Do Family member's of Doctors and Nurses get more rectal temperatures taken?

I have often wondered if people who grew up in a household where the parent was a nurse or doctor experienced rectal temperatures more then others. My mom was not a nurse so I have no firsthand knowledge, but several friends of mine had mother's in the nursing profession and they claimed to have had their temperatures taken rectally whenever they were sick and to a much older age, say 10 or 12 as compared to my experience of being switched to "oral" at age 6. So , members, what do you think ?

My wife's a nurse, and both I and our children have had our rectal temperature taken quite a few times. She strictly used rectal on the kids until they turned 5 years old. If I'm sick to the point of being in bed all the time like with the flu, she prefers to take mine rectally because I can sleep on while she takes it. It doesn't hurt when she does it, and I'm only disturbed for a minute so she can put it in. Then I can fall back asleep and barely feel it when she takes it back out.

Well as a nurse I can honestly tell you that I didn't take my kids temp rectally or any other way when they were growing up. My kids, the hubby, and myself have only been in the ER collectively someplace between 6-8 times in the past 25 years. My kids never had an ear infection, and only needed to be put on an ATB just a few times for strep.

It used to be that everyone needed to be treated with something, tylenol, advil, and ATB or something when they had a fever, but in the past 15 years or so I would guess they have come to the realization that you get a fever for a reason, which is your bodies way of fighting some sort of bug or whatever, and it's actually better not to treat it at all. Let the fever do it's job. If it gets over 101, monitor it, and over 103, it needs to be addressed.

I can tell by looking at someone whether they have a temp or not, and if it's high enough that it requires my attention, patients or kids, I don't need a thermometer to tell me that. As a matter of fact, I never even owned a thermometer whether it be oral or rectal until I started my med fet discovery. Now I have tons, lol.

Mashie

As a physician I can say without equivocation that we only took my sons temp rectally when he was very small. I only had my temp taken that way until I was about three. My ex was a doctor and had been a nurse first. Why take it rectally? Who cares how accurate it is? I'm reminded of my chief resident who never wore a watch. I asked how he took patients pulses. He replied who needs a watch? It's fast, slow, irregular or not there.

I can tell by looking at someone whether they have a temp or not, and if it's high enough that it requires my attention, patients or kids, I don't need a thermometer to tell me that.

The same here. There are more than enough outward signs to check to see if someone is ill. General listlessness, lack of strength, puffy eyes, reddish nostrils, just feeling the forehead, presence of sweating.

I truly doubt if 1 degree Fahrenheit more or less will make much of a difference in a diagnosis. Besides, some people have different base-line normal body temps. My wife has a low body temp and when she has all the other signs of an illness, her temp-reading may not even be that high at all.

So there is little use in fixating on exact temp readings in a real medical situation of the usual kind ... I'm not saying anything about tropical diseases or such, but the normal everyday illnesses one encounters ...

My father is a physician , my grandfather is a general surgeon and my three aunts are scrub nurses. I never had my temp taken rectally.

I agree with what Mashie said that generally you can see it .

Or even a feel on forehead is fine at times .

~Cookie

As a physician I can say without equivocation that we only took my sons temp rectally when he was very small. I only had my temp taken that way until I was about three. My ex was a doctor and had been a nurse first. Why take it rectally? Who cares how accurate it is? I'm reminded of my chief resident who never wore a watch. I asked how he took patients pulses. He replied who needs a watch? It's fast, slow, irregular or not there.

Certainly agree with the general tone of others here, generally there are outward signs and if patient or yourself is unwell but your temp comes back as normal I'm still going to treat how I feel and not what my bottom is telling the thermometer. The degree of accuracy isn't going to make a difference.

Although he (old resident) is true times have changed and certainly here in NHS vitals are recorded and should a patient deteriorate people will ask questions if the obs chart instead of recording pulse, temp etc accurately just wrote fast, slow or God forbid not there lol.

I think the days of letting the dr use own discretion /judgment have gone here in the uk and everything is protocol driven and everything must be noted in obs and charts religiously.

If can spot signs of developing sepsis or acute kidney injury early can prevent further deterioration.

Thankfully not where I worked but at my induction years ago they used a real example of obs chart showing increasing respiratory rate, pulse, reduced urine output and climbing temp.

All nicely recorded on pretty graph but other then take the obs nothing was done with bad news for patient.

Accurate obs do make a difference as looking back the deterioration could easily have been spotted sooner and try avoid a crash call however still needs someone who isn't a complete idiot to look at them.

