You saw a what?!

Because my patient was suspected of having a stroke, we had to perform neurological tests on him. One of these tests consisted of showing him a picture and having him describe what he sees. The picture we showed him had two boys climbing on a chair to steal cookies from the cookie jar, but the chair is tipping over. It also had a woman doing dishes at the sink, and the water is overflowing from the sink. For some reason, people with neurological problems don’t usually notice that anything weird is going on in these pictures. My patient was no exception. I held the picture in front of him and asked what he saw. "Carpet," he replied. I asked him what else he saw, his family anxiously listening. "Umm… a naked woman," he said. I looked at the picture, and did not see a naked woman. I looked down at myself, and thankfully, I had remembered to wear my scrubs. So I am not really sure what he was talking about! I’m sure when he’s better and life is back to normal, this will be a story that his family tells for years to come!
 

Side note: I just wanted to mention that I take all of my patients and their conditions seriously. I am in no way trying to make fun of my patient here. When he said "naked woman," it would have been extremely awkward if we just stood there and didn’t say anything. He was shocked at the words that came out of his mouth, so laughing at it eased the tension and allowed all of us a break from the reality of the situation. In nursing, humor is a wonderful way to get through a lot of situations. When my patients burp or have some other embarrassing thing happen, they always immediately look at me for my reaction. When I smile and laugh a little and say, ‘Well excuse you!" they laugh too. Ignoring things like that can make the situation more uncomfortable than it needs to be. My patient has a long road ahead of him. But with the help of his family, and a bit of humor, I am sure he will get back on his feet again, and at least smile when they tease him for the “naked woman” incident.

 

And thank you Bill Thomas, RN, for explaining this situation – "Your patient was experienceing expressive aphasia when he had trouble naming objects. The message from his eyes, to brain and then to his speech center becomes blocked.  He said "naked lady" because that noun was randomly spoken in place of the real answer. He knew what to say but was unable to "express" himself. Most of the time you can look at your patient’s facial expressions and see that they are perplexed at their own answer."

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33 thoughts on “You saw a what?!

  1. LOL! Poor guy – I hope his condition gets better! And maybe he saw what he WANTED to see!Thanks for visiting my Space again, and I\’m glad you liked my newest story!Finals are FINALLY over and I aced Microbiology! I am sure I will find some way to include this in a new blog. So, now I am moving on to the application process! Wish me luck! Hope you are doing well! Let me know how Finals go for you!Take Care,Rowan

  2. Yikes…that\’s crazy. I feel bad for that guy. I didn\’t realize what all could happen with stroke patients. Thanks again for visiting my page. Good luck on finals and school. Josh

  3. When I was reading your story I was wondering how someone picked that type of picture to show a stroke victim. Very interesting that they don\’t notice anything is wrong.

  4. Manny~I thought that was really interesting too- I had never heard of it until the nurse I was working with told me. The only explanation I can think of is that some people who have experienced a stroke have trouble speaking- they know what they want to say, but can\’t find the words. So maybe these people are struggling so much to name the objects in the picture that they can\’t step back and see the picture as a whole- they just see individual objects.

  5. Katie,Now it\’s YOUR TURN to bask in all the attention! I am thrilled that you and Mocha Mama (another of my regulars) have been featured this week. It\’s a fun ride that you\’ll love.P.S. You\’re MUCH cuter than that stock photo they used…. 🙂

  6. Congratulations, Katie! I just saw you are being featured this week! How exciting! You really deserve it! How come they didn\’t use one of your photos from your Photo Album????Keep up the great work!Hugz!Rowan

  7. Katie,You are always welcome to stop by my Space and I am honored that you would link me to yours. Good luck on the studying – I am sure you will do great!Congrats Again!Rowan (& Scout!)

  8. I\’m just reading the book "Blink" (which is on the best seller list…I usually try to avoid what is popular, but this time I couldn\’t) He has a chapter in which an autistic man is hooked up to a machine in order to monitor what his eyes focus on given a certain scene or picture. I guess a stroke victim would be similar…the parts of their brains that tell them what is important to focus on are just missing. But the naked lady?? Hmmmm. Maybe there is more to the story!Congrats on the selection! You keep us all entertained.

  9. I hope you know your breaking confidentiality laws and can be held liable as a nurse. I suggest if you would like to obtain a job as a professional you would think about what your writing about your clinical experience. Your lucky I don\’t forward this to the Texas and Kansas nursing boards.

  10. Katie,Hi, I am an "old nurse"…your patient was experiencing expressive aphasia when he had trouble naming objects. The message from his eyes, to brain and then to his speech center becomes blocked. He said "naked lady" because that noun was randomly spoken in place of the real answer. He knew what to say but was unable to "express " himself.Most of the time you can look @ your pt\’s facial expressions and see that they are perplexed at their own answer.Good luck with the nursing career. Sincerely Bill Thomas Lancaster,Ohio 25 years in nursing ( all as a staff RN)

  11. Sorry, but I had to comment on the person who wrote you were breaking confidentiallity laws….Information is only confidential when a name is involved. As long as your anecdotes are nameless, you aren\’t in violation of HIPPA laws. Sounds like your open discussion of stroke patents and their symptoms was actually education to several of the people visiting your blog..Isn\’t that what it\’s all about.Good luck again ……..Bill T.

