Monday, 15 August 2011

Ramblings: Faux Pas

If there’s one thing I’m good at it’s the faux pas. You can put me in almost any situation and I’ll say the wrong thing. It’s almost like a Tourette’s syndrome thing. If there’s a word I shouldn’t say or a thing I shouldn’t mention then I do it. I vaguely remember meeting a girl who’s father had hanged himself and ending up saying “hang up” and “hanging about” about ten times in 5 minutes. Tact hasn’t always been my strong point but I seem to get by, somehow. Maybe my choice of career was a dodgy one; coupled with my innate clumsiness it can make being a nurse a liability. I don’t think I’m alone in doing this, as many of the staff who worked with me have provided me with a few corking examples of what not to say over the years. Here’s a few of the more memorable ones. There are some worse ones but I’ll take those to my grave.
As a student nurse I was on a late shift on a busy general ward and a very elderly man had died peacefully with his relatives present. His family were particularly fond of me and we’d developed a nice bond. I was proud of how I handled the whole situation and mentally congratulated myself on my tact and sensitivity, in an unfamiliar situation. I was sent for a tea break and headed off to the canteen in the lift. As I arrived the man’s wife and daughter entered the lift too.
“Ooh, hello again!” I said
“You off for a break? You look tired, love. You all work so hard.” His very recent widow said.
“I am a bit tired. This ward is so busy. I’m absolutely dead on my feet to be honest, dead!” I blushed a fetching crimson.
Worse was what became known as “the dead wet dog incident” and there was no excuse of naivety or newness this time, just lack of tact and thought. I was a ward manager on a busy medical unit and I was catching up on office work one day when I decided to take a stroll onto the ward to stretch my legs and see what was going on. I walked into a room housing were six male patients and was instantly hit by a foul stench.
“Crikey! What’s that smell? It smells like a wet Labrador has died.” I said to the staff nurse on duty, not thinking. It did smell a bit like a wet dog had died, to be fair. She looked a little stricken and tried to discretely let me know that I was making a terrible faux pas.
“It’s the sluice.” She said, trying to stare me out but I carried on regardless, hapless as ever, missing her non verbal cues.
“The sluice? My goodness. Are you sure? The sluice is the other end of the ward. What a smell. I’m going to go and ring estates, now. It’s foul.”
She followed me out and whispered to me “The man whose bed you were standing next to has a gangrenous leg. That was what the smell was.”
“Bollocks!” I whispered back, realising my mistake and quickly racked my brains as to what to do to rectify the situation. Thinking on my feet, I waited 5 minutes then casually strolled back into the room where the poor embarrassed staff nurse was taking a blood pressure.
“I’ve rung estates and they’re coming to fix the sluice so it’s all fine. Thanks for letting me know.” I smiled at the poor rotting legged man whilst spraying half a can of air freshener. On reflection, the air freshener was a mistake also.
I was on a ward recently where a group of nurses were chatting around the desk about how they wished they were thinner and envied, but resented, skinny girls, all accidentally said in front of an anorexic patient who was being tube fed. A staff nurse who worked for me once asked a very emaciated girl with anorexia nervosa where she’d been after she’d been in x-ray for a lengthy time and jokily said “I thought you’d gone out for a nice meal!” It’s not just me who has the Tourette’s thing going off.
Many was the time, as ward manager, that I had to quieten a member of staff talking loudly about what they were having for tea in front of the nauseous or nil by mouth or  expounding about going out for a drink in front of the patient withdrawing from booze. A new porter once collected a patient for x-ray and as a jokey comment said “Come on me duck, let’s forget all this and take you to the pub. It’s a good day for a cold pint” I winced and tried to forget that the poor man had end stage alcoholic liver disease. 

I once tried to pacify an angry Jamaican man who was trying to discharge himself, by saying that he needed to stay in as he had a blood clot on his leg, not realising this has a bad meaning in Jamaican patois. He shouted at me "Blood clot! You calling me a blood clot!" He wasn't impressed and didn't stay. Maybe thrombosis might have been a better word.

I'm sure there isn't a nurse living or dead who hasn't done the mistaking someone's wife or husband for their father/mother/daughter/son. I famously told a middle aged woman what a nice son she had then turned round a few minutes later to see her kissing him with tongues. They were either very close or I'd made another faux pas.

One of my shining moments of miscommunication was when I was chatting to a middle aged Belgian lady who had cancer and asked her if she had any pain.

"I have these terrible feelings. They really hurt."

I was sympathetic. "I imagine it must hurt. You've been having a difficult time. It's normal to have painful feelings."

She looked puzzled. "But these feelings are so painful."

I again tried empathy and told her that bad feelings could be a normal part of the grieving process.
She suddenly twigged and shouted angrily "My fillings, you idiot! It's my teeth that hurt!" I'd misunderstood her strong accent.

My final example is not so much a faux pas but more of a spoonerism. If you don’t know the phenomenon, the Reverend Spooner was an Oxford don, famous for swapping the first letters of words, for example “Our queer dean” instead of “Our dear Queen” and the term spoonerism was named after him. Kenny Everett had a famous character called Cupid Stunt whose name was a spoonerism (figure it out). I tend to do them when I’m tired. It’s very odd and sometimes embarrassing. I was trying to be a little bit romantic/dirty one night with my long term partner. I’m not good at talking dirty and I’m not sure it always sounds so great with a regional accent but I thought I’d give it a go for the Hell of it. I leaned over and whispered seductively: “I want to cook your sock.” Now that killed the moment.

I hope this article doesn't cause any offence. I've made sure the patients aren't identifiable at all as I take confidentialtiy seriously and respect my patients. I also don't think it reflects badly on my workplace. We're all human after all and we make mistakes. Maybe me more than others, at times. I don't actually think the patients or relatives notice our faux pas as much as we do. It's fear of saying the wrong thing that leaves desperately ill people or the recently bereaved ostracised and ignored. A little well meant faux pas is better than being invisible or becoming the elephant in the room who no one mentions.

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