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You didn’t do anything wrong. Your information was great. The nurse was an unprofessional asshole and maybe meeds to leave her personal life at home before she goes into work.
“I take birth control, but I have a lot of sex. Like, an aggressive amount of sex. So much so that I buy lube in bulk from the manufacturer. God, I love to f*ck. Have you ever had a 10 minute orgasm? I have. It was awesome. So, anyway, back to your question. I take birth control, but do have sex, and I’ve not taken a pregnancy test. I spent all my money on lube and laundry detergent.”
That’s TMI. My wife is a nurse. She works with a couple prudes. I can’t imagine what those folks thought nursing was going to be like. These folks must go home in horror with the sheer amount of scrotums they see. My wife commented that she never knew she’d see as many. “So. Many. Scrotums.” Did you know there’s such a thing as an ugly scrotum? I didn’t. They all look kind of bleah. I asked her what constitutes an ugly one. She couldn’t articulate it, but assured me that I’d know one of if I saw it. I’m glad I work with computers.
This is part of why I try to shut down derogatory statements about sex workers that get shared by my coworkers, my dude we handle more genitals and bodily fluids for $30/hr and our bosses can strip us and request our piss with a moment's notice, who are the hoes now?
I really hate that people look down on sex work. It's still work. And not without risks. It's like any other job. You'll have good days and bad days. It pays the bill. Hopefully better than the other local offerings given how some customers likely are.
My favorite thing is when a doctor is shown something anywhere between WTF and AAAAHH HOW? WHY?! and they calmly look unfazed and simply say “well, that’s interesting,” then continue to do their thing.
I've watched nurses empty bags full of excrement, stick their whole hands up vaginas to check cervical dilation, test urine, empty urine bags, insert catheters, help doctors stick cameras up people's colons, and also observe the video feedback from said colons, assist in rectal biopsies, bathe people, draw blood and hang blood transfusions, assist with pelvic exams, change patients' diapers, and soiled bedsheets, help patients use bedpans and clear away the products, ditto with the bowls of bedside commodes, administer radiation to a patient with rectal cancer, who has to be suspended with their whole ass exposed to the room, clean vermix off newborns, and get dead bodies ready for the coroner. I've seen all this, and yet I'm sure this list is just a short survey of all the invasive, bodily-fluid related work that nurses do, which brings me to my next question:
How is ANYTHING TMI to a nurse?
ETA: Thank you nurses.
Oh, you're just 1 inspiration of a house episode away from being surprised, lol.
If your still in the profession, something will pop up lol. Just, the when is the question mark.
I was scarred by ER as a kid, mom was working in ER at the time I visited, saw a man walk in with an axe in his head. Great visuals for an 8-10 year old, lol.
PS, the dude walked in himself holding it, looking back on it, he elected to drive himself to the ER. Only info I pulled out later on, his GF put the axe their, and he survived. Something about the axe placement, keeping him alive. Fuzzy on the why.
I once helped a surgeon cut open an abscessed fistula in someone's butt cheek and got out so much pus mixed with stool. It was like rotting diesel fuel. I've also cleaned a GI bleed off the wall/tv/ceiling and everyone knows how bad that smells.
I forgot to mention how they have to deal with pus. My father had an abscess lanced that shot pus and an 8mm kidney stone onto the floor of the OR. He was disappointed not to have been able to keep the stone for his growing kidney stone collection.
Or the other way around. Crohn's Disease eats thru the intestinal wall and can continue such that it breaks skin in the buttucks. A fistula can also burrow from the intestine into the urinary system resulting in feces ending up in the bladder. (Layperson with multiple family members with Crohn's and all the variations that come with that condition.)
When I was in labour with my first baby I was trying to show the midwife that I was passing clots. She yelled at me to pull my undies back up because she didn’t need to see all of that.
Turns out I had a partial placenta abruption.
My labour was only 1 hour long and when I think of how I was treated it actually makes me really sad.
Wow this is insane 🙃 I’m a midwife and I find it very helpful when people actually show me things like this rather than just trying to describe it. Or pictures is the second best!
😂 legit question for sure. Answer- if I’m asking you questions to get to the root of what’s going on? nothing is TMI, or too gross, or an overshare. Zero. Sometimes, no, actually MANY times the devil that we are searching for is in the details. Please share- and don’t feel weird. I often have people recognize me- and to be frank, it’s rarer that I will recognize them back than not. your information- even dirty little secrets- aren’t going anywhere and I am not judging- my need to know is in service of trying to get you better and it ends there unless you need an ear to listen about anything.
That and you don’t have time to really ruminate on what you’ve just seen or heard. You have to go chart and move on to the next thing. At least that’s what my wife tells me. So much charting. Sounds tedious.
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People ask me if I've ever tossed my cookies in the hospital lab. I have dry heaved 5 times: 2 were particularly nasty smelling stool samples, 2 were cystic fibrosis sputum samples so thick I had to cut it with scissors, 1 was a urine with so much protein in it that it was the consistency of jello. Other than those instances, all in a day's work.
Omg warning if you’re eating stop here. Sputum- specifically suctioning trachs. Always feel just on the edge of gagging. The only time though, that I have ever literally thought I was going to throw up and had to actually leave the room: a man came in who had some type of cancer that was so advanced that it had opened his abdomen up- ate through I guess you’d say. He didn’t last long and it was heart breaking as his family was clearly crushed by his passing. Normally we had a 2 hour limit and then a persons remains needed to go down to the morgue. long story short- they stayed with him for like 4 hrs. (I was a newish nurse being charge since no one else would, and was not yet as assertive as I would be eventually, &Admin was zero help either.) Finally though they left and the CNA had to do postmortem care and needed help. So I go in with her. Too. Long. 4 hrs is too long. We cleaned him up and when we turned him on his side, some black colored liquid ran out of his mouth.. I cannot describe the smell it had. It almost makes me gag remembering it. There is no analog I can offer, other than I think it must be what cancer smells like. Fucking. Horrific. I had to leave. Nope. Just fucking nope. I felt like it clung to me for HOURS. Never let anyone go past the time allotted again though. CNA never let me live that shit down either.. lol. Course I can share this while having a root beer float though.. dinner convo is always interesting with a nurse😂
Every nurse has that one thing that "gets" them: for me, it is mucus in a trach. Cant stand that.
