Ears

In Emergency Medicine, you first meet patients on the worst possible day of their life. They have come to you for help, an explanation, some comfort, a second opinion or just to have someone  hear them. And we do.

One of the most useful senses a nurse has after her eyesight and touch is her hearing. It has always amazed me that we can block out all of the peripheral noises and din in the ER and be able to compassionately, calmly and quietly get to the root of what ails the person, by listening.

We can hear what the patient’s  complaint is but can better tell the extent of the problem by the tone of their voice as well as hear any strange body sounds that are occuring that could give us even more clues.

One memorable example of this for me was a rather nasty meningitis outbreak in the late 80’s when I worked Pediatrics. Parents would present with a fevered baby and have impatient requests for us to “do something because the Tylenol isn’t working!” The child would look normal sitting in their car seat with a snowsuit on. Once out of the suit the temperature of the skin, the glassiness of the eyes and the abnormal cry would put us all on alert. The cry of a child in pain with a headache is one thing but that high-pitched increased intracranial pressure cry is something you never forget once you hear it. It meant a quick triage into an isolation room, medication and IV on standby and a doctor assessment sooner than later.

You can hear when a congested cough sounds more like failure…..or a palliative breathing is near to end of life. It just sounds different. Croupy cough vs. an asthmatic cough, a marbles in your mouth sinusitis voice vs. a muffled swollen throat epiglottis voice. There are so many!!

Ears…..with or without a stethoscope, they can detect so many subtle changes from the norm. Your ears can also just listen when a patient needs you most.