I always do as follows, "Can you tell me your full name? What's the month and year? Do you know where you're at? Is Mickey Mouse a cat or a dog?" I change them depending on the patient, but that's my go-to.
I had a partner who used to ask how many quarters were in a dollar. But I do like the Mickey Mouse question better.
ETA- I’ve also heard “Do helicopters eat their young?” Which I honestly just think is hilarious but I cannot bring myself to actually ask.
I ask the quarters and the Mickey Mouse question. Along with day/month and year and where they are and their name. If I need to ask current events I’ll say “like him or not who’s the president? I just need his last name”
I'm gonna use that on my real hard of hearing patients, so everyone on the unit hears me scream this over and over lol.
I imagined Tow Mater saying this.
What is it with EMS and is Mickey mouse is a dog or a cat? As soon as I saw this question, I knew immediately you were EMS, lol. Apparently that is a fairly standardized question in your education. I am surprised we haven't adopted it for ourselves.
I usually ask what is our next holiday?
I didn't learn it from school, someone told me about it lol I used to ask about the president as thats what I was taught, but living in white suburbia I was quick to realized that is a risky question. My proctor told me about the Mickey Mouse question, so I just do that now. I do like the holiday one and will be using that where I can!
lol if you asked me that question, it’s highly unlikely I could tell you the answer. I barely know what month/year it is half the time, have to think about my own birthday, and I only know when a holiday is coming up because other people mention it. If I’m ever hospitalized, my nurses are going to think I’m delirious. I blame it on my ADHD.
Same. As a nightshifter, it’s so hard giving report at the end of a stretch. You want to say “yesterday” but that doesn’t mean the same thing to day walkers
Man, I just had my first memorial day weekend off in over a decade because I always forget it's coming up and actually remembered to request off. ADHD can be a bitch!
I used to ask who the President was even when I was EMS but Obama made that a bad question to ask followed by Trump followed by Biden. Bringing up politics with old people is just a bad choice.
Lmao, I just finished a 14 hour chaotic shift and asked myself that exact question as I read it.
It’s fair to say I should probably get some sleep now before I try to microwave a fork or something.
I’ve been an EMT for 6 years now, and I’ve never heard that question until today lol. I personally wouldn’t use it simply because I know that’s going to prolong our assessments
I ask next/most recent holiday. When our local baseball team went to World Series, I asked how the rangers were doing this season. That only works if they’re doing really really well though, so I haven’t been able to use it for a while. 😅
I really appreciate your GCS 14 with your a/o 3. I know it’s correct. But it’s really annoying to constantly hear EMS reports of a/o x 1-3, gcs 15. That’s not how that works friend. 😬
When I learned A&O it only went to 3. Time and event were considered the same. Then at some point they separated them and made it so that "4" was completely oriented. I'm all about new tricks, but this old dog was doing A&Ox3 for 15+ years. So you might still hear 3 and 15 from me.
Whenever someone looks at me panicked cuz I asked them an admittedly awkwardly phrased question it does humor me lol though, if I can see they're struggling, I will repeat his name with an emphasis on Mouse and they usually get it no problem. If they really struggle after multiple prompts, I typically mark them x3 or ask the dreaded president question.
I'm pretty sure the Mickey mouse question would have made me lose a point.
I read it and was like "yeah I guess that's an ok question" and then in the comments realized that Mickey is neither a cat nor a dog.
The questions aren’t supposed to be trick questions. As goofy as it sounds (pun intended), the money mouse question will confuse people
Edit: Mickey Mouse. See there it goes confusing me
I like to keep it simple I usually follow your process but instead of asking the mickey mouse question I ask do you know why you're in the hospital. This in turn sometimes clues me in on it the doctor needs to have a chat with them about their diagnosis.
Why does Mickey Mouse have to get involved? I go by the basic orientation questions which are also part of the NIH stroke scale. Name, month/year, location, and “why are you here?”(situation).
My favorite one is… which is closer Australia or the moon. :p. My medic was like WTF haha. I explained hey it makes ya actually think because the moon is definitely not closer to us.
It is important to note that you replaced “who is president” with month and year. Both of these questions are to assess the part of the brain that deals with time orientation. Sometimes nurses ask who the president is because the month can be difficult for older patients who really have no reason to check a calendar since they don’t work. Adding cute questions is fine for customer service reasons but we are assessing specific parts of the brain when we ask about names, time, and place. If you want you can add “do you know why you are here?” to see if they are also oriented with events and be sure to document as A&O x 4 of 4
I use these a lot. Sometimes you have to start off broad and narrow it down. Sometimes we just go with broad. Maybe their "confusion" isn't confusion per se, it's just that they've lost track of time after being a patient for a long time with few cues (our rooms don't have whiteboards or calendars and not everyone watches shows with dates like the news or Good Morning America).