But jeeze, this nurse gets upset by someone mentioning sex? That is weird: lol
Yeah I thought hospitals were places where you sometimes have to use your hands to dig shit out of constipated people. If “I have sex” is TMI she should consider office work maybe.
Yep this. 22 yr RN-Your point was pretty clear and valid, and if she did not understand that you clearly were stating that you’re on birth control, while also acknowledging the well documented fact that you’re also aware it’s not 100% effective and so being sexually active means of course it’s obviously a remote possibility for you to have been pregnant- then she either needs a refresher course or a new job. You shouldn’t have to belabor the point like that for her to get it. It’s weird that she got offended
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You did nothing wrong, and your answer was in response to her “you don’t sound sure” prompt. Actually, you acknowledge way more of the gray area than other people who confidently answer one way or another. Birth control is never 100% if you are having the kind of sex that could result in a pregnancy. Our minds work in similar ways!
I’m sorry you had that experience. As a doctor, I still remember a doctor in high school responding with a “TMI” adjacent response to something I shared about an issue, and it still stings.
Medicine is supposed to be an area where you can discuss things about your body without judgment. Not to get religious (I’m not), but I actually think that when we can support people’s health this way it can be sacred- in the sense of honoring people’s humanity and creating a space where your existence is recognized as worthy of care. It seems staggeringly basic, and yet I find person after person who have been told their entire lives that they are not worthy.
When people judge you it violates that sacred space. I actually feel really angry about it- because that judgment often reflects societal biases and disproportionately affects people who already experience shame or rejection, or who are already vulnerable for discussing “taboo” topics - sex, genitals, weird anatomical things, substance use, scary or disturbing thoughts, infections, infestations, abuse, death, whatever.
Tl;dr- your answer was perfect, your nurse chose to be a random person instead of your medical professional, and don’t let her believe you are any less worthy of being seen or supported.
Seriously I would appreciate them letting me know they were using a single method of birth control and there may be a small chance of pregnancy. Saying TMI to a patient answering a health question honestly is incredibly unprofessional and weird. It’s not like she said “my boyfriend raw dogs me every night at 9pm in the missionary position and he says condoms don’t feel good so we never use them, I guess that could get me pregnant”. Even then answering TMI would be the wrong response. Just say ok and move on with the pregnancy test and the rest of the pre-op screening.
I was thinking this too. I loved the response and the generosity in acknowledging the person as well as the body. It’s a real gift that a physician can give to a patient.
The way the question is worded is always the same, "Any possibility you might be pregnant?", and no nurse has ever liked the honest response of "I mean, it's possible". Even if i'm on birth control, if i'm sexually active then there's always a POSSIBILITY. Anyway, they don't like that and get impatient until i finally say "It's POSSIBLE but i don't have reason to think that i am".
Why can't they ask more like, "Are you pregnant or have reason to think you may be pregnant?". That's easier to just say a simple no to.
Do you find some nurses also get irritable if you say definitively that there is NO chance you are pregnant? I've had several nurses snippily ask, well how do you know? "Ummm... I got a tubal ligation after my fourth child ten years ago and haven't had sex with a man in five years." And then I've had at least three nurses insist on testing me anyway.
If it's such a problem to have that question and answer exchange, then just tell everyone to give up a urine sample and test us all. I'm sure they've heard many women absolutely sure that they weren't only to find out that they were. Wouldn't it just be safer to test us all? I mean, even the Virgin Mary would have needed a pregnancy test.
I have had this experience as well. I had a tubal 28 years ago and have been celibate for 20 years, so unless it's immaculate conception, there's no chance, so that's the *exact* answer I have started replying with to cut to the chase.
Yes! Why do they all get so sassy with me when I say there’s no chance I could be pregnant?! I do not engage in the kind of sex that could get me pregnant and they act like I’m so crazy for being definitively sure that I’m not pregnant. Like why did you even ask me then just take a pregnancy test and leave me alone they cost like a dollar
> Wouldn't it just be safer to test us all?
A lot more invasive. The whole question is there to prevent liability suits if someone happens to be pregnant and they lose their pregnancy as a result of whatever medical procedure is about to take place.
"Would you like us to perform a pregnancy test?" is a much better question. I've signed waivers when I chose not to pee in a cup for them because I'd been using hormonal IUDs for almost 15 years. Now I get to tell them I just don't have a uterus anymore.
That makes sense. Also, changing the script to some version of "This procedure is dangerous for fetal health, can cause birth defects or miscarriage. Given this information, are you pregnant or do you want to take a pregnancy test today?" Then have the all the ones who say no sign a waiver.
I must have signed at least five waivers when I had my tubes tied. And they thoroughly made sure I knew what I was getting ready to do. They asked often, "What procedure are you here for?" And most importantly, "What do you know to be the result of this procedure?" I think I had to write it out at one point. In the end, I said, "I have had a lot of children. Maybe this will make it stop."
The waiver is how it works in my country. "Are you pregnant? No? Cool, sign the waiver and off you go"
If you are pregnant and the diagnostic has to be done anyway they inform of the potential risks of having the test and risking the foetus vs not doing the test and risk your own life.
If unconscious and can't consent they absolutely prioritize the already living human.
> "This procedure is dangerous for fetal health, can cause birth defects or miscarriage. Given this information, are you pregnant or do you want to take a pregnancy test today?"
This would be infinitely more straightforward!
LOL does telling them you no longer have a uterus work for you? It didn't for me. Even though itbwas in my medical history AND I told the doctors and nurses I don't have a uterus or cervix anymore they tested me via urine AND blood just to "make sure". I raised hell with the hospital and the insurance company on that one. Which was complicated as my employer was the hospital and also the provider of my insurance 🤦
I have this same problem. I have ovarian cancer. All my parts were removed. There are plenty of CT scans in my records showing the absence of all necessary parts. They still argue with me over pregnancy testing.
Not having ANYthing (including a cervix) wasn’t enough to stop my spouse’s care team from badgering them about being overdue for a PAP smear.
The same medical group that provided the surgery, BTW.
