# What not to say or do with a patient?



## ironcoffin (Oct 27, 2009)

Just wondering what are somethings that you shouldn't say to a patient as a joke to get some good laughs.  Here are some of mine I heard and ones I want to say.

"Well atleast he isn't brain dead yet."  Edmonton Medic picking up a pt with Cushings.

"Atleast we don't have to listen to any more country music!"-  Me after BVJ 09.

"So you come here often?"- I used this on a few people in the waiting room.

"Well no wonder no one likes hospitals since there isn't a bar in it!"- to partner.

"Oh me?  I'm an EMT this Halloween?  Still need help?"- waiting for halloween lol

"Here hold my beer.  What seems to be the problem?" - So tempting but so wrong.

Also another thing a service of mine did.  We were working a concert and we where sheet dragging this 19 y/o with ETOH and me and another person where some what grabbing the sheet at the head.  We lower her slowly and I we were paying attention to the rest of the body when we heard a light "Thud".  We both turn around and start to giggle saying how its not funny.  The boyfriend was with the girl.

Same concert this guy is on some extacy.  We get him on the stretcher and my partner pulls his flash light out and shines it on the ceiling in circles.  The guy starts tripping out.  Giggles soon follow.

There is also this one http://www.emtcity.com/index.php/topic/12237-things-not-to-say-during-a-delivery/  which I am saying no matter how old/mature the female is just to hear her reaction!


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## medichopeful (Oct 27, 2009)

ironcoffin said:


> Just wondering what are somethings that you shouldn't say to a patient as a joke to get some good laughs.  Here are some of mine I heard and ones I want to say.
> 
> "Well atleast he isn't brain dead yet."  Edmonton Medic picking up a pt with Cushings.
> 
> ...



Unless you know the patient, I would avoid anything political.  You could quickly offend them.

And all jokes ABOUT the patient should be said in private amongst co-workers, if they must be said at all.


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## Sasha (Oct 27, 2009)

I've learned not to ask psych transfers where about in Florida do they live... a good number of them are homeless.


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## exodus (Oct 27, 2009)

Psych Pt the other night.

(Actually cute Psych [not really, bs 5150] pt we had to restrain):Oh boy, I sure loved getting tied up I want you to do me right now.

Me: You're pretty cute and all but I don't think my girlfriend would like that!



Then later on:

*moans loudly* oh man nothing better than getting pushed down a hall by two very hot men.


xD


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## Seaglass (Oct 27, 2009)

It's one thing to joke with a patient, and quite another to joke about them. Especially in front of them. With some patients, humor can really help them relax. But it's a good idea to get a sense of their character and the situation first.



exodus said:


> Psych Pt the other night.
> 
> (Actually cute Psych [not really, bs 5150] pt we had to restrain):Oh boy, I sure loved getting tied up I want you to do me right now.
> 
> ...



Reminds me of a teenage guy I had awhile ago. He had broken some stuff, but was just drunk enough to be coherent but not feeling much pain. He was pretty scared, but trying to be brave.

Patient: "I always wanted to get tied up by ladies like yourselves who'd cut off my clothes." 

A few moments later: "You know, you three are really hot and all, but this is really embarrassing. Can y'all at least put something over the crotch?" 

Partner: "I can think of all kinds of things we can use for that..." 

Patient: "Y'all are great..." 

(For the record, we gave him as much modesty as possible. Like we do with everyone.)


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## Lifeguards For Life (Oct 27, 2009)

not to engage the delusions of the psych patients. my favorite was, if they were misbehaving to put up the "wall of silence". explain to them what you are about to do and as talking "pull" screen up as to form a barrier between you and the patient. as the invisible "screen" rises above mouth level, continue moving your lips, but don't actually talk. as you "pull" it down begin actually talking again as it passes mouth level. 

I've also heard one medic who had an obnoxious psych that was being uncooperative, threatened to "suck all the air out of the ambulance". the patient retaliated with "oh yeah, how will you breathe if you do?" the medic then put on a HEPA mask and turned the exhaust fans on. the patient apparently freaked, apologized, and begged for him to turn the air back on. apparently it was a nice peaceful ride from there on out


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## reaper (Oct 27, 2009)

While joking with a regular pt is fine and can break the tension, Please think before doing it with a psych pt!

Joking with and playing into delusions can all have very bad effects on a mind that is already not 100%. It may seem funny to watch or seem like it helps, but you can leave a lasting effect, that you may not see right away.

Just noting this, for the newer people that may not understand psych pt's that well, yet!


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## Shishkabob (Oct 27, 2009)

"Oops"


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## EMSLaw (Oct 27, 2009)

What not to say: 
"Wow.  That's gross!"
"Dude!  You are seriously f****ed up!"
"How could someone so stupid have survived to adulthood?"
"Don't worry, it's my first time doing this, too."
"Hrm.  I've never seen /that/ happen before."

What not to do:
Drop the patient.  
Drop heavy objects on the patient. 
Drop the O2 bottle, causing it to turn into a projectile.


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## Sasha (Oct 27, 2009)

EMSLaw said:


> What not to say:
> "Wow.  That's gross!"
> "Dude!  You are seriously f****ed up!"
> "How could someone so stupid have survived to adulthood?"
> ...




That one's so much fun, though. I love it when I get patients who are like "This is my first time in an ambulance..." I get a really excited look on my face and going "Really!? Mine too!!!" Good conversation starter.


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## guardian528 (Oct 27, 2009)

we work with some volunteers occasionally on the beach and in the dunes(NOTE: these are not volunteer EMT's. They are not involved in healthcare. This is not a bash on volunteer services. These volunteers basically pick up trash and explain rules to people.)