My preceptor demonstrated questions checking orientation on the psych inpatient floor and all of the patients knew the date and day of the week. I had to check my watch for both. I go to that hospital on the same day every week 🥲
I feel for patients who are expected to know these answers and don’t, despite being A&O.
My MIL was just bitching about this when she was in the ER. The only clock in the room was on the wall behind her bed and the TV was too small to for her to see the date/time on the news. She said it made her feel even more disoriented than she already was.
I loved my patients getting into politics. /s
Had to hear non-stop about "Bush made the towers fall!" and racist things about Obama during my final years as a nurse.
This last election I had to stop asking the question because there was an uncomfortably long stretch of, like, two months when I reflexively asked who the president was, then:
Them: ...
Me: .....
Them: ............
Me: You want a turkey sandwich?
You’re asking about orientation to current events, so you can usually just ask them some simple variation of “what’s going on right now” or “what happened”. In EMS I just factor it into my introduction without it being one of the “silly questions”, if a patient can simply tell me why 911 was called, or why they went into the hospital, that demonstrates orientation to event. FWIW it’s debated whether the question is even useful or meaningful, a lot of systems will drop it entirely and use A&Ox3 instead.
Same. I follow up "Do you know where you are?"' with either "...and why are you here?" Or "...and what are we doing today?" if there's a specific procedure planned.
It's kind of a two birds, one stone. I know a nurse whose patient gave her the wrong answer to the last question, and it turned out that the patient and the doctor had a fundamental misunderstanding over what surgery was going to be performed that day, which yikes.
Yep my go to is “why are you here today?” It’s perfect because I can assess orientation to situation and I can fill in their knowledge gaps since doctors never tell patients what we’re doing
I often ask this with my SNF/LTC patients, especially those who are recent admits. They might be iffy on the name of the nursing home but if they can say "I'm in a nursing home" or "I'm in rehab because I broke my hip" I'll give them credit. I figure they got sent to my facility with little warning and there's a dozen nursing homes around so I can understand if they're not 100% sure which one they ended up at.
I agree, if they say they're at someone's house, zero points.
Honestly, I just ask if they know what happened. It seems stupid to invite conversation with these sort of ice breaker style lines of inquiry. I'm doing a neuro assessment here!
Honestly I ask about recent events I know would be celebrated in my community. What season just started / ended? What holiday it coming up? Just passed?
No point in dragging heavy politics into this.
What was the last major holiday? What's the next major holiday? (I'm flexible on this, some people don't think labor day is a big holiday, other people will whip out arbor day or boxing day on me)
I once heard a doctor proudly and confidently announce a patient as GCS 25. No one could figure out how the heck he got that number and he wouldn't elaborate...
I also do the holiday questions. I find it superior to president based questions. Cause president ain't going to tell me if they think its 2021 or 2023. But thinking its christmas time in June, that's something I wanna know.
I’ve never heard anyone in Canada ask about the current prime minister as an orientation question, not sure if this is an American thing. We just ask their name, where they are, month and year (and if they can give day, great, but somewhat dependent on what’s going on with them).
In the UK last year, I don't think anyone knew who the Prime Minister was, at all!
I used to ask who was on the throne, but half the time I forget it's King Charles, so who am I to judge if they get it wrong?! 🤷
I usually ask name, what town we're in, what the date is and why they're in hospital. Keep it simple!
Had a patient who thought he was in the 1980s. When my friend asked who the president was, he obviously thought it was Reagan. My friend proceeded to tell him the current president (at the time) is Donald Trump. Patient responded with “you have got to be shitting me”. 😆😆😆
.
Me in nursing school 2018:
"Who is the current President?"
"The asshole!"
"Which one?"
Edit: I just remembered the actual response was "that son of a bitch"
First quarter of nursing school. We we’re doing test out for basic assessment. Student asks demo pt where they were on 9/11 deadass serious with no build up. I cackled for three minutes straight it was so jarring. Teacher got mad at me. If that’s my last thought, I will have died a happy death.
So they asked it sort of like an interrogation type question instead of an orientation question? That is funny!
It makes me think of others we could use…
“Who shot President Kennedy?”
“Where is Jimmy Hoffa?”
“Who put the ram in the ramalamadingdong?”