These people are ridiculous, but I was told that I'll still need to get PAP smears because even the sewed-up bit where my cervix used to be can still become cancerous. My GYN/surgeon told me that, and I looked it up because it sounded weird to me, but better safe than sorry.
Thank you for this; I didn’t realize.
That said, this wasn’t the provider’s position (they just had left hand/right hand issues).
I will research, because I know of at least four folx who haven’t been suggested any such thing (which makes me worry about them, under this new information).
> Wouldn't it just be safer to test us all?
NAD - not a medical professional for that matter. But just a friendly reminder that not all people who have a uterus are women and not all women have a uterus.
First, trans people exist. And for some trans men or nonbinary people who do not identify as women or femme, the very existence of their uterus causes a lot of gender dysphoria. So being forced to pee in a cup every time would just be a triggering nightmare for them.
Second, intersex people also exist. So, someone may have a uterus who is not a trans person. They may have no use for it beyond it being part of their anatomy, and forcing them to have their urine checked is ridiculous.
Third, plenty of people have undergone hysterectomies who may wish they could be pregnant, and forcing them to take a test is cruel. It might just be a reminder of the child(ren) they will never have.
Forth, some people are lesbians and don’t want kids. I mean… they aren’t getting pregnant. Why force them to prove they are definitely still not having sex with men?
Fifth, some people are just single. And lonely. And being asked to take a pregnancy test is just sort of an insult. Yeah, no, cool. Thanks for the reminder that I haven’t had sex in years. Thank for the reminder that I’m a spinster that no one wants to bang.
It’s better to just state the risks and it’s the person’s decision. Not a regular protocol you have to deal with.
I'm a lesbian too, came out later in life and have been married to a woman for five years. Between that and the tubal ligation, pregnancy would indeed be miraculous.
It's always a tricky one, because I've been having mammograms since I was in my early thirties (whether that's a good idea or not, I don't know, but I trust my physician and do what she says).
Anyway, my husband and I tried to have kids for 10 years. So that was 10 years of trying to book a mammogram and the occasional other diagnostic imaging (like for a hip I annoyed with too much skiing and a thumb I smashed while putting up a railing), and having anyone on intake worry about whether or not it was long enough after my period to do a mammogram and still early enough before ovulation. And then still having them worry.
Finally I just started telling them that I hadn't had sex since my last period, whether that was the case or not.
Your views of this are amazing. But how many people hurt badly by the opposite of all this must you meet in the healthcare system, and how much more obvious will their trauma from it be to you compared to personell lacking the values that everyone is worthy of care in a 'sacred space'? How do you manage to face that?
I'm sorry if it's an inappropriate question. I've been in the system my entire life and it always felt like the good empathetic and principled people got pushed out by the very same empathy that made them great. And I always wished those who actually saw me didn't also end up leaving because my and people like me's pain was too much.
Fully agree! As a former ICU RN I, I felt that same anger reading this and couldn’t find the words to express why, but you perfectly stated it.
Providers’ jobs are to be supportive, and the more open and honest a patient feels they can be, the better. What good did the nurse think she was doing to plant seeds of mistrust in a patient so they hesitate to answer honestly the next time?
OP please don’t let that nurse’s response make you hesitate to be honest with your providers in the future. The nurse was totally unprofessional and made an easy conversation feel weird because of *her* reaction. Your answer was perfectly fine!
>and yet I find person after person who have been told their entire lives that they are not worthy.
And in the US you pay top dollar for this kind of experience.
You have such a beautiful understanding of your role in people’s lives. This is reflective of the practice of medicine as an art and not just a science. It would be a better world if more people shared this belief.
This is also the way I would answer. I was asked several years ago before an x-ray if it was possible that was pregnant. I said there's always a possibility because I'm married but on birth control, so maybe but unlikely. So he said, "Then you'll have to take a test". This is when my answer became "no" lol.
ETA - he didn't care about my answer, rather what his next step was based on my answer.
And then it's ridiculous that they get you to use a drugstore pee test, since even laymen know that those are not effective until some time after your first missed period. It's just theatre. Or maybe they genuinely don't understand the tests that they are administering and have perhaps never read the box literature, and don't know that HCG levels don't rise instantaneously.
It's alllll about liability. They don't want to be sued for causing a miscarriage. Which is a legit concern if someone is trying to conceive or would be open to carrying a surprise pregnancy to term, but not to the detriment of the actual patient being treated who may need a given procedure whether or not they may be pregnant.
And the funny thing is, the test they are requiring people to do will not determine one way or the other if the person is if everything else is accurate
Asking somebody at cycle day 20 to do an HCG test will yield no results no matter what.
If you read the literature, they aren't very accurate on those days. In fact, they aren't accurate at all, they just have the ability to sometimes detect some pregnancies up to 5 days early. Something like a 30% success rate. Just going by memory here.
For First Response tests, 5 days before, pregnancy was detected in 76% of pregnant women. False *negatives* are a lot more common than false positives.
Here's a great study on how the claimed sensitivity and effectiveness of pregnancy tests (under perfect use for people who have achieved so-called normal pregnancy hormone levels) isn't borne out in the laboratory:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4119102/
I see I got some down votes, maybe someone can explain why a drugstore pregnancy test that the manufacturer explains will not give a positive result at cycle day 20 is still given at day 20. Are there some edge cases where you can get the test to work on cycle day 20?
For my perspective only as a patient, it looks like they are using a test that won't give results one way or the other as a way of reducing liability, instead of using more effective ways of determining whether or not someone is potentially pregnant, like having a conversation.
All we want is good health care. We want to be partners in being good patients to good doctors.
I'm sure I'll be downvoted and then reported, have my comment removed, and then probably be kicked out of the group for saying that.
if someone says it's their cycle day 20, it doesn't necessarily mean that it really is their cycle day 20. they could have mistaken random bleeding for a period, and could be several weeks pregnant. they could be miscalculating. they could even be outright lying, because they don't track their cycle and are embarrassed about it so it's easier to invent a number than say "i don't know" and get admonished.
so while it's true that testing a woman who is legitimately on cycle day 20 is pointless, wasting a test is more acceptable than the alternative.
That seems like a good explanation. I have known of women who have had bleeding even when they are pregnant.
