Friday, November 11, 2005

"I" statements

We are all taught to speak to patients in "I" statements, especially when confronting something that is potentially uncomfortable. This may include, "I notice that you have bruises in the shape of fingers" or "I see that you weigh 498 pounds" or "I can see that you are upset by your gonorrhea infection and need for a painful Rocephin injection."

However, sometimes newFNP's "I" statements escape her. This week, it was because I wasn't sure what I was (not) seeing and feeling. When I was in school, I had a similar experience in which a patient, upon whom I was gearing up to perform a DRE, assumed the position, thereby exposing her tail. "I see you have a shaggy tail. Has that always been there?" No, no - I didn't say that, but any sensitive statement I may have been able to come up with was vanquished by the magnitude of my shock. Why didn't they tell me in Advanced Health Assessment that I may happen upon a tail? I was ill-prepared.

I was also ill-prepared for my 36-year old father of three with tiny, hard testicles as well. Now, although newFNP does not possess said equipment, she has once or twice been familiar with those who do *and* has seen enough in the clinical context to know that they should be more like matzo balls than walnuts. So, what was I to say?

"I notice that your testicles are like raisins. Were they ever prune-like?"

"I feel that your testicles are firm like marbles... and not much bigger. Were they ever more like Everlasting Gobstoppers - the big ones?"

"I see that your testicles are essentially non-existant. Do you really have three children?"

See? It's hard to have good "I" statements on the fly. Part of the reason it was difficult is because I was uncomfortable telling this gent that his balls were weird. Is there a guy out there who wants to hear that? In Spanish. In my crappy-assed Spanish.

"Sus testiculos son demasiado locos." Bad, bad newFNP. Must learn sensitive Spanish!


Anonymous said...

Wow! I'm an NP student who has seen some real challenges... I usually ask if they are experiencing any problems, then chart asymptomatic (and describe the freaky things I see).

I look forward to reading your new adventures. Sounds like you are a pro at maintaining composure.

NP student

Anonymous said...

I don't get it. there was an actual TAIL?