Since the patient is confused, I do my usual assessment for orientation, memory, etc. When I walked into the room her nurse followed me. She was a new hire I'd never seen before.
So I went in, introduced myself to the patient, and started: "Mrs. Jones, do you know where you are right now?"
Before Mrs. Jones could answer Nurse Dingbat, with a look of astonishment, said "We are in the hospital, Doctor."
27 comments:
I usually give the nurse/staffer my quiet stare with one slightly raised eyebrow, which I perfected while teaching high school. The deep inhalation and the pursing of the lips automatically happen. Doesn't usually take 'em long to figure it out themselves.
Sounds like a real keeper.
But we all make stupid mistakes.
She does have an IQ and she is qualified, right?! Now this is the sort of thing that scares me when I go to hospitals: what if these people are there when I need to have an emergency operation????!!!!
From now on I'm eating all my apples.
Heh. I have to admit sometimes I catch myself saying "Jane, can you tell me your name?"
Back in the day when I was in med school the average i was taught that the average nurse had an IQ around 1 standard deviation below that of the average physician. My one observations both then and since lead me to the conclusion that the nursing `IQ bell curve is very flat, ranging from the very bright indeed at one end to very average at the other end. What i would love to see if a paper documenting any secular change in IQ, "g' or whatever you want to call it of nurses over the last 40 years. Has the right and proper opening up of the learned professions to women resulted in a decrease in the average IQ of nurses or has the this been balanced out by by the increasing number of men training as nurses? Whatever the truth of that, i still adher to the old fashioned belief that if you want to practice medicine you shoud go to medical school....
I agree this could just be a stupid mistake. We all do that. I misspelled Tacos yesterday.
It was more the timing of this one.
@John Woolman...what??
I bet she was cute and ends up with a Mrs MD....
Too many years working in the ER with these types.
Well at least she did recognize where she was.
@peedee. Are nurses more stupid, on average, than they used to be, now that bright young women have a choice of a variety of other professions. And if they are is it not ironic that more and more are playing at being doctors? Perhaps I should be less gnostic in my posts.
I would love to know what qualifications john woolman brings to this discussion...
Dr Grumpy, this reminds me of my psych rotation in nursing school - full time mom - working all weekends and holidays - and full time student. Listening to the MD go thru the standard orientation questions - I realized that I was severely sleep deprived when I couldnt answer the majority of them for myself!
@John Woolman: I'm offended on three levels -- as a woman, a nurse, and a psychologist. As a psychologist, I find your little dissertation on intelligence to be particularly frustrating. My guess is that you read the book, "Bell Curve," and applauded the author's interpretation of statistics.
Dr. Grumpy -- again, funny stuff. My guess is that she was that she was nervous and trying too hard to be helpful.
I remember on my first hospital rotation once reading in the chart how the elderly patient was going to have her hip staples removed soon.
I had wanted to meet the patient for pain assessment all that day, and there was always someone visiting, doing a bed bathe, etc. so I finally just stood outside the curtain and listened while it seemed the patient was counting the staples in her leg as the nurse removed them.
The next morning, when my doc mentioned this patient, I was very surprised to see his eyebrows shoot up when I helpfully mentioned that it sounded as if she'd had her staples removed late in the previous day. Little did I know that patients just don't sit on the side of the bed for hip staple removal.
yeah, ok.
Dr. Grumpy,
I recently found your blog and I love it! I read through the whole thing today. You,(and your patients) are so humorous.
I am an "older" pre-med and I find your stories fascinating. I may be crazy to want to deal with the kinds of things you write about here, but that is what I find so appealing.
Peggy
That reminds me of "Airplane"...
"a hospital?" "you know, a big building with patients..."
@anonymous: I bet she was cute and ends up with a Mrs MD....
That's exactly how one addresses the wife of a [male?] m.d. in German [Frau Doktor].
And a derisive term for what you're referring to- women who marry doctors and become snooty in the process, is the same: "Mrs. Doctor".
Woolman, in my area, the demand for nursing school far exceeds availability which leads to REALLY smart people getting into nursing. Obviously, in Grumpy's area, the demand is far lower :-(
In my 4-year program, they're currently accepting those with entrance GPAs (or GPA's if you're Grumpy) of > 3.8 only. Fear not! Retards are not flocking to nursing, at least around here.