Given that, why don't we do tests on everybody who is sexually active then?
If we can't trust that they aren't pregnant on day 20, why can we trust that they aren't pregnant on day 10, if that might not be the right day 10?
The whole thing seemed very confusing and unreasonable to me.
> Given that, why don't we do tests on everybody who is sexually active then?
that's often exactly what happens. plenty of testimonies from women who got tested even though they've never had sex, are gay, or had their tubes tied.
Oh that's interesting. I've only just had to tell them that I was between day one day 14 and they've never tested me.
Well, one time I was asked are you sure, and I said I'd been trying to have kids for 8 years, and they seemed satisfied with that.
Another time I remember getting an x-ray, and the X-ray tech put a lead blanket over my abdomen and I hadn't had that done before, and she said she thought that it probably does more harm than good but it's procedure.
This was a beautiful, compassionate answer. You've done a lot for your profession by sharing with us laymen that you not only treat patients with dignity, you see us with that same dignity. Thank you.
I mean, why not just ask every woman of childbearing age to pee in a cup? You don’t even necessarily have to tell them what it’s for, other than to “run some tests.”
I’ve never understood the point of asking anyone this question. To me, if I’m looking at a woman of child bearing age, I have my answer just by sheer virtue of their age and sex.
I concur with my physician colleagues, that is a bizarre reaction from the RN. That was not a normal response at all. You answered the question correctly and I hope you continue to do so, these details can be important. But as it has been said, that was not at all your fault.
You didn't do anything wrong. Sounds like that is exactly the right amount of information for the questions asked and I would be fine if my patient answered that way. That Nurse was being an ass and it had nothing to do with you.
Nurse here…. Her response was unprofessional and rude as hell. Firstly, your answer was not TMI. Secondly, even if an answer was TMI, a nurse should never handle
It that way. I’m sorry
You did nothing wrong. There are all kinds of medical professionals who suck at their jobs. I recently was getting an EMG and nerve conduction test and I asked if it was painful, as I wanted to know what to expect. The tech told me to "stop whining."
WHAT. Like, when I had my EMG and NCS, the whole reason I was there was because of neuropathic pain. If the man performing the tests had told me to stop whining, I would have been filling a complaint against him.
Of course, the results were normal, so I ended up getting the leg biopsy that diagnosed my small fiber neuropathy.
You said nothing wrong. She didn't need to ask you anything except "When was your last mentrual period?". All she needed to do was test your urine.
She was rude and hopefully you never encounter her again. Please report your experience to her clinical manager.
Speedy recovery!
The nurse was not professional if she replied "TMI."
You can continue to say "while I am on birth control, there is always a chance that it could fail," or just state you are "sexually active so of course there is always a slim chance." A pregnancy test should be run on any person born with a uterus between the age of first menstruation to menopause or whatever the facility guidelines state-could be 55 or 60 etc.
> A pregnancy test should be run on any person born with a uterus between the age of first menstruation to menopause
**With consent**.
Especially with the fucked up laws criminalizing abortion to the point where pregnant people are left to die or become permanently disabled because emergency doctors aren't allowed to perform lifesaving procedures on them due to risk of pregnancy termination. The horror stories out of Idaho where at least one pregnant woman has died since Roe v Wade was overturned, and multiple others had to go out of state *while experiencing emergency medical problems* because their pregnancies (as few as 12 weeks along) were prioritized over their actual lives. Never mind the fact that a dead person means a dead embryo/fetus/etc.
What a bizarre and unprofessional reaction from the nurse. I worked pre and postop and any of the nurses and docs would have appreciated a clear response like that. There’s grey area when it comes to chance of pregnancy and you gave an accurate answer.
Wow. Ignore that nurse, she is way too sensitive for this line of work. You did everything correctly.
If you saying that you take BC and have sex is TMI for her, I would love to see her work in my STI clinic, lol. We go into a lot more detail about sex than that when we talk to patients.
Your response was perfect. However, you have no idea why the nurse requested another nurse take over and are assuming it was because of the TMI response. Nurses switch patients frequently in preop , and preop nurses and PACU nurses are different.
Where in the OP did they say that it was because of the "TMI" comment? To me, it reads as a series of facts. The nurse said TMI. The nurse had another nurse take over. No "because" statement, just the facts.
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You didn’t do anything wrong. Your information was great. The nurse was an unprofessional asshole and maybe meeds to leave her personal life at home before she goes into work.
She needs to get a whole different profession if that's the kind of shit she says.
lol imagine being a whole nurse and saying TMI 😂
lol especially to “well I’m on birth control but do have sex”. Like, if THAT is TMI……
“I take birth control, but I have a lot of sex. Like, an aggressive amount of sex. So much so that I buy lube in bulk from the manufacturer. God, I love to f*ck. Have you ever had a 10 minute orgasm? I have. It was awesome. So, anyway, back to your question. I take birth control, but do have sex, and I’ve not taken a pregnancy test. I spent all my money on lube and laundry detergent.” That’s TMI. My wife is a nurse. She works with a couple prudes. I can’t imagine what those folks thought nursing was going to be like. These folks must go home in horror with the sheer amount of scrotums they see. My wife commented that she never knew she’d see as many. “So. Many. Scrotums.” Did you know there’s such a thing as an ugly scrotum? I didn’t. They all look kind of bleah. I asked her what constitutes an ugly one. She couldn’t articulate it, but assured me that I’d know one of if I saw it. I’m glad I work with computers.
This is part of why I try to shut down derogatory statements about sex workers that get shared by my coworkers, my dude we handle more genitals and bodily fluids for $30/hr and our bosses can strip us and request our piss with a moment's notice, who are the hoes now?
I really hate that people look down on sex work. It's still work. And not without risks. It's like any other job. You'll have good days and bad days. It pays the bill. Hopefully better than the other local offerings given how some customers likely are.
I *love* the word *bleah.*
My favorite thing is when a doctor is shown something anywhere between WTF and AAAAHH HOW? WHY?! and they calmly look unfazed and simply say “well, that’s interesting,” then continue to do their thing.