  12. Sorry, but I had to comment on the person who wrote you were breaking confidentiallity laws….Information is only confidential when a name is involved. As long as your anecdotes are nameless, you aren\’t in violation of HIPPA laws. Sounds like your open discussion of stroke patents and their symptoms was actually education to several of the people visiting your blog..Isn\’t that what it\’s all about.Good luck again ……..Bill T.

  13. Yeah what she said. That person complaining about HIPA is dead wrong. You can chat here all you want about your patients and things that happened. You just can\’t put their name. Shame on that poster for trying to intimidate you.Now, let me introduce myself lol. I saw your blog link by chance on my MSN homepage and thought I\’d take a peek. I\’ve been an LPN for 32 yrs and am back in school now to obtain my RN. Nursing has so changed over the years. But I still recommend it as long as you always keep your focus on the patient and giving them a good hospital stay and NOT focus on all the gossip and backbiting that goes on in nursing. As long as you steer clear of that you will have a wonderful career. Good luck!

  14. Oh, the joys of nursing school. I am a second year BSN student and you sound like you are having a wonderful time with those neuro tests!! Anyway, keep up the good work and thanks for the blog. People should see how hard we students work to learn to care for people.Take Care-Christen

  15. Katie-Your blog brings back memories of my nursing school days! Believe me, we ALL felt the way you do! I have been out of nursing school for 8 years now and I laugh at my nursing school days and dramas! I am now a nurse anesthetist- you should consider it— you would love it!

  16. Oh I know exactly what you mean, I am in nursing school right now. I am in the medical surgical rotation. Some days I think will I ever get all the meds given, all the charting done plus all the little extra things. I am glad to see that I am not the only one who struggles or has those moments of doubt. I wish you the best in yours and as I am sure you are doing, I cant wait till the day I graduate. Best of Luck in your endeavors.

  17. Katie, don\’t listen to the cowardly person who couldn\’t even leave his/her name when saying you were breaking confidentiality blah blah blah. You haven\’t named anyone so how is that breaking confidentiality? No different from a professor telling his students about his experiences. I have throughly enjoyed reading about your experiences and because of it I have a much deeper respect for nurses and the education they go through. Props to you Katie!

  18. Congratulations – but did you REALLY have to look to see if you were wearing your scrubs? If so, they\’re working you WAY too hard! :-)J.

  19. This is funny! What a great idea. Sharing the pain of nursing school with the world (I hope you do not scare people off… LMAO).I think it\’s great that you are "Featured". I hope that this brings more people into the profession.As for the psychotic person who believes you are violating HIPAA… Mr(s). Confidential needs to get a life. It must be a lonely existence if all you can do is sit around in the middle of the night and spend your time spewing fallacies; marring a wonderful blog.Good Luck in Nursing School…

  20. Congratulations on being featured. I must admit I check your blog daily for updates. Also, do not be bullied by the HIPAA threat. You do not use names or identifying information. I talk about the foster kids I have in my life. I just change the names to protect their anonymity. Nessa

  21. He said "naked lady", because in an inkblot test, that is what you are supposed to see if you are normal. It\’s the obvious thing to say when a medical professional asks you what something is in a picture, and you don\’t know. (besides "I don\’t know", of course!)

  22. AH, the cookie jar picture!! One we use in speech pathology….it sounds as if this guy has possible aphasia!! I am in school for speech path and love the things that clients come up with!!

  23. hey katie i love your website. I relate to you in many ways. I also work in the healthcare field and endure the emotional and physical aspects of our daily work. I also believe that it is important to keep a positive and upbeat attitude while working with the patients and their families.I think we sometimes are the only stablity and sanity that these people see for most of the day. By having a good sense of humor and trying to reassure people of their situations and emotions is important in the healing process. I think in this blog you express that well instead of ingnoring the patient like most nurses do. You make light of it and probaly made him smile. I think that previous people who have left comments stating that it is unproffesional to have a sense of humor in our setting have lost touch with what is important. Making patients understand that no mater what thier condition is, they still have every aspect of humanity which includes humor. I know that your are going to be a wonderful nurse and i wish you the best in your career. Keep spreading the cheer to your patients

  24. Hi there! I read your article about assessing for a stroke. That sounded very interesting! Its amazing what goes on in the minds of others. It makes one wonder where it came from. I am a nurse that works in Long term care facilities. I am an LPN currently, may have to change my career d/t a back injury. I have a daughter who is 25 and has my grandbabies, goes to school to get her RN degree, works at the same time. I am proud of her. My son is a officer in the Marine Corp. I have had to take off of work due to depression, along with that severe pain (back), the thing of it is my kids dont understand me. Especially my daughter, she stated that I frustrate her. I dont know what to do. I dont mean to rain on your parade so to speak. Just needed someone to vent to, I hope you dont mind. I am proud of your achievements! You will make it and graduate this spring/summer. You have a great educational background. I like how you have set up your space, gives me ideas how to finish mine. Have a great day. Debra

  25. Bless you for knowing that the best thing to do when something funny (but embarrassing) happens for a patient (person), the best thing to do is laugh or share a joke. This tends to work well in non-nursing situations too (sex comes to mind). My thought is if you don\’t want people to laugh then don\’t do anything funny. Just stay alone in a locked room.

  26. This is a great blog hee. I loved it. As for you humor in medicine…… I have used this too so much or the time. Laughter heals more than just the body, but the mind, and this is half the battle, even in degenerative situations. Thus improving the quality of life. PBW for 16+ years. Professional Bumm WiperChau Y suerte.Feliz Navidad.

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