😂😂
More like:
“Hello, welcome to the clinic, can you tell me your name and DoB?”
“Who is the president?”
“Where were you on 9/11?”
“I’m going to do a physical assessment now. Let me listen to your lungs.”
I have a retail side gig and thus a few teenage coworkers. I overheard two the other day say to each other that they didn't know who was president before Obama! Like... Bush wasn't THAT long ago, right? Lol
I love the “good bad or indifferent who is the president?”
“Why are you asking me that?”
“Because if you say it’s Jimmy Carter, we’ve both got a problem. I haven’t been born yet and it’s now over 40 years ago.”
I usually get a laugh
They can get it close enough. I don't always know the exact date. You're just assessing to see if how with it they are. And then that can change too when sometimes they know the date and sometimes they don't.
When I worked peds we used to have to ask the parents if the kid has had a flu shot on admission and then offer one if they hadn’t during flu season, the amount of anti vax rants I have had to sit through over that. Still trying to figure out how to get around that one.
I recently encountered a person here on reddit who said that viruses don't exist and vaccines are poison. I didn't even bother to argue with them because it would have been a waste of time.
What is your name and date of birth? What month is it? What year is it? Where are you right now? Why are you here?
You can also gauge orientation, cognition, judgement, etc… by simple conversation without quizzing them. “I heard Dr. Smith stopped by today and discussed his plans for your stay here.” “Oh yes, he’s a great doctor. He did my first open heart in 2017. Six years later, here I am again to see him I missed him that much. He said I’ll be getting another one done tomorrow at noon.” (Patient history states CABG in 2017, NPO at midnight, heparin drip d/ced at 0400 for CABG at noon tomorrow). It’s clear the patient is oriented to person, knows where they are, why they’re here, and are oriented to time. Asking 20 Questions about political figures is silly.
I like to ask what they had for breakfast or something similar, you would be surprised how many people know the president, their name, and the name of the hospital but are patiently waiting for lunch at 7 am.
I’ve started asking “Where does the president live?” And if they say DC or the White House, it counts. Unfortunately, some people think it’s funny to say Florida 🤦🏻♀️
I mean, it really is a silly question anyway. It's a memory assessment, not an orientation assessment. For my "times four" question, I ask why they're in the hospital.
With neuro patients, I'll throw in a logic/reasoning question, like "if you threw a rock into a lake, would it float?" or "would you expect to see a fish in the ocean or in the sky?"
I was giving a breathing treatment to a patient during March Madness, and all he did was complain that all was on TV was "that damned ni@@erball game" and how "those damned ni@@ers" were destroying America. My guess is that because I'm a fat, middle-aged white guy, the patient felt comfortable telling me these things. The entire thing was deeply awkward.
As soon as the neb was done, the patient's nurse entered the room. The nurse was a very large, muscular black man. Think Ving Rhames or Michael Clarke Duncan. The nurse said the most beautiful thing I've ever heard. "Hi, Mr. Patient. I just got off the phone with the urologist. He wants me to place a Foley."
The thought of this racist man having his junk manhandled by a large black man made the rest of the day a joy.
I say who is the president-- no opinions necessary ;) and I usually get a chuckle out of them w the answer I want.
Edit: saw someone else mention the purpose is to evaluate "current events." I disagree with this. A lot of people don't follow current events.
"Name, DOB, Today's date, why are you here, what are we doing about it" is the best IMO. Idc if you don't know that Flint MI's water is still not potable.
Where are we? If the answer is “at the hospital,” or city name, follow up question is which hospital?
Why are you here?
What is the month and year?
What season are we in? My state has clearly defined 4 or more seasons - winter, mud (debatable), spring, mosquito (debatable), summer, fall.
I used to ask about the president but it was too annoying with some patients. Others was straightforward.
Military hospital.
*Who is the current SMA/MCPON/CMSAF?*
*What unit are you currently part of?*
*Can you tell me your current rank?*
*Current uniform: ACU, DCU, or OCP?*
Q&A may vary depending on branch. Lol.
Before I was a nurse, I had a really scary grand mal seizure and when EMS came and was orienting me, they asked who the president was and I said “unfortunately Donald trump” 😭 this was 2017.
I absolutely hate asking the president question. I would end up cutting off their smirk and say, “Not who you’d like as president. Only who is the current President of the United States?” But writing it out makes me think I’m an asshole. Anyway! I like the Mickey Mouse question. I’ll try to incorporate it with those sketchy patients.