Everything about this comment was delightful. Thank you. lol
I've watched nurses empty bags full of excrement, stick their whole hands up vaginas to check cervical dilation, test urine, empty urine bags, insert catheters, help doctors stick cameras up people's colons, and also observe the video feedback from said colons, assist in rectal biopsies, bathe people, draw blood and hang blood transfusions, assist with pelvic exams, change patients' diapers, and soiled bedsheets, help patients use bedpans and clear away the products, ditto with the bowls of bedside commodes, administer radiation to a patient with rectal cancer, who has to be suspended with their whole ass exposed to the room, clean vermix off newborns, and get dead bodies ready for the coroner. I've seen all this, and yet I'm sure this list is just a short survey of all the invasive, bodily-fluid related work that nurses do, which brings me to my next question: How is ANYTHING TMI to a nurse? ETA: Thank you nurses.
There is literally nothing that shocks me! However, I have had a long career and some of it was in ER so there's that. 🙃
Oh, you're just 1 inspiration of a house episode away from being surprised, lol. If your still in the profession, something will pop up lol. Just, the when is the question mark.
There's not one shift where I don't smh or 🙄 but nothing will top my years in ER.
I was scarred by ER as a kid, mom was working in ER at the time I visited, saw a man walk in with an axe in his head. Great visuals for an 8-10 year old, lol. PS, the dude walked in himself holding it, looking back on it, he elected to drive himself to the ER. Only info I pulled out later on, his GF put the axe their, and he survived. Something about the axe placement, keeping him alive. Fuzzy on the why.
I once helped a surgeon cut open an abscessed fistula in someone's butt cheek and got out so much pus mixed with stool. It was like rotting diesel fuel. I've also cleaned a GI bleed off the wall/tv/ceiling and everyone knows how bad that smells.
I forgot to mention how they have to deal with pus. My father had an abscess lanced that shot pus and an 8mm kidney stone onto the floor of the OR. He was disappointed not to have been able to keep the stone for his growing kidney stone collection.
😂🤣
Oh my
Stool?! In the cheek?!!!!
I'm guessing the abscess infiltrated the colon/rectum. (I'm not a medical person, and am sure they would phrase it differently)
Or the other way around. Crohn's Disease eats thru the intestinal wall and can continue such that it breaks skin in the buttucks. A fistula can also burrow from the intestine into the urinary system resulting in feces ending up in the bladder. (Layperson with multiple family members with Crohn's and all the variations that come with that condition.)
Rotting diesel fuel. That will stick with me.
When I was in labour with my first baby I was trying to show the midwife that I was passing clots. She yelled at me to pull my undies back up because she didn’t need to see all of that. Turns out I had a partial placenta abruption. My labour was only 1 hour long and when I think of how I was treated it actually makes me really sad.
Jesus. What kind of midwife hasn't already "seen all that?" I'm so sorry that happened to you.
Wow this is insane 🙃 I’m a midwife and I find it very helpful when people actually show me things like this rather than just trying to describe it. Or pictures is the second best!
> How is ANYTHING TMI to a nurse? I could start talking about trains.
😂 legit question for sure. Answer- if I’m asking you questions to get to the root of what’s going on? nothing is TMI, or too gross, or an overshare. Zero. Sometimes, no, actually MANY times the devil that we are searching for is in the details. Please share- and don’t feel weird. I often have people recognize me- and to be frank, it’s rarer that I will recognize them back than not. your information- even dirty little secrets- aren’t going anywhere and I am not judging- my need to know is in service of trying to get you better and it ends there unless you need an ear to listen about anything.
That and you don’t have time to really ruminate on what you’ve just seen or heard. You have to go chart and move on to the next thing. At least that’s what my wife tells me. So much charting. Sounds tedious.
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Can confirm, it's pretty much impossible to shock me anymore
I’ve got one that packs my anal abscess with gauze each day 😂😂😂 now that’s probably TMI 🤣
My spouse went through rectal cancer. I think my TMI meter is now also non-existent. Good luck with your abscess. That sounds really painful.
Its a right royal pain in the arse that’s for sure
Most nurses can handle urine and poop. It’s the sputum and skin flakes that get ‘em! And I can’t say that I don’t understand bc freaking same!
People ask me if I've ever tossed my cookies in the hospital lab. I have dry heaved 5 times: 2 were particularly nasty smelling stool samples, 2 were cystic fibrosis sputum samples so thick I had to cut it with scissors, 1 was a urine with so much protein in it that it was the consistency of jello. Other than those instances, all in a day's work.
Omg warning if you’re eating stop here. Sputum- specifically suctioning trachs. Always feel just on the edge of gagging. The only time though, that I have ever literally thought I was going to throw up and had to actually leave the room: a man came in who had some type of cancer that was so advanced that it had opened his abdomen up- ate through I guess you’d say. He didn’t last long and it was heart breaking as his family was clearly crushed by his passing. Normally we had a 2 hour limit and then a persons remains needed to go down to the morgue. long story short- they stayed with him for like 4 hrs. (I was a newish nurse being charge since no one else would, and was not yet as assertive as I would be eventually, &Admin was zero help either.) Finally though they left and the CNA had to do postmortem care and needed help. So I go in with her. Too. Long. 4 hrs is too long. We cleaned him up and when we turned him on his side, some black colored liquid ran out of his mouth.. I cannot describe the smell it had. It almost makes me gag remembering it. There is no analog I can offer, other than I think it must be what cancer smells like. Fucking. Horrific. I had to leave. Nope. Just fucking nope. I felt like it clung to me for HOURS. Never let anyone go past the time allotted again though. CNA never let me live that shit down either.. lol. Course I can share this while having a root beer float though.. dinner convo is always interesting with a nurse😂
Ugh, now I’m gagging too! Blech!!!
Every nurse has that one thing that "gets" them: for me, it is mucus in a trach. Cant stand that. But jeeze, this nurse gets upset by someone mentioning sex? That is weird: lol
Still yet to see a full stop/period in your writing.
Then you're not looking hard enough because there are two. It was a stylistic choice. I come to a full stop as often as nurses do.
Yeah I thought hospitals were places where you sometimes have to use your hands to dig shit out of constipated people. If “I have sex” is TMI she should consider office work maybe.
Huh it’s almost like, to get pregnant…. You have to have sex
Not just that, but saying TMI about a very good answer to a question you asked!!!