I know you and old Chief resident in that case would not have needed obs chart to see the patient was in trouble but hope I have semi got my point across ?

It's called a throwaway line. He was and is known for his sense of humor. It wasn't meant literally. For a quick bedside assessment no watch is needed however.

Maybe I should clarify a bit before someone thinks I"m a bad nurse, lol. I do take temps on my critical care folks, but on my stable normal every day patients no almost never. Those are the ones that I can tell easily if they are sick. Even when they are going down hill and I have to call the doctor the doctor never asks what their temps are.

I have to laugh at your chief resident LIquidsky about the pulse thing. He's right. Numbers really are not all that important. You can tell in about 5 seconds what the pulse is and whether it's fast, slow, WNL, or not there. Or I should again clarify and say that an experienced medical professional can.

Some of Doc's patients will complain if he doesn't take their vitals with every visit and their weight. Well seriously, what does that bring to the table? How will that make a difference in your being treated that day? With the exception of a few medications such as blood pressure medications or the like, if you are in there to have your ingrown toenail looked at how will the doctor knowing your blood pressure add to what's wrong with you, or help him treat you any better?

Really if you want to know the truth, at least the truth as I see it anyway, you walked into the doctors office on your own two feet and are talking. So I automatically know that you have a blood pressure and a pulse already. Then we would go from there.

Mashie

Agreed. Here it's really strange doesn't matter if you walked in the hospital is very good at making you non ambulatory. I mostly work in respiratory physiotherapy but have done ward work in the past and patients are very quick to forget they walked in and aren't immobile.

Molliewhite, you actually made me laugh out loud. I so totally understand what you are saying there.

This is where I get myself in trouble here on the board, when I talk bluntly, frankly, and tell the truth about how I work as a nurse and as a medical professional. I realize that I often come across as a total bitch, uncaring, and what not, but sometimes we, meaning us medical professionals know what's best for our patients even when it doesn't seem like it to laymen. Sort of like parents and children.

I specialize in critical care/rehab, as well as vent/trach nursing. I know my patients are hurting, scared, and often easily overwhelmed. So it's my job to take them from that place to where they can go home or can transition to where ever it is they will be going. It never ceases to amaze me that I get patients who have had knees or hips replaced and they are on their call lights for someone to come and hand them their glass of water that is on their over the bed table right in front of them.

We see behaviors like this all the time. Lots of time people find any reason to be lazy while in rehab, like they are there on vacation or something. Sometimes it makes our heads spin patients are so over the top ridiculous. What other nurses allow their STNA's to do is their business, but when I'm in charge patients will do everything they can for themselves because that is what is best for them. If we do everything for them then they don't get any stronger or better. Their insurance runs out and they have to either go home or pay out of pocket. If we don't push you then you will not be ready to leave and go home so you can continue with your life. If we baby you, go easy on you, then when you have to go home you are not ready or capable. So when at home you hurt yourself again, or your quality of life isn't what you want it to be, or not what you are capable of.

So when I admit my patients I tell them this. I half jokingly tell them that this rehab, not the hotel Hilton. If you can you will, and if I think you can't you will even when you think you can't. They usually get the message pretty quickly and comply once they understand what is expected of them. Rehab is work, not a vacation. It is what is best for them.

Mashie

To anyone who works in a hospital you absolutely don't sound a like a "bitch" or "uncaring". It is very easy to loose your independence especially if older on hospital so your right to encourage them to do as much as they can by themselves.

I always feel terrible when bariatric patients pit their arm up asking to be pulled up. I want to but at same time I know I'll only damage myself and I will support and encourage them to do it themselves.

Most of physiotherapy is cruel to be kind. Without your attitude Mashie your patients would spend even more time on the ward when home is best place for them.

When it comes to bariatric patients I have absolutely no sense of humor. I will always be a complete professional, but I will not ever enable them. I will never sugar coat things for them, will never underplay things for them, and the same for their families.

For those of you who don't know what bariatric patients are they are the ones that are over weight, and I don't mean 200 pounds, I mean 400 pounds and above. When I ran the vent trach unit for 3 years I had one ward room with 4 women, and another with 2 men. Sometimes that would change, they would die and others would fill the beds. I guess I learned really quickly that I had a very short fuse when it came to them because I was trying to care for them and my vents. The bariatric patients seldom ever think they can wait for anything. They never seemed to care that someone in the next room wasn't able to breath and was in respiratory distress, they wanted a snack. And they wanted it right that second.