Anyways, on a compound clavicle fracture, one of said volunteers wanders up, peeks in, and quickly says, "oh my god, look at all that blood!"

not a good thing to say. needless to say we explained it to him afterwards


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## Medic744 (Oct 27, 2009)

Depending on my patient and what mood they are in after I get the blood drawn and IV started I usually get a giggle out of them when I say "Not bad for my first time doing that!"  After an initial look of shock and horror they realize Im joking and relax a bit.


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## medichopeful (Oct 27, 2009)

Linuss said:


> "Oops"



You know, we were practicing backboarding/extrication yesterday in class (I was the patient), and one of the students "working" on me said either "oops" or "damn," I can't remember.  I found it pretty funny, but that was in a class environment.  I hope I would NEVER hear anybody say that out in the field.  Quick way to lose the patient's trust.


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## medichopeful (Oct 27, 2009)

EMSLaw said:


> "
> 
> What not to do:
> Drop the patient.
> ...



Fixed it for you


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## Seaglass (Oct 27, 2009)

Had a brand new EMT say "Oh my God, that's a lot of blood!" the other day for a rather small forehead laceration that was just doing the usual minor head injury thing. Luckily, the patient was like, "Uh.... no it's not..." before any of us could jump in. 



			
				reaper said:
			
		

> While joking with a regular pt is fine and can break the tension, Please think before doing it with a psych pt!
> 
> Joking with and playing into delusions can all have very bad effects on a mind that is already not 100%. It may seem funny to watch or seem like it helps, but you can leave a lasting effect, that you may not see right away.
> 
> Just noting this, for the newer people that may not understand psych pt's that well, yet!



This. For someone whose grasp on reality is already thin, the last thing I'm going to do is reinforce their delusions or do anything that might confuse them further.


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## fma08 (Oct 27, 2009)

What not to say: "Oh SH*T!!!!!!"

What not to do: Drop them


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## Dominion (Oct 27, 2009)

I use the following lines all the time, usually in a joking tone.  I do take care when to use them though, if a patient is already nervous I'm not going to use them, I'll try a different tact.

"Holy crap that's gross!"

"Don't worry I stayed at a holiday inn last night" (or some other form of "this is my first time")

I especially like starting an IV or doing something else on a patient on my clinicals, if I'm successful without troubles I'll say "That wasn't so bad"
"No you did a good job on it, I barely felt it"
"Good to hear, that was literally my ## IV" usually they laugh and that gets us talking about what i do and puts them at ease.

The other day we had a seizure patient who was vomitting and it smelled FOUL, the mom was in the back with me and I reached over and grabbed the garbage can and placed it next to my feet, she caught my eye and I guess I was already looking green she smiled and said "You don't have kids do you?"  "Nope!".  

It's all in how you approach the patient.


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## ChicagolandIFT (Oct 29, 2009)

I almost always do IFT's and nursing home "emergencies", but occasionally we get calls from municipalities for 911 calls when they cannot get to them.  My very first 911 call I was super excited, the guy was in a bar fight and was badly bruised and bloody.  I was setting up the IV tubing for the medic and listening to them talk.  She asked what happened, and he told the story of the fight, and I asked "did you win?".  He gave me a look I will not forget.  Obviously only one of them needed an ambulance... I felt like a horses behind.  When we got to the ER the doc asked the same question, but with a sarcastic tone.  The pt looked at me and asked "do you want to tell him or should I?"


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## Pyromedic (Oct 29, 2009)

fma08 said:


> What not to say: "Oh SH*T!!!!!!"
> 
> What not to do: Drop them



funny thing. during emt school i was the one who someone drop man that sucks so bad.


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## bunkie (Oct 30, 2009)

fma08 said:


> What not to say: "Oh SH*T!!!!!!"
> 
> What not to do: Drop them



One of my classmates got dropped in extrication. Then I got to be that teams next PT. :unsure:


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## DV_EMT (Oct 31, 2009)

how bout the generic.... "uh-oh", "oops"...

and lets not forget "that can't be good" or "that's not supposed to happen"


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## mycrofft (Oct 31, 2009)

*"Is that a real Rolex?"*

........b)......


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## Brandon O (Oct 31, 2009)

After banging the back of the pt's head on the top of the rear door frame during an elaborate bariatric lift assist...

Me: (points to red "ALLERGIES" wristband) You're not allergic to bumps on the head, are you?

Went over like a stale fart. Okay, they can't all be winners.


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## bunkie (Oct 31, 2009)

Brandon Oto said:


> After banging the back of the pt's head on the top of the rear door frame during an elaborate bariatric lift assist...
> 
> Me: (points to red "ALLERGIES" wristband) You're not allergic to bumps on the head, are you?
> 
> Went over like a stale fart. Okay, they can't all be winners.



I would have giggled. *high fives*


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## EMT Fan15 (Nov 1, 2009)

My friend Myke always pulls this one on me, whenever i get injured: Once, I had hit my head on a Oak shelf, and my friend Myke who is an EMt, picke dme up from my house in a rush, because of the fight with my father, and he climbs into the back seat with me, and checks my bump. He goes: "Oh My God! That's a huge bump!" Then, i freaked, and he laughed. 

One thing funny in my Sports medicine Class in zhighschool though, is last thursday, we practiced giving the Standardizd Assessment of Concussions test, I was the PT, and my friend was the evaluator. earlier in the day, I got into a fight with my father, he wakced me on the head with a Controller. And, after max gave me the SAC, he looked at my Score. A 23/30. Failure.  Good thing my Athletic trainer didn't see my score. Lol. I'd be screwed.


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