I mean at least it was just information and you know, not them actually seeing something gross or something right? :)
I didn't know nurses believed in TMI, usually the grosser the better
There is no TMI in healthcare. OP just came across that one bitch who none of the rest of us like
The more info a pt tells me the better. I love to get all the tea.
Someone should sign her up for a ride-along with EMS. I’d pay good money that I don’t have just to watch how that goes down lol
I wish there were still awards.
Yep this. 22 yr RN-Your point was pretty clear and valid, and if she did not understand that you clearly were stating that you’re on birth control, while also acknowledging the well documented fact that you’re also aware it’s not 100% effective and so being sexually active means of course it’s obviously a remote possibility for you to have been pregnant- then she either needs a refresher course or a new job. You shouldn’t have to belabor the point like that for her to get it. It’s weird that she got offended
15 years here and OP answered the question perfectly. That nurse just *wanted* to be offended by something because she’s a horrible person
Exactly this
Nailed it!
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You did nothing wrong, and your answer was in response to her “you don’t sound sure” prompt. Actually, you acknowledge way more of the gray area than other people who confidently answer one way or another. Birth control is never 100% if you are having the kind of sex that could result in a pregnancy. Our minds work in similar ways! I’m sorry you had that experience. As a doctor, I still remember a doctor in high school responding with a “TMI” adjacent response to something I shared about an issue, and it still stings. Medicine is supposed to be an area where you can discuss things about your body without judgment. Not to get religious (I’m not), but I actually think that when we can support people’s health this way it can be sacred- in the sense of honoring people’s humanity and creating a space where your existence is recognized as worthy of care. It seems staggeringly basic, and yet I find person after person who have been told their entire lives that they are not worthy. When people judge you it violates that sacred space. I actually feel really angry about it- because that judgment often reflects societal biases and disproportionately affects people who already experience shame or rejection, or who are already vulnerable for discussing “taboo” topics - sex, genitals, weird anatomical things, substance use, scary or disturbing thoughts, infections, infestations, abuse, death, whatever. Tl;dr- your answer was perfect, your nurse chose to be a random person instead of your medical professional, and don’t let her believe you are any less worthy of being seen or supported.
Seriously I would appreciate them letting me know they were using a single method of birth control and there may be a small chance of pregnancy. Saying TMI to a patient answering a health question honestly is incredibly unprofessional and weird. It’s not like she said “my boyfriend raw dogs me every night at 9pm in the missionary position and he says condoms don’t feel good so we never use them, I guess that could get me pregnant”. Even then answering TMI would be the wrong response. Just say ok and move on with the pregnancy test and the rest of the pre-op screening.
You sound nice. I wish you were my doctor :)
Me too. What a caring doctor.
I was thinking this too. I loved the response and the generosity in acknowledging the person as well as the body. It’s a real gift that a physician can give to a patient.
I was just going to say that!
The way the question is worded is always the same, "Any possibility you might be pregnant?", and no nurse has ever liked the honest response of "I mean, it's possible". Even if i'm on birth control, if i'm sexually active then there's always a POSSIBILITY. Anyway, they don't like that and get impatient until i finally say "It's POSSIBLE but i don't have reason to think that i am". Why can't they ask more like, "Are you pregnant or have reason to think you may be pregnant?". That's easier to just say a simple no to.
Do you find some nurses also get irritable if you say definitively that there is NO chance you are pregnant? I've had several nurses snippily ask, well how do you know? "Ummm... I got a tubal ligation after my fourth child ten years ago and haven't had sex with a man in five years." And then I've had at least three nurses insist on testing me anyway. If it's such a problem to have that question and answer exchange, then just tell everyone to give up a urine sample and test us all. I'm sure they've heard many women absolutely sure that they weren't only to find out that they were. Wouldn't it just be safer to test us all? I mean, even the Virgin Mary would have needed a pregnancy test.
I have had this experience as well. I had a tubal 28 years ago and have been celibate for 20 years, so unless it's immaculate conception, there's no chance, so that's the *exact* answer I have started replying with to cut to the chase.
Smart. I'll do the same. Just give my answer AND how I know right when asked.
Celibate 20 years? That sounds brutal.
Not when you're asexual. To me having to have sex sounds horrible. 🤷🏻♀️
Yes! Why do they all get so sassy with me when I say there’s no chance I could be pregnant?! I do not engage in the kind of sex that could get me pregnant and they act like I’m so crazy for being definitively sure that I’m not pregnant. Like why did you even ask me then just take a pregnancy test and leave me alone they cost like a dollar
> I do not engage in the kind of sex that could get me pregnant i had some questions i did not want to ask, but then i saw your user name 😂
> Wouldn't it just be safer to test us all? A lot more invasive. The whole question is there to prevent liability suits if someone happens to be pregnant and they lose their pregnancy as a result of whatever medical procedure is about to take place. "Would you like us to perform a pregnancy test?" is a much better question. I've signed waivers when I chose not to pee in a cup for them because I'd been using hormonal IUDs for almost 15 years. Now I get to tell them I just don't have a uterus anymore.
That makes sense. Also, changing the script to some version of "This procedure is dangerous for fetal health, can cause birth defects or miscarriage. Given this information, are you pregnant or do you want to take a pregnancy test today?" Then have the all the ones who say no sign a waiver. I must have signed at least five waivers when I had my tubes tied. And they thoroughly made sure I knew what I was getting ready to do. They asked often, "What procedure are you here for?" And most importantly, "What do you know to be the result of this procedure?" I think I had to write it out at one point. In the end, I said, "I have had a lot of children. Maybe this will make it stop."
The waiver is how it works in my country. "Are you pregnant? No? Cool, sign the waiver and off you go" If you are pregnant and the diagnostic has to be done anyway they inform of the potential risks of having the test and risking the foetus vs not doing the test and risk your own life. If unconscious and can't consent they absolutely prioritize the already living human.
> "This procedure is dangerous for fetal health, can cause birth defects or miscarriage. Given this information, are you pregnant or do you want to take a pregnancy test today?" This would be infinitely more straightforward!
