So do family members.

If the ear size of the average family member of an ER patient were proportionate to their ability to hear every little iota of conversation in the department, they would have appendages the size of Dumbo.

Trouble is, they don’t always hear what is actually said. For example:

Doctor says: this patient suffered a head injury secondary to a mechanical fall. He is drunk.
Family hears: He’s a drunk.

We can’t help if a family misinterprets what they hear, but we can try to make sure they don’t hear what they can misinterpret.

Sometimes it’s pretty obvious that they have overheard exactly what was said.

I have occasionally cringed over the years as I have received report at the nurse’s station. Obese patients described as ‘big, fat mama”. Overly dramatic presentations described as “up for an Academy Award”. Elderly females as “little old lady”. Patients with migraines noted to be “full of bulls***”. Adjectives like manipulative, stupid, obnoxious, ridiculous….all at the nurse’s station, sometimes only a few feet away from the patient. At normal conversation levels.

Sure, we may use sick humor or sarcastic comments when talking amongst ourselves, but we sometimes forget we don’t speak in a vacuum.

Remember “Get Smart”? We talk about patients as if we think a Plexiglas “Cone of Silence” drops over the station as we speak.

If only it did.

It isn’t just derogatory remarks about the patients that the family hears. They listen to how we treat each other.

I recently took care of a patient in a room so close to the nurse’s station that I could have carried on a full conversation with the patient, from the station, in a whisper. This patient was rather difficult and had a family who was, well, of the high maintainence variety. The doctor’s desk is about 10 feet outside the door of that room and I knew the family was listening to every word I said because they would go totally silent when they heard me. I approached the doc to pass along a patient request. As is my custom, when in the presence (or hearing) of patients I refer to the ER doctor by the title “Doctor”, as in “Dr. Smith”.

Call me old-fashioned.

In this case, the name could easily have been Dr. Thomas Twit, because the first thing he did was snap at me for not using his first name. And I do mean snap. Loudly. The family heard every word (and will probably forever refer to this man as “Tommie”).