Dear Nurse Marge,
I am losing my faith in humanity — or my mind — and I can’t tell which!
Yesterday, I was taking patient information from an elderly gentleman. And when we got to the complaint portion, he looked me dead in the eye and said, “I gots roaches.”
That’s not a diagnosis I ran into before. I’m trying to figure out what he means by this. His clothes aren’t the cleanest I’ve ever seen — maybe there’s something wrong at home. He didn’t have much in the way of hair, but maybe he was talking about lice?
So I’m asking those kind of delicate questions, because I didn’t want to embarrass him. And he’s getting more and more agitated, because I’m not understanding him.
“Roaches!” he shouted. “From the drinking!”
The light dawns. I don’t have a lot of experience in psychiatric nursing, but this must be some kind of alcohol induced hallucination. Maybe a withdrawal symptom.
I ask him who his psychiatrist is.
He gets very indignant. “I don’t need a psychiatrist! I’m not crazy! I’ve got roaches in my liver from drinking, and they’re paining me something awful…”
Roaches in my liver. Cirrhosis of the liver.
I finished getting his info and sent him along — but now I’m wondering: who was at fault here: the patient, for not knowing his diagnosis, or me, for not intuitively knowing that roaches in the liver means cirrhosis! Am I ever going to get the hang of this?
Dear Bugging Out,
Short answer: No. It doesn’t matter how long you’ve been a nurse, nor how experienced you are: patients are going to come to you with complaints you couldn’t even imagine, much less anticipate! Don’t sweat it: think of it as your chance to revel in the complex, creative, innovative ways our patients regard their health.
After a while, you won’t even raise an eyebrow when a patient complains of blood clogs.
And you’ll know that Copper Toed Syndrome is actually Carpal Tunnel.
When a patient complains of Smiling, Mighty Jesus, you’ll know they don’t actually have a beef with the man upstairs. They’ve got spinal menegitis.
Just hang in there. It gets easier with time…or you get used to it!