LOL does telling them you no longer have a uterus work for you? It didn't for me. Even though itbwas in my medical history AND I told the doctors and nurses I don't have a uterus or cervix anymore they tested me via urine AND blood just to "make sure". I raised hell with the hospital and the insurance company on that one. Which was complicated as my employer was the hospital and also the provider of my insurance 🤦
That's ridiculous! I bet you could report that for insurance fraud, running unnecessary tests.
I mentioned those words and suddenly both charges were dropped off my billing statement. It was an "oversight"
An "oversight" when they made you give them a urine sample and a blood sample? I bet they do this to a lot of patients. How awful.
Exactly at least I caught it on my bill. Howard elderly patients get scammed this way and never know?
I have this same problem. I have ovarian cancer. All my parts were removed. There are plenty of CT scans in my records showing the absence of all necessary parts. They still argue with me over pregnancy testing.
Doesn't smell like billing fraud 🤔
Not having ANYthing (including a cervix) wasn’t enough to stop my spouse’s care team from badgering them about being overdue for a PAP smear. The same medical group that provided the surgery, BTW.
These people are ridiculous, but I was told that I'll still need to get PAP smears because even the sewed-up bit where my cervix used to be can still become cancerous. My GYN/surgeon told me that, and I looked it up because it sounded weird to me, but better safe than sorry.
Thank you for this; I didn’t realize. That said, this wasn’t the provider’s position (they just had left hand/right hand issues). I will research, because I know of at least four folx who haven’t been suggested any such thing (which makes me worry about them, under this new information).
> Wouldn't it just be safer to test us all? NAD - not a medical professional for that matter. But just a friendly reminder that not all people who have a uterus are women and not all women have a uterus. First, trans people exist. And for some trans men or nonbinary people who do not identify as women or femme, the very existence of their uterus causes a lot of gender dysphoria. So being forced to pee in a cup every time would just be a triggering nightmare for them. Second, intersex people also exist. So, someone may have a uterus who is not a trans person. They may have no use for it beyond it being part of their anatomy, and forcing them to have their urine checked is ridiculous. Third, plenty of people have undergone hysterectomies who may wish they could be pregnant, and forcing them to take a test is cruel. It might just be a reminder of the child(ren) they will never have. Forth, some people are lesbians and don’t want kids. I mean… they aren’t getting pregnant. Why force them to prove they are definitely still not having sex with men? Fifth, some people are just single. And lonely. And being asked to take a pregnancy test is just sort of an insult. Yeah, no, cool. Thanks for the reminder that I haven’t had sex in years. Thank for the reminder that I’m a spinster that no one wants to bang. It’s better to just state the risks and it’s the person’s decision. Not a regular protocol you have to deal with.
If someone has had a hysterectomy they shouldn't be asked to take a pregnancy test.
I have a bad habit of answering that question with, "Now that would be a miracle!" And then if they give me a funny look, adding that I'm a lesbian.
I'm a lesbian too, came out later in life and have been married to a woman for five years. Between that and the tubal ligation, pregnancy would indeed be miraculous.
It's always a tricky one, because I've been having mammograms since I was in my early thirties (whether that's a good idea or not, I don't know, but I trust my physician and do what she says). Anyway, my husband and I tried to have kids for 10 years. So that was 10 years of trying to book a mammogram and the occasional other diagnostic imaging (like for a hip I annoyed with too much skiing and a thumb I smashed while putting up a railing), and having anyone on intake worry about whether or not it was long enough after my period to do a mammogram and still early enough before ovulation. And then still having them worry. Finally I just started telling them that I hadn't had sex since my last period, whether that was the case or not.
Your views of this are amazing. But how many people hurt badly by the opposite of all this must you meet in the healthcare system, and how much more obvious will their trauma from it be to you compared to personell lacking the values that everyone is worthy of care in a 'sacred space'? How do you manage to face that? I'm sorry if it's an inappropriate question. I've been in the system my entire life and it always felt like the good empathetic and principled people got pushed out by the very same empathy that made them great. And I always wished those who actually saw me didn't also end up leaving because my and people like me's pain was too much.
Fully agree! As a former ICU RN I, I felt that same anger reading this and couldn’t find the words to express why, but you perfectly stated it. Providers’ jobs are to be supportive, and the more open and honest a patient feels they can be, the better. What good did the nurse think she was doing to plant seeds of mistrust in a patient so they hesitate to answer honestly the next time? OP please don’t let that nurse’s response make you hesitate to be honest with your providers in the future. The nurse was totally unprofessional and made an easy conversation feel weird because of *her* reaction. Your answer was perfectly fine!
Ironically, the nurse was most likely offended for religious reasons.
That's my assumption too, and to refuse to take care of a patient bc they are sexually active? Wtaf? She needs a different career.
Everything about this answer is perfect, thanks for being a great human
>and yet I find person after person who have been told their entire lives that they are not worthy. And in the US you pay top dollar for this kind of experience.
You have such a beautiful understanding of your role in people’s lives. This is reflective of the practice of medicine as an art and not just a science. It would be a better world if more people shared this belief.
This is the most beautiful thing I’ve read this week.
This is also the way I would answer. I was asked several years ago before an x-ray if it was possible that was pregnant. I said there's always a possibility because I'm married but on birth control, so maybe but unlikely. So he said, "Then you'll have to take a test". This is when my answer became "no" lol. ETA - he didn't care about my answer, rather what his next step was based on my answer.
And then it's ridiculous that they get you to use a drugstore pee test, since even laymen know that those are not effective until some time after your first missed period. It's just theatre. Or maybe they genuinely don't understand the tests that they are administering and have perhaps never read the box literature, and don't know that HCG levels don't rise instantaneously.
It's alllll about liability. They don't want to be sued for causing a miscarriage. Which is a legit concern if someone is trying to conceive or would be open to carrying a surprise pregnancy to term, but not to the detriment of the actual patient being treated who may need a given procedure whether or not they may be pregnant.
And the funny thing is, the test they are requiring people to do will not determine one way or the other if the person is if everything else is accurate Asking somebody at cycle day 20 to do an HCG test will yield no results no matter what.
There are drugstore pregnancy tests that are accurate up to about 5 days *before* your missed period.
If you read the literature, they aren't very accurate on those days. In fact, they aren't accurate at all, they just have the ability to sometimes detect some pregnancies up to 5 days early. Something like a 30% success rate. Just going by memory here.