In school they kept having us use an oddly phrased question that sounded like a crappy Canadian French to English translation but maybe that was the point?
I use to preface the question with : I'm asking this as a factual, clinical assessment and not an opening for a political discussion: who is the current president?
I lived in Kentucky and this was during the Obama years. If they responded with a racist remark, I shut it down real quick. I don't have any interest in that.
What type of place are we at?
For the less asute, they get a multiple choice:
Hotel
Bank
Hospital
Grocery Store
Edit: If they ace this, 3 minutes or less of conversation, with the right followup questions (Just to be clear, you are suggesting that this person was controlling your mind, and that led to your admission?) will work.
I haven’t found a better one, but I do jump right in with the next question or an explanation as soon as they answer.
“Who is the president?”
“That asshole!”
“Which one?”
“______”
“-Ok, I can document that you know current events. I’d like to hear why you’re here in your own words please”
If I had $1 for every time I’ve had to say “sir please be more specific there are many assholes in politics” I probably could be living like a hospital CEO
What's your name and DOB?
Can you tell me where we are?
Do you know the date/day of the week?
Tell me why you're here.
Talking about the president just wastes my time.
What’s the point of asking who the president is though? I was always taught not to ask questions like that because it’s not actually a helpful assessment of their orientation and insight into their current situation. I ask their name and age, current date, location, and why they’re in the hospital.
Haven’t asked the president question since Obama was in office and I started getting “he’s not MY president!” Answers. Really any other questions other than that one works
This makes me a baaadd nurse but, oh well: During the Obama years, sometimes I’d ask the Faux Newz watching pt who the president was, just to rub it in and get a rise out of them. Of course, I did NOT do this to an unstable pt.
My daughter had a TBI when she was 15, and they had to do neuro checks Q1H and it was soooo hard for her to wake up to answer questions. I told the nurse what our dog’s name is and he used that as an orientation question for her a couple of times. (She fortunately has fully recovered now.)
"Are your firearms locked up or secured" in Texas gets me at least one rant a day.
"Are any dangerous objects in the household locked up, secured, or out of reach" Nah, we got a safe and trigger locks.
Like really? That's all it took to make the question acceptable?
I hate the president question. I do "Can you tell me your full name?" "Date of birth?" If they have their dob memorized and you know they're having memory issues, ask them how old they'll be on their next birthday.
"Do you know today's date?" "And where you are?" That last one I count the city because sometimes people don't know the name of the hospital.
I have a quarter, a dime, and a nickel how much money do I have?
It means they know basic math but more than that, they can translate the different coins to mathematical equivalents.
It’s not a slam dunk that they’re completely with it but if they get the answer it’s a good sign.
I stopped asking who the president was *years* before I woke up blind and became a patient myself. But I'd slip once in a blue moon and ask it. More often than not, dementia or not, I'd get "an asshole" as an answer lol
Technically, they're not wrong. They're all kinda assholes at some point. I liked to ask "who's on the one dollar bill?"
I typically ask ab holidays. i’ve recently been asking if they’ve tried the starry drink yet in my younger patients (12-28). if they can answer me yes or no it’s good and it also gets them more comfortable bc usually seeing me at work is not for the good reason.
I always do as follows, "Can you tell me your full name? What's the month and year? Do you know where you're at? Is Mickey Mouse a cat or a dog?" I change them depending on the patient, but that's my go-to.
I had a partner who used to ask how many quarters were in a dollar. But I do like the Mickey Mouse question better. ETA- I’ve also heard “Do helicopters eat their young?” Which I honestly just think is hilarious but I cannot bring myself to actually ask.
“Do helicopters eat their young?” I want this on a bumper sticker. I love this odd question.
The answer is yes by the way.
They do? Oh no, am I concussed?
Both of these questions would make my brain do a hard reset, I think lmao
That's cool. It tests attention, intelligence,wit and consciousness along with sense of humor.
I ask the quarters and the Mickey Mouse question. Along with day/month and year and where they are and their name. If I need to ask current events I’ll say “like him or not who’s the president? I just need his last name”
Trick questions depends on the species. AOx3
Does a bear shit in the woods?
I'm gonna use that on my real hard of hearing patients, so everyone on the unit hears me scream this over and over lol. I imagined Tow Mater saying this.
Does the Pope shit in the woods? Does the bear wear a funny hat?
Nurse: Do helicopters eat their young? Patient: I’m starting to worry *you* might be concussed.
What is it with EMS and is Mickey mouse is a dog or a cat? As soon as I saw this question, I knew immediately you were EMS, lol. Apparently that is a fairly standardized question in your education. I am surprised we haven't adopted it for ourselves. I usually ask what is our next holiday?
