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Blind Spot – At the Intersection of Mother and Nurse

October 6, 2011

By Marcy Phipps, RN, a regular contributor to this blog. Her essay, “The Soul on the Head of a Pin,” was published in the May 2010 issue of AJN.

Being a nurse has changed my reactions to situations at home. For one thing, I don’t get overexcited about non-life-threatening medical problems. I can hardly stand the thought of going to an emergency room (Steri-Strips and ice are my usual “go-to” treatment plans). I’d like to blame this on working in a trauma center—it makes sense that seeing catastrophic injuries every day tends to make less severe injuries look insignificant—but I’m not sure that completely excuses my recent diagnostic error.

My son, who’s 12, came home from school last week complaining that his hand was sore. He’d hit a wall in gym, he said, but it was a padded wall, and he hadn’t hit it very hard. Still, he was absolutely certain that, at the very least, he’d dislocated something, and that, most likely, he’d broken his hand.

To my defense, he has a history of overdramatizing situations, and I took his self-assessment with a grain of salt. Although the side of his hand was slightly swollen, nothing was bruised, and everything seemed to be moving all right.

We iced it, of course, and although hand pain didn’t seem to interfere with his usual activities, he proceeded to tell anyone who would listen that he’d broken his hand.

“Stop saying that!” I told him. “You did not break your hand!”

And so it went, for an entire week. Until his volleyball coach mentioned, kindly, that my son had been complaining quite a bit, and asked if I thought I should have his hand looked at.

So I took him for an X-ray, certain we’d be sent on our way with education about soft tissue injuries. I certainly didn’t expect to find out my son had a “boxer’s fracture” (see image above), or to find myself sitting in the office of an orthopedist I regularly see at work, explaining why it took a nurse a week to believe that her son could have a fracture in his hand.

No harm done (physically, I should say). My son graciously forgives my dismissive diagnosis, but I’m left considering the intersection of mother and nurse, and wondering which part of me I should blame for my error.

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7 comments

  1. The summer before my daughter entered high school, she told me she had to go to the doctor for asthma medicine. I was dumbfounded: She did not have asthma, and had never been on asthma medicine. She explained to me that she needed medicine for physical exercise, that in high school she had to meet a minimum standard, and in jr high, she just had to do her best, and she could stop when she got winded. So I took her to the doctor, a test was done, she did indeed have ‘exercise-induced asthma’, and received her medicine. I said, but Sarah, you bike all over town. She said, Mom, I stop when I get tired! (Duh!). And there was this vague memory of a camp nurse, saying to me, as Sarah was running, ‘she has asthma’, and me ignoring her, because I did not hear it. In my defense, at that time I was a Rehab nurse, with no experience with children other than my own, and had never ‘heard’ asthma, except for the tapes in nursing school, and she didn’t sound like that, and didn’t seem short of breath. After high school, I asked her if she was going to keep taking the medicine, she said no, she just will stop when she gets tired. And she kept biking all over town.

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  2. My 15 year old daughter complained of not feeling well and two bites on her shoulder. I sent her on to school. At 10am the school nurse called me to come get my daughter who had Chicken Pox. And I am a pediatric nurse. Of coarse at 10am she had a lot more Chicken Pox leasions. She did not let me forget that I sent her to school sick.

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  3. It’s both yet neither you are human. I ve done the same. You did everything I would have done even better what my parents would have done who are non medical. 30 years ago you didn’t rum your child to the ED unless it was serious obvious deformity. First and foremost your a mom first you know your child now its time for you to go over the kid who cried wolf with him you should in no way feel guilty but use as am object lesson for your son.

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  4. Boy, does this resonate with me! One of my sons had jumped off his bed when he was 3 years old. He kept saying his foot hurt but I looked and didn’t see any injury, so I just figured he’d bruised it, kissed it and made it better (best treatment for most 3 year-old problems), and then just told him not to worry about it. Then two days later, the nursery school called to tell me he was complaining and his foot was swollen. Yup – broken. He was in a cast (a tiny little blue cast!) for 3 weeks and I felt terrible for longer than that.

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  5. I am the same way, not only with my own kids, but (maybe even) more so with other people. haha Great post!

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  6. I have been there not once but 3 times with bones fx. I have since been forgiven.

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  7. I had exactly the same situation with a dramatic daughter playing field hockey — a sport where you spend ALL your time bending over. We spent endless time getting a referral and fitting the MD visit and imaging into her busy varsity playing schedule, only to find out AFTER the season had ended that she had a fractured vertebra. Which part of my brain was on duty then?

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