Thursday, September 16, 2010

Anatomy 101

Yesterday I saw a guy who repeatedly mentioned that he's a nurse.

When he called he said he was having "carpal tunnel problems". That's fine, I can handle that.

But when he came in, all he wanted to talk about was his neck pain.

I can handle that, too. But I asked him why he'd said he was having carpal tunnel problems when he called.

He said "because the carpal tunnel is in the neck".

When I tried to correct him, he argued with me, then walked out. Said he was going to "find a doctor who knows his damn anatomy."

58 comments:

f8hasit said...

That guy obviously doesn't know a tunnel from a hole in the ground.
:-)

Nurse?
And he passed?
Amazing...

Anonymous said...

Why'd he come to a neurologist for neck pain?

Grumpy, M.D. said...

We do that.

Julie said...

shakes head ...

SBG23 said...

I've been up in the O.R. with nurses and overheard them looking at xrays and commenting on anatomy...You think they never took a class... geeeeez...

Kyla said...

I heard someone in the grocery store last night say, "Don't worry about it! Sodium and potassium are the same thing."

I worry about the world sometimes.

Anonymous said...

In this case, perhaps, the head bone is connected to the jawbone is connected to the neck bone is connected to the wrist bone, now hear the word of the ...

Tex said...

I guess I have to defend the nurse, I mean, geez, I get a toothache in my toe all the time. ;/

Diana said...

Stop it! Y'all are scaring me!

Anonymous said...

(cut to) Man in Scrubs:

Are you a pain in the neck?
Many of us are.
You should see Dr. Grumpy!
Call today for an appointment!

Anonymous said...

Once met a nurse who insisted the jugular vein was an artery...

Mad Pharmacy Tech said...

It's why I'm so grateful that my mom isn't one of those nurses...if she doesn't know, she doesn't pretend to. She goes and finds out what she needs to know.

Anonymous said...

I think Dr. G. needs a course in googling.

Carpal tunnel syndrome can commonly coexist in patients with neck pain conditions. Symptoms of tingling and numbness in the fingers can be a combination of cervical nerve root irritation and the concomitant presence of carpal tunnel syndrome.

Any dipwad knows that.

Grumpy, M.D. said...

I'm well aware of that. But this patient had no hand symptoms.

Thanks,

Dr. Dipwad.

Li'l Azathoth said...

You get the impression that this guy doesn't get a lot of second dates?

Anonymous said...

We nurses can only hope that this gentleman was a CNA with an inflated sense of his own knowledge (and title).

Nothing quite frosts my fanny like people who claim the title "nurse" without earning it! MA's are the very worst culprits IMHO, especially those who work in doctors' offices and refer to themselve as "Dr. Grumpier's NURSE".

*steams sizzling out of the ears of a torqued middle aged N.U.R.S.E.!!!


Pattie, RN

action potential said...

Carpal tunnel in the neck... I can think of a couple of our anatomy lab groups that have completely aberrant cadavers (two axial arteries!), but we sure as heck haven't seen any carpal bones or intrinsic hand muscles in the neck.

Anonymous said...

I'm with you Patti.

I once asked one person (who was giving out medical advice) if she was a nurse or a PA - and she said "yes". When I then asked "Which one?", she said she was a medical assistant. Grrrrrr.

The Mother said...

As usual, a little knowledge can be very dangerous.

Dunning-Kruger?

Jackie said...

*is with Pattie*

Nothing I HATE more than someone saying they are a nurse!! "Oh i'm a nurse!" uhh no no you're not. You are a Personal Support Worker. (or a care assistant or some other health care type worker! But not a nurse!) You have no license, no regulatory body. I have a degree and 4 letters after my name for a reason!

If he was actually a nurse I honestly hope he's not directly involved with patient care...

xx
Jaxs

Anonymous said...

I've had some lovely nurses as clients, but I've also had some very stubborn know-it-alls. In fact, nurses have a rather...negative reputation in the veterinary world.

Much respect to nurses, but please...kitties and puppies are NOT just little furry humans. Please don't give them Tylenol!

Dr. Grumpy, you are a daily read for me. You crack me the heck up and make my crazy clients seem much more normal!!

--a Canuck Veterinarian.

me said...

he should have been eaten when young ~

GunDiva said...