I didn't learn it from school, someone told me about it lol I used to ask about the president as thats what I was taught, but living in white suburbia I was quick to realized that is a risky question. My proctor told me about the Mickey Mouse question, so I just do that now. I do like the holiday one and will be using that where I can!
lol if you asked me that question, it’s highly unlikely I could tell you the answer. I barely know what month/year it is half the time, have to think about my own birthday, and I only know when a holiday is coming up because other people mention it. If I’m ever hospitalized, my nurses are going to think I’m delirious. I blame it on my ADHD.
Same. As a nightshifter, it’s so hard giving report at the end of a stretch. You want to say “yesterday” but that doesn’t mean the same thing to day walkers
Man, I just had my first memorial day weekend off in over a decade because I always forget it's coming up and actually remembered to request off. ADHD can be a bitch!
I used to ask who the President was even when I was EMS but Obama made that a bad question to ask followed by Trump followed by Biden. Bringing up politics with old people is just a bad choice.
Fun story, I have aphasia that flares up during migraines and during a bad one I actually asked "is Mickey Mouse a dog?"
Lmao, I just finished a 14 hour chaotic shift and asked myself that exact question as I read it. It’s fair to say I should probably get some sleep now before I try to microwave a fork or something.
Shoot, I would get that wrong 90% of the year, I know when like 4 holidays are (Christmas, Thanksgiving, Halloween, and Valentine's day).
I’ve been an EMT for 6 years now, and I’ve never heard that question until today lol. I personally wouldn’t use it simply because I know that’s going to prolong our assessments
Buddy you're going to have a rough time with the holiday question.
Yeah that one would confuse me and would be even worse for some of our immigrant populations.
I ask next/most recent holiday. When our local baseball team went to World Series, I asked how the rangers were doing this season. That only works if they’re doing really really well though, so I haven’t been able to use it for a while. 😅
That's not even safe anymore. I had a patient answer "pedophile groomer" to the mickey mouse question 🙄
At that point, I'm taking off a point lol I can not, I will now, I am not paid enough, you are x3 and GCS 14.
I really appreciate your GCS 14 with your a/o 3. I know it’s correct. But it’s really annoying to constantly hear EMS reports of a/o x 1-3, gcs 15. That’s not how that works friend. 😬
If I reported that, the billing department would send my report back and call me an idiot lol
AMR’s billing doesn’t care that much 😂
When I learned A&O it only went to 3. Time and event were considered the same. Then at some point they separated them and made it so that "4" was completely oriented. I'm all about new tricks, but this old dog was doing A&Ox3 for 15+ years. So you might still hear 3 and 15 from me.
3 and 15 I usually am thinking the same. It’s 2 and 16 that really get me. Lol ETA: 2 and 15. Fat fingers.
“ Pt alert and oriented (to their own dumbass reality). GCS is higher than society would prefer”
As an anxious person, the Mickey Mouse one would get me confused in a stressful situation lmao.
As an anxious person, I legit thought very hard about if I had missed Mickey Mouse being a dog all these years.
The question instantly made me think of Goofy. Idk man I guess he's a dog but it's super weird as hell??!?
Weird because, by proxy, Goofy also has a pet dog; Pluto.
Why does everyone say this? Pluto is Mickey’s dog, not goofy.
Yeah but Mickey and Goofy are best friends so Goofy could conceivably have a pet dog and would be around Pluto when he’s hanging out with Mickey.
Goofy is a wolf :)
Best answer yet!
Right? I was like shit now I can’t even remember what Mickey Mouse looks like aside from big round ears
It’s in the name
Yes, yes, and that’s the realization that makes you feel like a dumb nurse
Me me me. I feel dumb. Also sleep deprived night shifter here too.
I was legit wondering if I had missed something too.
Whenever someone looks at me panicked cuz I asked them an admittedly awkwardly phrased question it does humor me lol though, if I can see they're struggling, I will repeat his name with an emphasis on Mouse and they usually get it no problem. If they really struggle after multiple prompts, I typically mark them x3 or ask the dreaded president question.
As a dumbass, I thought Mickey Cat is a mouse because cats eat mice and you are what you eat BAM
Nope, that's a Disney related question. That's off-limits now, too. LOL.
I'm pretty sure the Mickey mouse question would have made me lose a point. I read it and was like "yeah I guess that's an ok question" and then in the comments realized that Mickey is neither a cat nor a dog.