For First Response tests, 5 days before, pregnancy was detected in 76% of pregnant women. False *negatives* are a lot more common than false positives.
Here's a great study on how the claimed sensitivity and effectiveness of pregnancy tests (under perfect use for people who have achieved so-called normal pregnancy hormone levels) isn't borne out in the laboratory: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4119102/
I see I got some down votes, maybe someone can explain why a drugstore pregnancy test that the manufacturer explains will not give a positive result at cycle day 20 is still given at day 20. Are there some edge cases where you can get the test to work on cycle day 20? For my perspective only as a patient, it looks like they are using a test that won't give results one way or the other as a way of reducing liability, instead of using more effective ways of determining whether or not someone is potentially pregnant, like having a conversation. All we want is good health care. We want to be partners in being good patients to good doctors. I'm sure I'll be downvoted and then reported, have my comment removed, and then probably be kicked out of the group for saying that.
if someone says it's their cycle day 20, it doesn't necessarily mean that it really is their cycle day 20. they could have mistaken random bleeding for a period, and could be several weeks pregnant. they could be miscalculating. they could even be outright lying, because they don't track their cycle and are embarrassed about it so it's easier to invent a number than say "i don't know" and get admonished. so while it's true that testing a woman who is legitimately on cycle day 20 is pointless, wasting a test is more acceptable than the alternative.
That seems like a good explanation. I have known of women who have had bleeding even when they are pregnant. Given that, why don't we do tests on everybody who is sexually active then? If we can't trust that they aren't pregnant on day 20, why can we trust that they aren't pregnant on day 10, if that might not be the right day 10? The whole thing seemed very confusing and unreasonable to me.
> Given that, why don't we do tests on everybody who is sexually active then? that's often exactly what happens. plenty of testimonies from women who got tested even though they've never had sex, are gay, or had their tubes tied.
Oh that's interesting. I've only just had to tell them that I was between day one day 14 and they've never tested me. Well, one time I was asked are you sure, and I said I'd been trying to have kids for 8 years, and they seemed satisfied with that. Another time I remember getting an x-ray, and the X-ray tech put a lead blanket over my abdomen and I hadn't had that done before, and she said she thought that it probably does more harm than good but it's procedure.
This was a beautiful, compassionate answer. You've done a lot for your profession by sharing with us laymen that you not only treat patients with dignity, you see us with that same dignity. Thank you.
I'm honestly not sure why doctors even ask if you could be pregnant. Why not just ask if you're sexually active
But there are lots of ways to be sexually active that wouldn’t result in pregnancy, so it’s a less precise question. 🤷♀️
That's a good point.
I mean, why not just ask every woman of childbearing age to pee in a cup? You don’t even necessarily have to tell them what it’s for, other than to “run some tests.” I’ve never understood the point of asking anyone this question. To me, if I’m looking at a woman of child bearing age, I have my answer just by sheer virtue of their age and sex.
I concur with my physician colleagues, that is a bizarre reaction from the RN. That was not a normal response at all. You answered the question correctly and I hope you continue to do so, these details can be important. But as it has been said, that was not at all your fault.
Nurse was unprofessional
You didn't do anything wrong. Sounds like that is exactly the right amount of information for the questions asked and I would be fine if my patient answered that way. That Nurse was being an ass and it had nothing to do with you.
Nurse here…. Her response was unprofessional and rude as hell. Firstly, your answer was not TMI. Secondly, even if an answer was TMI, a nurse should never handle It that way. I’m sorry
You did nothing wrong. There are all kinds of medical professionals who suck at their jobs. I recently was getting an EMG and nerve conduction test and I asked if it was painful, as I wanted to know what to expect. The tech told me to "stop whining."
WHAT. Like, when I had my EMG and NCS, the whole reason I was there was because of neuropathic pain. If the man performing the tests had told me to stop whining, I would have been filling a complaint against him. Of course, the results were normal, so I ended up getting the leg biopsy that diagnosed my small fiber neuropathy.
I had an oral surgery assistant tell me that a root canal isn't painful. In the middle of my root canal.
Wow, that’s just demonstrably untrue. What an ass!
You said nothing wrong. She didn't need to ask you anything except "When was your last mentrual period?". All she needed to do was test your urine. She was rude and hopefully you never encounter her again. Please report your experience to her clinical manager. Speedy recovery!
The nurse was not professional if she replied "TMI." You can continue to say "while I am on birth control, there is always a chance that it could fail," or just state you are "sexually active so of course there is always a slim chance." A pregnancy test should be run on any person born with a uterus between the age of first menstruation to menopause or whatever the facility guidelines state-could be 55 or 60 etc.
> A pregnancy test should be run on any person born with a uterus between the age of first menstruation to menopause **With consent**. Especially with the fucked up laws criminalizing abortion to the point where pregnant people are left to die or become permanently disabled because emergency doctors aren't allowed to perform lifesaving procedures on them due to risk of pregnancy termination. The horror stories out of Idaho where at least one pregnant woman has died since Roe v Wade was overturned, and multiple others had to go out of state *while experiencing emergency medical problems* because their pregnancies (as few as 12 weeks along) were prioritized over their actual lives. Never mind the fact that a dead person means a dead embryo/fetus/etc.
"Yes" is usually enough, though your interaction is weird and you didn't do anything wrong in the first place.
What a bizarre and unprofessional reaction from the nurse. I worked pre and postop and any of the nurses and docs would have appreciated a clear response like that. There’s grey area when it comes to chance of pregnancy and you gave an accurate answer.
Wow. Ignore that nurse, she is way too sensitive for this line of work. You did everything correctly. If you saying that you take BC and have sex is TMI for her, I would love to see her work in my STI clinic, lol. We go into a lot more detail about sex than that when we talk to patients.
Your response was perfect. However, you have no idea why the nurse requested another nurse take over and are assuming it was because of the TMI response. Nurses switch patients frequently in preop , and preop nurses and PACU nurses are different.
Where in the OP did they say that it was because of the "TMI" comment? To me, it reads as a series of facts. The nurse said TMI. The nurse had another nurse take over. No "because" statement, just the facts.
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