Patients never fail to amaze me, sometimes the things they come out with seem so bizarre and obviously need addressing. Now I’m not going to get deep into the debates about health beliefs, alternative therapy and placebo effects. I don’t know if moonlight soaked daisy leaves have an effect on the sexual behaviour of the over 80’s, nor am I going to research it, but health beliefs still come into play with every patient we see.
I’ve been meaning to write about health beliefs for a while, but I was spurred on by a post entitled X-rated patient by May. Now May is of tender heart, and wasn’t sure if this was funny or sad. From her comments most people felt it was funny. I agree or else I wouldn’t have mentioned it.
Health beliefs can be varied and totally inbedded in history, or just as in May’s story, just based in a complete lack of understanding.
The ones with historical backing are the most difficult to combat and in some cases I just ignore them if they are not directly adverse to treatment. Some I can not ignore and oddly feel quite passionate about.
If I don’t use cotton buds my ears will wax up:
OK this is not too funny, but bugs the hell out of me…
I know it’s sad but true. Impacted wax pushed down the canal but a bloody cotton bud, makes my BP go up. The belief that this is going to help is habitual, and will envoke my 5 point lecture on why not to use them, finishing with… ” my personal favorite is it says on the box not to put into your ear canal!”
Pain killers won’t help:
Another sort of health belief that drives me potty is the patients that present with pain, but haven’t taken any pain killers. This tends to be for one of two reasons:
“I don’t like taking tablets” : response: “you prefer the pain do you?”
“I thought it would mask the symptoms”: response: “that’s the whole bloody point!!”
Actually with the latter I can understand the logic. I do feel the need with inflammatory problems to explain that the anti-inflammatory tablets will actually help resolve the problem, “it’s like…urrrr…. in the name man!”.
I can’t get pregnant if…:
One of the scariest areas of health belief is teenages and sexual health, there are numerous antedotes suggesting wierd and very unreliable methods of contraception…”Maria in 6th form said that if I go on top, his spunk won’t be able to stay inside, so I can’t be pregnant”.
Then there is the otherside: paranoid teenagers. I recall a 15 year old attending for emergency contraceptive, after her boyfriend ejaculate in his underwear, while she was also wearing underwear. Look if a grown man can’t find the hole, I don’t expect a microscopic sperm is going to have much luck navigating it’s way between two pairs of undies, then find it’s way to the vagina and still have the strength to swim any further! Although you do start to doubt yourself from time to time.
But my child will look like Arnie….
One for the asthma nurses. There are multiple challenges trying to get asthmatics to use their medication to give them maximum therapeutic value. One barrier is parents belief that steroids (short course oral or long term inhaled) will leave their child muscle bound. Firstly it just isn’t going to have that effect, and secondly I’d rather have increased muscle growth than acute respiratory difficulty.
These are merely the common ones. It’s the occasional sporadic ones that make me giggle. So be on the look out for them and let me know…
I am a member of the NPUK nursing forum, and one of the regulars just mentioned:
A 92 year old lady who heard that a lot of people die at 3a.m. so she sets her alarm for ten to 3 to take a couple of swigs of brandy to ‘keep her heart racing ‘ till morning!!!!!! Great logic! Thanks for that one Dee – hope you don’t mind me poaching it.