Pattie, RN -
I'm an MA instructor and I repeatedly teach my students that they are *not* nurses and should never pass themselves off as such. However, it has been my experience that the physician they work for tends to refer to them as such and the patients don't know the difference, despite attempting to educate both the physician and the patient.


I think that as MAs become more common and patients become more educated that an MA is not a nurse, we'll see less unintentional misrepresentation. Also, any certified MA who misrepresents his/herself intentionally stands to lose his/her certification.

Anywho....

What a fruitcake (the patient, not the RN).

GlassHospital said...

Hope you billed him for your troubles, is all I can say.

Anonymous said...

what ever happened to PN's and LPN's; and candy stripers ?

Grumpy, M.D. said...

I always thought candy stripers were just volunteers.

Gen said...

gundiva is right! Most MAs are called nurses by doctors or other staff. If I call and ask about some lab results, the receptionist will say she's connecting me with the Dr.'s nurse. Grrrrr...

Pediadoc said...

Once had a nurse diagnose ventricular fibrillation in my patient....wait for it....by looking at the wave form on the pulse oximiter. She's not just an RN, she has a master's degree, trains other nurses, and of course is the union rep. She once administered chest compressions to a girl who passed out after a painful vaccine. Had to admit the child to monitor for possible cardiac contusion after. Oh I don't love working with her and there's nothing I can do, I've tried.

Rothase said...

I was a candy striper! Mostly, I just wheeled people back and forth from radiology.

GunDiva said...

Pediadoc - that's some scary stuff.

Gwyn said...

Pattie, RN,

I'm a Certified MA and I HATE when people call me a nurse!

I am not one! Stop calling me that! I will correct them.

I work as a Pharmacy Tech now (certified, thanks Ohio), and people call me a Pharmacist. Uhhh, no. Sure, I'll take their salary, but I don't want their job.

DrB said...

damn... I could have sworn that (when I was a hand surgeon) there was a white 'tunnel' that I released time and time again IN THE WRIST that made patients with carpal tunnel syndrome feel better. Could I have been working in the neck and not known it?!

Arzt4Empfaenger said...

I'm glad not all nurses are like that, actually, many I've met are pretty damn smart, especially the ones in the ER and ICU. However, I guess there's a normal idiot quota (just like with doctors and any other professions). There's to hope I won't ever meet one of those when I'm a patient...


Also - hey, maybe *he* was the fifth anon commenter? ;-) Don't let that make you grumpier!

Anonymous said...

I think the nurses have hi-jacked Grumpy'e Blog, that ought to make him real happy.

My daughter just received her nursing degree from a prestigious eastern university. How long does it take to get the exam results, cause I am thinking there might be, should be, hope there is a job sometime not too far off.

Christine-Megan said...

Pediadoc- Sometimes I can suspect that a patient is in atrial fibrillation based on looking at the pulse from the pulse ox monitoring fluctuating, but I certainly know it can't be diagnosed without ecg. Actually, as that's a medical diagnosis, I know it's out of my scope of practice to diagnose it at all!

Doing compressions on someone with a pulse is just scary.

Christine-Megan said...

Anonymous- If she's taken her NCLEX already, she can pay a small fee to get her results online in about 72 hours. Otherwise, they take several weeks to come in the mail. Most hospitals will hire graduate nurses before they're officially licensed as long as they get licensed in a certain time frame.

Ms Lynette said...

Hmmm, maybe it's not a good neurologist I need to see afterall for the burning, tingling and numbness down the outside of my arm. Maybe I just need a nurse. Nah!

Anonymous said...

@ Christine-Megan -
"Doing compressions on someone with a pulse is just scary." - Compressions are appropriate if the pulse is 40 or less and the patient is symptomatic.

ERP said...

You should have just let him run with it and then casually open your Netter to the hand page...

Anonymous said...

I knew a woman who was pregnant and had had problems with premature labour previously. So she went to have a stitch put in her cervix. The consultant she was referred to looked at the notes, saw the comment that she was there for a cervical problem, and asked her to tell him about her neck problems...

Anonymous said...

0915- carpal tunnel syndrome is common. it coexists with every human condition. it is important to separate it diagnostically from neck problems, but you are still a dipwad. major dipwad......1641- if the patient is telling you about their symptoms, cpr is not at the top of the list of helpful therapies.

Anonymous said...

Anon 3:12, she can also check online at the BON - if her license is listed as "active," then she passed.

