Being Judgmental

As a nurse I strive to be aware of when I am being judgmental. I just found this old post from nursing school....

So Mary* was in the hospital because she had bilateral abscesses from muscling (injecting into the buttocks when no more veins are available) black tar heroin. In the US there are two main types of heroin: China White and Black Tar. Black tar is from Mexico and is in general crappier and slightly cheaper. It is seen mainly on the West coast. It is black/brown colored because it is mixed with any black/brown substance (this includes: brown sugar, and poop! seriously). It makes sense that Black is dirtier because its mixers are.

We are talking deep holes, like fit two of those giant erasers into. I cannot imagine ever wearing a swim suit again with that significant of a portion of my buttocks missing. She had gotten skin grafts and was in a special (and expensive bed to keep pressure off of them). She had a central line because she didn't have many veins left.

She was pleasant and a bit whiny. But she had been in the hospital for weeks. She wasn't homeless but did hate her group living facility. Unfortunately she was from a different area and couldn't work with social work to fix her living situation.

 

I recognized how I had checked my main judgements at her door when my nursing advisor commented on how she was probably citing more pain than she actually had because she was an IVDU (intravenous drug user). Now her chart said she quit using heroin 15 years ago, and I hadn't seen any new track marks during the examination, and she was on methadone. I was taken aback that my well educated and usually respectful nursing advisor would imply that she had not quit using and was using excess pain meds. Although I agree that IVDUs are more likely to abuse pain meds in the hospital this pt had reestablished a good relationship with her son and mother, which takes a lot because IVDUs really abuse their family (stealing, lying, abusing). While I do not think that methadone is the answer it had kept Mary off of heroin to the extent that her son and mother were back in her life, visiting her at the hospital and helping to arrange her out of hospital care.

Knowing why she ended up with skin grafts to her buttocks made my mind go in judgmental directions. But recognizing this I try to put aside the "you did this to yourself and now the state/citizens/us/me are paying for it" thoughts. Everyone judges people instantly whether they admit it or not, so I am at the least trying to be aware.