Huh? Communication tips

In my world, there are four basic communication possibilities with patients: statements, demands, questions, and requests. Prodding the patient to clarify which is intended simplifies interactions considerably, especially with kiddos.

  • Statement: "I have a headache."
  • Demand: "Give me medicine."
  • Question: "What causes headaches?"
  • Request: "May I have medicine?"

Labeling communications helps tremendously. Even adults often do not have a point when they start talking, and labeling what they're saying helps them to formulate one.

I'm amused by this constellation of communication habits I have because after I work around a group of kids for a while, I start hearing my own words parroted back from them ("I know, I know, that was a statement!").

As a typical example, consider the 12-year-old boy with behavioral issues and an inability to communicate with any degree of respect. He walks up to me and yells, "Nurse X forgot my goddamn Tylenol!" My emotional reaction is, "Don't walk up to me and start yelling about something another nurse did!" But I've figured out a truly workable system for teaching these kids how to communicate better, and it reduces frustration all the way around.

In this case: "OK, that's a statement. You've given me information." This is usually initially followed by more of the same ("I TOLD him I had a headache, and he SAID he would bring me something, and he forgot!"). At first, this step can last a long time ("You're still just giving me statements. Do you have a request?").

Eventually the kid learns that "Can I have some Tylenol?" is the way to get the job done.

They learn. You just have to help them label statements and demands versus questions (needing information) and requests. Things go better for everyone.

I'm surprised at how many people, even most adults, speak in subtexts. It's no wonder communication is difficult. They'll tell long stories from which I'm supposed to guess what they want or need. Sometimes when directly queried they have no clear idea what the goal of the communication is. Most memorably, my old boss four times removed brought me in once and told me the same story four or five times. I finally asked her if the visit was purely informational or whether she was asking for further input or had a request for a behavior change from me. The conversation ended there, and I learned a valuable lesson about the importance of, shall we say, aiding our opponents in constructing their own arguments.

How the other half live

The weirdest thing happened. I went to the doctor with sickness and pain, and she paid attention and administered appropriate treatment.

I'm so baffled I don't really know how to react. Normally I have to battle through the assumption that it's anxiety or that I'm just nuts.

This time I got a diagnosis of a bad kidney infection, and I received an antibiotic and pain/nausea medication. Again, I am shocked and cannot remember the last time a physician said, "Ah, you are indeed ill. Allow me to treat you competently and in a timely fashion."

This is the way to do it.

Turns out, FWIW, I have pyelo and also an ovarian cyst, so those are good reasons to be in horrible pain. I got two shots of Rocephin, which I dreaded, but truly they didn't hurt much.

And now for a nap.

Prison stories, part X

I hope I can stay in juvenile corrections for a while, because it's a fantastic fit. I cannot explain why I like the kids. Who chooses problematic teenagers as their patient population of choice? I can explain why I like the job (a little ER, a little of this, a little of that).

Anyway, I figure I'll have a lot of stories, like I used to have "ER stories, part X" on Tumblr, so I'm just starting a thread RIGHT NOW.

This is a funny story.

I went to a new unit where all the kids were locked in their cells and I knew only one. I walked in and couldn't see any kids: I could just hear them from inside their cells.

"Who dat?"

"That's the nurse!"

"What she look like?"



Little did THEY know I would go on to kick ass at Wii Dance Party with my favorite 8-year-old THE VERY NEXT NIGHT. Other than that, "white" pretty much does it.

Which Is Better: 8- or 12-Hour Shifts? | Blog @ Online LPN to RN

The 12-hour shift paradigm has cropped up relatively recently in our profession, and it is the norm for hospital nursing. Unless you wear a tie, you will work 12′s in almost any hospital setting except, occasionally, rehab. This scheduling framework is increasingly being targeted and questioned both regarding patient and nurse safety. For brevity, I won’t include a bunch of links, but perform a Web search for “12-hour shifts safety” or similar for your own curiosity. The summary is that nurses make more and worse errors with longer shifts and don’t sleep enough between shifts.


Stuff people Google to get to this blog

Occasionally I click on that section of my blog with numbers and graphs and such, and one option is "Search Queries." This can be fun. Not as fun as the queries The Bloggess gets, but what can you expect? She makes having diarrhea funny. I'm just not in that sphere.

Still, here are some interesting ones.

  • 2 votes for "work is stupid and I'm sick of it"
  • 2 for "heart blocks are like relationships" (I'd like to hear more on this one actually)
  • "nurses suck"
  • "nurses depress"
  • "Not Ratched isp" (only 1 stalker this time?)
  • "code switching is can hurt communication" (yes and so is can verbing oddly)
  • "what if your tongue goes back in your mouth whilst getting it pierced" (?)

Ah well. I was amused for a second or two. I must move along now.