Although there are not a lot of jobs for nurses right now, especially new grads. I also just graduated and only half my class has nursing jobs, and one's already gotten laid off...

nurse8

storkdoc said...

So was he a Real Nurse or a Little Pretend Nurse?

Anonymous said...

personality disorder much?

a.generic doc said...

Damn, I thought the Carpool Tunnel was in New York. Or maybe that was the Lincoln tunnel.

mcgee said...

Avera McKennan and Sanford Health (bigass hospitals in Sioux Falls, South Dakota) are expanding all over the place. They are advertising for nurses.

Feistess said...

Okay, I'm a nursing student with a lowly liberal arts degree to my name. Even I know that carpal tunnel has to do with my wrists. Idiots come in all shapes and sizes. And you didn't see his credentials. For all you know, he just barely passed his CNA (some of those folks do actually call themselves nurses). Or he could be a compulsive liar.

Ms Lynette said...

Anon nurse 8, I personally have had CTS and cervical nerve root compression and mild prolapsed disc pressing the spinal column causing stenosis. All causing symptoms in my left arm and hand. I can assure you, they feel nothing alike! While I could have diagnosed nothing, I was able to accurately describe the location and way it felt without telling my doctor what I thought I had. I then received accurate dx and proper treatment. I know that because it worked. Still working on some of the issues but I think I will stick with a doc like dipshit grumpy. Thanks

Christine-Megan said...

Anon 4:41- I meant a regular pulse, like one that would likely be found on an otherwise healthy person who just had a syncopol episode, such as described in the comment I was responding to.

Christine-Megan said...

Nursing jobs are very regional, it seems. It'd definitely a better field to be a new grad in than, uhm, any other major. Pretty much every hospital in my area is hiring nurses right now.

vicki said...

check dialysis centers .. they need RNs all the time
i've been in hospitals a lot (over 100 days total) and i can only complain about one idiot nurse in that whole time. they need references just like doctors in my opinion. i've asked around and find out where my fave nurses are and try to get on that floor or wing. and if you read the name tags it will say MA, RN, LPN, etc on them

Anonymous said...

Why must so many idiots fill their days with nothing but the sole purpose of embarrasing my chosen profession....
I do indeed hope this person was not really a nurse. FML if he is...

RehabNurse said...

Doc:

I'm an RN and I always go to my doc and say, "I have x, y, and z? What could be wrong with me?"

If I've read something that worries me, I say, "I saw an article on something with similar symptoms called...whatever...could I have that?"

I am not paid to medically diagnose anyone, and I frequently tell them that. My license does not allow me to, so if someone wants that, I kindly direct them to the nearest MD.

Now, if my doc is blowing me off, and I'm still having symptoms, you'd better believe I'm going to get a second opinion. That's every patients right.

But, I'm with you, some nurses don't act as if they've ever had A&P. Sure, in some specialties we use some areas of the body more than others, but come on! I never heard of carpal tunnel in the neck in any of my A&P!

Maybe the patient just needs a masesses (word verification looks dangerously like masseuse!)

Jeff said...

Ha! This reminds me of a job I once had, tutoring biology students at a community college. Biology, of course, included the nursing students' anatomy and physiology classes. I once had a young lady who was THIS CLOSE to flunking her A&P class, and hence flunking out of the nursing program. Instead of buckling down and studying, she threw a fit in the learning center and concluded with the statement that she didn't know why nurses had to know anatomy anyway, and that learning anatomy was (and this really is a direct quote) "a stupid, f***ing waste of time."

Punchline: when my mother was in the cardiac ICU at a local hospital, guess who I saw working there? I went to the floor supervisor and requested that Ms. How-the-hell-did-she-get-this-job NOT under any circumstances be allowed near my mom.

Anonymous said...

I'd love to know if he ever finds a doctor who agrees with him that the carpal tunnel is in the neck and, if so, what their real qualifications are. A phony nurse needs a phony doctor.

C said...

The husband and I call it Crappal Tunnel because it's been such a PITA for him. It makes us laugh at least.

Linda said...

when I say "Thank you Doctor" to my pharmacist am I insulting him or her?

Anonymous said...

I don't see how that would be insulting to your pharmacist. Any pharmacist who graduated pharm school since 1990 is a doctor of pharmacy (and some schools began offering doctoral pharmacy programs in the early 70s).

 
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