I never usually knew what happened to them in their past, what caused them to be that way, to be so selfish, so demanding, so nasty. Sometimes they had a diagnosis that would support a weight issue, but they took that and used it as an excuse. Bariatric patients always have an excuse for everything. They always have to justify things. The sad thing is that they believe it, and most of the time their family starts believing it too.

When they come to me they start hearing the truth whether they like it or not. I can't tell you how many families I have sat down with to discuss a plan for their family members. All of them say the same thing basically. Their family member can't even get out of bed, can't do anything for themselves. How is it that they keep getting fatter and fatter? The family members always say that they have to get the food for them that they want or they will get mad and yell. I always ask them the same things. Do you love them? Do you want them to live? Naturally they say yes. So I put it right back on them and basically tell them that it's their fault they are getting fatter and dying. They need to learn to tell them no, and if they get mad and start yelling, so what. Just walk out and shut the door. You do that enough and eventually they will be able to get out of bed and come after you, which is a great thing.

These are the patients that I oddly enough feel the worst for because they will die, 100 percent of them will die and unless I or my team, or their family can get them to change the way they think about food, they will all die. When you are sitting at a table with the families telling them like this they sit there crying. They feel bad when they find out that they are the problem, not the solution, and they need to be the solution. Then a few days later you walk into their room and they are sitting there with an entire chicken and a 8 by 8 pan of brownies that they don't plan on sharing with anyone, and do plan on eating it all in one sitting, on top of the meal that we gave them.

I don't mind telling you, I have more than a few times as professionally as possible let them and their families have it. The families actually have the nerve to look at me in the face and tell me that their family member made them go and get them that food. So I tell them the truth, they don't like to hear it, but it's what they need and have to hear.

The sad part is when they die, and they ALWAYS die. Their family member always come to me crying and telling me that they should have done more to help them and that they should have listened to me and why didn't I convince them harder? Well because any harder and I would get in trouble, and because according to some I already cross the line with my bluntness with them, lol. It's really a sad thing. And with every single one of them I had hopes that I might be able to save one of them, but I never could, especially when the family members were going behind my back bringing them food. Their families were guilty of being enablers and loving them too much. I couldn't change that.

Mashie

My uncle Jack was an M.D. in Connecticut, from around the late 40's to the late 70's. I don't believe that his 4 children had their temps taken rectally at home. My own pediatrician, who practiced around the same era, discouraged my mom from taking my temp rectally past age 5 or 6. I never had a rectal temp. taken by a after age 5. I did know of friends who were hospitalized, and had rectal temps taken in the pediatric ward, even as teens. My belief is that doctors and nurses were evenly divided on the rectal temps. being administered after a certain age. If a child can responsibly hold a thermometer under their tongue, why the need for rectal ?(And please...no responses from uneducated jerks, claiming that "youths who are intellectually challenged, with ADHD, require a rectal temp being taken.)

I've taken care of a number of morbidly obese patients. It's no fun. Using a spinal needle to draw blood gasses is not my idea of a good time. Needing an engine hoist to help with intubation isn't either. By the time I see them they are doomed. Pray that they're not diabetic so that they're still able to have the surgery. As for changing their eating habits, I just refer them to OA. Without the surgery that rarely works.

Vis a vis what JJM said. There really is no need to take rectal temps when the patient is able to responsibly use an oral thermometer. It's not more accurate. It doesn't need to be accurate anyway. The reading doesn't need to be accurate to three significant figures. Trends in fevers can be followed with the method used. Yes it should definitely be used in infants, small children, stuporous or comatose patients or those too impaired to take an oral temp. With the latter however, the better part of valor is often to use an ear thermometer although these can be inaccurate.

My mother was a pediatric nurse, who always took rectal temperatures on her patients- and us. That also included a few 18-22 year olds, who were placed in pediatrics, due to shortages of adult beds. Mom saw nothing wrong with rectal temperatures at any age, even in our twenties. My future husband even found this one out. Whenever when she was sick, she insisted on a rectal temperature. When I was older, she would tell me how to shake the thermometer down to 96 degrees, as well as how to Vaseline the bulb end. She would examine it, hand it back to me, before undoing her pants or pajama bottoms. Once they were down, mom would go bare bottoms up in the Sims position, which facilitated insertion and holding in place for 5 minutes. Unlike us, she never seemed to blush!

As a critical care nurse I can say I have never taken any family members temperature rectally. Oral or tympanic is fine as others have mention there really is no need to take rectal temps when the patient is able to responsibly use an oral thermometer. Its not critically important as in Intensive care or High Dependency Care ( we mointor all our patients using a rectal temperature probe or a urinary catheter with a temperature port ).