My brother was in MENSA, and a lot of geniuses have jobs like "customer service rep" or "waitress" or other such jobs normally associated with average IQs or lower.
Aw, John Woolman. I bet you long for the days that we little ol' nurses and our weeee little tiny brains had to give you our seat at the nurses station. If I were working with you, I'd feign simplemindedness to just to irritate you.
Grumpy, did you chart that the nurse was oriented to place? Bless her heart.
Hey Wool Man - maybe when you learn how to spell you can write a semi-articulate letter to the nurses telling them how stupid they are. Moron.
LOL, Dr. Grumpy. That was great!
I'm pretty sure I work with Nurse Dingbat! or at least A nurse dingbat... :-)
lmao. I knew I was on to something. I must not be a nurse in Woolmans world.
the average nurse, in my experience, is pretty damn smart. mostly smart enough to avoid Dr Grumpy in the morning, before he's had sufficient diet coke. This one nurse didn't seem to know that rule, so by definition, she's one of the dumber ones. That explains the dumb comment.
Dumbness does not necessarily equate to stupidity. And it does not pertain only to nurses. I have worked with many people in the medical field that fall under this heading....and we do not all understand each other's jobs. As ws shown by the doctor who is treating my very slowly healing broken ankle...as he told me yesterday I would have to stay off work some more or maybe they would let me work as I stumble around in the boot? I usually know when this doc is kidding and he was very serious about this....just proves that we dont all understand what all goes on in each other's worlds...I am sure, if no one else cares, the parents in the NICU I work in would be horrified seeing me 'stumble around' doing my job...
My perception is that nursing has the broadest spectrum of intellectual ability amongst its members of any of the professions. When someone describes herself or himself as a nurse, you really cannot judge, sight unseen, what their intellectual ability is, except that its is likely to be above average for the population as a whole. You have to talk to them and work with them before you make a judgement. The same applies tomembers of every other profession, but the prior probability that someone will only have a somewhat above average intellectual ability if they describe themselves as a nurse is higher if than if they are a eg lawyer or physician.
I'm sorry that Dreaming Tree feels offended by my comments as a woman. I can only say that I totally welcome the opportunities that women now have in access to higher education and in the professions as compared to their opportunities even 40 years ago. In particular I think that the special qualities that women can bring to medicine, which men do not possess in such abundance, is, on balance, very much a force for good and is improving the zeitgeist of medicine for the better. If you find what i said insulting as a nurse, then I suggest you read what I said, and this post, again. if you found it insulting as a psychologist, all I can say is I find it surprising how much time seems to be spent trashing "The Bell Curve" in undergraduate psychology courses. I respectfully suggest you take the time to read it from beginning to end starting with an open mind. There is much to criticise in in it and also much food for thought.
As for M'Lynn's comment, any member of a caring profession who simulates stupidity to annoy a colleague in a work situation probably actually is stupid and is certainly unprofessional.
@John Woolman: I carefully read your first and second comments many times before drawing my conclusion. In your first comment, you wondered if the average IQ of nurses was "balanced out by the increasing number of men training as nurses?" It's offensive to think that gender influences intelligence.
I really don't have a problem with the assumption that more career offerings would influence the number of women drawn to nursing (thus, possibly influencing average intelligence of nurses). It seems to be an inaccurate assumption, though. Nursing schools are overwhelmed by applications of interested students, so they filter out students based on grades. With that said, this doesn't necessarily mean that those with the best grades have the highest IQ's. High IQ does not always equal high academic success. Knowledge does not equal intelligence.
Your first post was also offensive because of the last statement about medical school being the preferred choice. I respect doctors for the vast amount of knowledge they must absorb and then use. As a nurse, I bring something else to the table -- I'm not, "playing doctor."
I have read "The Bell Curve." The best I can say about it is that it stimulated great discussions in the psychology courses I taught. It's a great example of misunderstanding statistics and intelligence.
Sorry for highjacking your blog, Dr. Grumpy... No more discussion of IQ.
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