One big part of my job is doing assessments on patients. Obviously. I have my little routine down that I believe is very efficient (cause who would I be if I weren't efficient?) and I've learned a lot. Assessments are very important for establishing baselines and assessing changes. They become second nature. However, for patients who have never been in the hospital before (a number which is drastically decreasing), some of the things I do are unfamiliar. When it's unfamiliar, some patients do things that I find funny. I shouldn't laugh because how are they supposed to know? But I still end up giggling in the hallway as I leave the room.
Here are a few examples:
- I bring out the stethoscope and say, "I'm going to listen to your heart and lungs now." Before I even place the stethoscope, they start taking deep breaths. Most of the time this isn't a problem, but some of them only have the capability to take 3 or 4 before they start feeling dizzy.
- I do neuro checks on patients who have shown signs of a stroke or seizure activity or something else related to the brain. A neuro check has me making sure that the patient can use all of their limbs effectively. I test their strength by having them push and pull their limbs against my hand. (Pull your arms up, push your arms down, etc.) It's a quick and easy way to see if one side is weaker than the other. My favorite is when I have them squeeze my fingers and then they don't let go. I'm pulling my hands away and my patient is desperately trying to prove to me that they're strong and that they can hang on.
- Another neuro check feature is having the patient flex and extend their foot. They're lying in bed and I tell them to push their feet against my hand. Easy enough. Then I tell them to pull their toes towards their nose. For whatever reason, patients do not understand this concept. I remember one patient in particular who couldn't understand what I was asking until I grabbed her foot and imitated the motion so she could do it for herself.
- The elderly of this world are obsessed with bowel movements- the color, the consistency, the frequency... I feel like it might be the most exciting part of their day.
- I giggle a little every time a patient apologizes for the way their feet smell or look. Sometimes they really should be apologizing.....
- I can't tell you how many times I've had a conversation about how warm OR cold my hands are as I'm touching their feet.
- I ask people if they're having any type of pain. Frequently they say no. Then I'll start asking other questions and they tell me about their extremely tender stomach that I can't touch cause it hurts too much..... Umm.... That doesn't count as pain?
- I choose to giggle when a patient and their family member start disagreeing about symptoms and histories and medications. As the nurse, I often feel like I'm stuck in the middle of an argument. I just wanted to know if you had a bowel movement yesterday!
That's all I can think of for now. I'm sure there will be more installments in the future :)
-C-
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