In response to my post, “How to Conduct a Physical Exam on an Assaultive Patient“, curious commenter Suzanne asked:
“For example, your patient could feasibly bludgeon you with the bell/diaphragm of your stethoscope. Those things hurt when they smack against your head. (Another story for another time.)”
So… is it time for that story?
Yes. The following is the (unimpressive, anti-climactic) story detailing my first-hand experience of the bell/diaphragm of a stethoscope hitting my head:
Like any good intern, I was sitting in an aisle seat during the lunch conference. Nurses have innate abilities to sense when interns and residents are unable to promptly answer pages—for example, when we are eating, in the bathroom, or engaged with patients (ranging from interviewing patients, performing procedures on patients, or trying to revive actively dying patients)—and those are the exact moments they page us. Their clairvoyance is both astonishing and disturbing. To avoid climbing over people and potentially falling into their laps, I selected an aisle seat to secure easy escape to answer any pages.
An older physician—greying hair, wrinkled face, academic scowl, and long white coat—ambled down the aisle. Both the ear buds and the bell of his stethoscope were peeking out from his pocket; he clearly belonged to the camp of physicians who “stuff” their stethoscopes into their coats (versus those of us who twist the stethoscope tubing into an informal knot and drop the “tied”, compact stethoscope into our pockets for easy retrieval). Something behind the older physician caught his attention—maybe he heard his name, maybe he forgot to add a cookie to his lunch plate, maybe he saw a sign on my head that read, “Maim me!”—
—and he abruptly turned around.
His loose stethoscope flew out of his coat, but one rubber earbud caught the lip of the pocket. Thus anchored, the bell of the stethoscope continued its flight path…
… directly into my forehead.
“Ow!” I ungraciously exclaimed, my hands immediately covering my forehead to prevent any further assaults from the delinquent Littman.
“Oh! Are you okay?” the attending inquired, reflexively responding to my utterance of pain. He was still unaware that his stethoscope was responsible for the contusion that was forming on my left forehead.
“Yeah,” I said, rubbing the tender spot. I leaned over and, quashing my desire to wince, picked up his limp stethoscope (how it feigned innocence!) from the ground, grasped the rubber tubing, and handed it to him. “You dropped this.”
“Oh,” he answered, his face revealing that he now understood that he was an accomplice in the assault. “Sorry about that.”
“It’s okay,” I mumbled, still rubbing my forehead.
13 Apr 2007 |
I had an incident in which an elderly confused woman grabbed my tie and pulled me down toward her with it. It took a surprising amount of effort to pry her little hands off as she was choking me with it.
Comment by Greg P | 14 Apr 2007 @ 7:57am
I’ve been scratched by the claws of tiny babies - and it hurts every darn time!! I’ve also had my hair pulled. Haven’t had my earrings pulled yet, but I don’t wear anything bigger than posts! I don’t wear necklaces because of the fact that I know they will get their tiny fingers wrapped around that, and it does take a lot of effort to get an angry baby’s fingers unpried!! I’ve had many of them grab the stethoscope, and it makes me smile every time….they just want to grab something! The best part is when I’m sitting there feeding one that is going through withdrawal, and instead of scratching their faces, they hold onto my finger as if they will die if they don’t hold my hand.
But even babies can cause some interesting forms of pain - the scratching is the worst! We aren’t allowed to trim their fingernails because it is considered a surgical procedure! Craziness….
I know I have other funny medical injury stories, but most of them are not what people inflicted on me, but what I did to myself by being a klutz - like the huge bruises I always have on my thighs from walking into where they jut out of the wall flowmeters (in the NICU, they are lower on the wall than in the adult settings!), and other such things….wacking my head off the monitor on accident or into the corner of the cabinet.
Sorry to hear the stethoscope story!! I keep mine hung around my neck - however, I wonder if I’d still do that if I was an adult nurse. I have such a small stethoscope diaphragm and bell that the whole thing is really light! I often pull it off if I’m going to sit and hold a baby because I don’t want them to lean against that - doesn’t seem very comfy to me! :)
Take care,
Carrie :)
Comment by Carrie | 14 Apr 2007 @ 2:55pm
Greg - when I started doing psych we were actively discouraged from ever wearing a tie - too easy to be choked ! My consultant at the time demonstrated this by leaning across a table and yanking my tie into a semi-noose.
He was a strange man.
Comment by DrDork | 14 Apr 2007 @ 6:18pm
I recall being told on my psych rotation in medical school to wear clip-on ties. Apparently, they pull off easily when grabbed giving you a chance to escape. Generally, I don’t wear a tie. As to stethoscopes, I belong to the camp of docs that carry their stethoscopes draped around the neck, the bell/diaphragm hanging down one side, the ear buds hanging down the other. Occasionally the stethoscope slips and falls off, but it has yet to cause anyone an injury.
Comment by dr. david | 15 Apr 2007 @ 3:11pm
Wow, thanks for sharing the story! I was so surprised when I saw that you had posted the story in response to my comment, so thank you. Somehow that little thing brightened my morning a bit. I know you posted this several days ago, but I’ve been away from computers for a few days (blame work trips and Jury Duty).
I was expecting a story where a patient grabbed your stethoscope and somehow used it against you, so this was an unexpected bit of lightness.
Comment by Suzanne | 18 Apr 2007 @ 7:57am