Nursing Etiquette: Embarrassing situations

Q: Dear Nurse Pagana, One thing I never learned in school, and haven’t figured out as a nurse, is how to handle embarrassing situations in the clinical area. For example, if my patient “lets go of gas,” he and I both feel uncomfortable. Do you have any etiquette guidelines to help me handle uncomfortable situations? —Needs Help

A: Dear Needs Help,
You’ve raised an important concern. Unfortunately, the very fact that embarrassing situations make people uncomfortable is also the reason you probably never addressed this as a student and the reason your nursing colleagues don’t discuss this now. The best way to handle any embarrassing situation related to physiology is to clinicalize it—explain it in a clinical context. Here are three examples, with suggested responses or explanations:

• The patient “lets go of gas” (has flatus): “That’s a good sign. It means your intestines are working.”
• You’re in the operating room and your male patient has an erection: “General anesthesia causes vasodilatation. The patient has no control over this response.”
• Your post-operative patient is embarrassed because he fainted when he tried to get out of bed: “This happens often. Many patients feel lightheaded and pass out when they first get up after surgery. This dizziness will pass as your body fluids are replaced and the effects of the anesthesia are gone.”

Of course, there are many nonclinical examples of embarrassing moments. Here are three that are very common, with suggestions for handling them:

• You address a patient by the wrong name: Admit your mistake. For example: “I’m sorry, Mrs. Smith. This is the reason we depend on the name bands.”
• You address a doctor by his or her competitor’s name: Admit your mistake. For example: “I’m sorry, Dr. Bailey. I was just speaking to Dr. Carey on the phone and had his name in my head.”
• You bend down to empty a foley bag and your pants rip: Know where you can go to get some alternative clothing. A common solution may be getting scrub pants in the operating room.

Embarrassing moments are common in health care. Providing a clinical response is the best way to handle situations related to bodily functions. Being honest and maintaining a professional attitude will help in nonclinical situations. Learn from each situation. Remember, you’re only human.

Kathleen D. Pagana, Ph.D., RN, is a keynote speaker and bestselling author. She recently wrote The Nurse’s Etiquette Advantage: How Professional Etiquette Can Advance Your Nursing Career. She is also the coauthor of Mosby’s Diagnostic and Laboratory Reference and Mosby’s Manual of Diagnostic and Laboratory Tests. These books have sold more than one million copies and have five language translations. Please visit Kathleen’s Website at kathleenpagana.com.