Funny Thought for the Day

So, to check orientation of all of our patients when doing our assessments, we have to ask each patient three main questions: Their name, where they are, and what time/date it is. Well, with my younger middle aged patient with something simple like Cellulitis or an earache, I usually skip over this and assume, from my normal conversational interactions with that patient, that they know who they are, where they are and what day it is. Just a hunch.


So it then becomes a matter of where do you draw the line? Is there an AGE where I should assess or not assess for orientation? Is there a diagnosis?

I really think it just depends, its different for every patient. Granted, the older the patient, the more likely I am to check for orientation right off the bat. Some people fool you pretty easily, they are having a full fledged normal conversation with you and you think they are oriented, until you ask them what month it is and they say its February when really its August. And its 1982.

So the other night, I got a new patient under my care. She was elderly, but with her husband. She seemed to be pretty with it but on the verge pretty forgetful. So I decided to definitely check for assessment. This is how it went down:


Me: "This is going to sound pretty silly, but I have to ask, Can you tell me your name?"

Patient: " Mrs. IKnow MyName"

Me: "Okay good, Can you tell me what day it is?"

Patient: "It was just Thursday, but now its Friday."

Me: Okay good. Can you tell me where you are?


Patient:   "Yes."


Me:  ...........


Patients Husband:  "Dearest, I think she wants you to tell her where you are."

Patient: Oh! I thought you just wanted to know if I knew where I was. I know where I am.

Me:    ...........


Patient: ....... I'm in ThisLovely Hospital........ *looks around at everyone*, Right?




*sigh*


~ WNB

Just Answer the Question

These can be the most aggravating types of assessments:

Me: "have you ever had an ulcer before?"

Patient: "well my grandmother did, on my maternal side. She died from that ulcer, then my uncles step-son lives near her in Alaska and had to take care of her cat because it had no where else to go and then that cat turned out to have diabetes and my brother had to give it insulin- you know what insulin is, right?- and then the cat ate this flower once so then my uncle couldn't buy flowers anymore."

"okay. But have you ever had an ulcer?"

Patient: "oh uh, no. My stomach is great. My friends aunt had stomach cancer though."


-_____-


Very nice people indeed, but when I have 110 questions to ask when admitting someone and they answer every question with a story that always circles back to a friend/aunt/uncle or CAT, you kind of just want to stick yourself with 100 units of insulin and call it a day.



Am I already jaded??!


:/

WNB



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