Dysphagia Faux Pas

I work with a hypothetical patient who exhibits severe dysphagia. He is hypothetically my first silent aspirator. He is also just a mind-trip. On some days, he is a real pill (for understandable reasons). On other days, he is easy to work with. Unfortunately, he did not make a delightful first impression with any of the therapists (OT, PT, nor ST).

I was quite surprised when I saw him yesterday b/c word up and down the unit was that he got into it with the PT in the AM, so the PT's student was extremely reluctant to work with him. MC sent me in alone with the tip, "Just don't let him walk all over you." When I saw him, he was all charms. Imagine my surprise! The other day, we barely chatted; he rushed through the OME so he could kick me out. But yesterday, in b/t OME, we talked about the places he's traveled to and his favorite countries to vacation at. It is seriously hit and miss with this guy.

Today, when I saw this hypothetical guy, I casually asked him, "So, have you eaten lunch yet?" (1) He politely said, "No, not yet." I exclaimed in shock, "What?! You haven't eaten yet? It's already 2 o'clock!" He shrugged. Me and my big mouth kept pushing, "Did you not want to eat?" He shrugged again and finally responded, "Well, I can't." "Huh?" (I am infamous for my obvious facial expressions, too.)

"I'm not allowed to eat."

Dude, it finally got through to my thick head that I had just committed the hugest dysphagia faux pas. Here I am, interrogating a guy that is on tube feeding (NPO - nothing per os) with a trach who cannot wait to get back to eating. I was mortified!

I apologized profusely for that faux pas right when my MC walked in. Fortunately, she fessed up that even after 14 years of experience, she still makes that mistake from time to time!

The "best" part was that this person was so nonchalent about it, and I even graciously commented on how he was so "nice" about it.

Sometimes, I wonder who's the patient and who's the therapist.

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(1) In retrospect, this question cracks me up! I have totally become "acculturated," but sometimes, I think that maybe it's just that I've "assimilated" to the American culture (and that I'm truly a FOB). The other day, BSILF commented on how Chinese/Taiwanese people greet with, "have you eaten yet?"

It just struck me today that I've been doing that a lot! IDK why I use it as a conversation starter when I'm working.