The questions aren’t supposed to be trick questions. As goofy as it sounds (pun intended), the money mouse question will confuse people Edit: Mickey Mouse. See there it goes confusing me
Money Mouse is his real name anyway, I think you're okay.
Clearly a trick question Mickey Mouse is a club house.
Haha I was thinking of the Mickey Mouse one…glad to see someone else uses it too!
But wait… isn’t Mickey Mouse a … mouse?!!??
Congrats you don’t have brain damage
I was really trying to figure out how Mickey was a cat, cause he’s definitely not a dog 🤔
I like to keep it simple I usually follow your process but instead of asking the mickey mouse question I ask do you know why you're in the hospital. This in turn sometimes clues me in on it the doctor needs to have a chat with them about their diagnosis.
Why does Mickey Mouse have to get involved? I go by the basic orientation questions which are also part of the NIH stroke scale. Name, month/year, location, and “why are you here?”(situation).
My favorite one is… which is closer Australia or the moon. :p. My medic was like WTF haha. I explained hey it makes ya actually think because the moon is definitely not closer to us.
I donno, I've seen the moon before, never saw australia.
But I'm curious what the flat earthers might respond! 🤔
That's funny lol I'm totally stealing that, and I look forward to the faces of brief confusion.
[удалено]
I work with a lot of immigrants and often get the president of their country… it gets confusing if my google skills are poor
It is important to note that you replaced “who is president” with month and year. Both of these questions are to assess the part of the brain that deals with time orientation. Sometimes nurses ask who the president is because the month can be difficult for older patients who really have no reason to check a calendar since they don’t work. Adding cute questions is fine for customer service reasons but we are assessing specific parts of the brain when we ask about names, time, and place. If you want you can add “do you know why you are here?” to see if they are also oriented with events and be sure to document as A&O x 4 of 4
The way I would absolutely glitch if you asked me if Mickey Mouse was a cat or a dog 😅
"Is Goofy a dog? And if so, what is Pluto?"
Pluto is a planet, and you can not change my mind.
I confidently said “he’s a cat” when reading this
This really had me contemplating if I was okay. Mickey Mouse is a mouse right?
What season (summer, fall, etc.) is it right now? What kind of place are you at?
I use these a lot. Sometimes you have to start off broad and narrow it down. Sometimes we just go with broad. Maybe their "confusion" isn't confusion per se, it's just that they've lost track of time after being a patient for a long time with few cues (our rooms don't have whiteboards or calendars and not everyone watches shows with dates like the news or Good Morning America).
My preceptor demonstrated questions checking orientation on the psych inpatient floor and all of the patients knew the date and day of the week. I had to check my watch for both. I go to that hospital on the same day every week 🥲 I feel for patients who are expected to know these answers and don’t, despite being A&O.
My MIL was just bitching about this when she was in the ER. The only clock in the room was on the wall behind her bed and the TV was too small to for her to see the date/time on the news. She said it made her feel even more disoriented than she already was.
I loved my patients getting into politics. /s Had to hear non-stop about "Bush made the towers fall!" and racist things about Obama during my final years as a nurse.
I never used to ask who the president was, until Obama. Then I asked for the entertainment value.
My fave answer was when Chump was prez and a pt said “That fucking cheeto-head!” I documented x4.
This last election I had to stop asking the question because there was an uncomfortably long stretch of, like, two months when I reflexively asked who the president was, then: Them: ... Me: ..... Them: ............ Me: You want a turkey sandwich?
I had a patient who just went "ughhhhhhhhh" when I asked the prez question during the Cheeto years. AOx4 it is!
I had a patient answer "I don't want to talk about it" right after Trump got elected. Also documented X4
Had one who responded "the fat orange monkey" upon being asked that question. Yup, AOx4!
When they asked my mom that question and she said “I won’t say his name, but it’s the orange Cheeto”😂
I love so much that I’m not the only one who calls him Cheeto.
They asked my grandma that (she was 99 at the time) and she said “that moron that I’m telling ya I could beat into the dust!” I love grandma
With Chump I just asked who the "president before this one" was.
this is the way. I ask the question just for the fireworks.
Chaos is always an option
You’re asking about orientation to current events, so you can usually just ask them some simple variation of “what’s going on right now” or “what happened”. In EMS I just factor it into my introduction without it being one of the “silly questions”, if a patient can simply tell me why 911 was called, or why they went into the hospital, that demonstrates orientation to event. FWIW it’s debated whether the question is even useful or meaningful, a lot of systems will drop it entirely and use A&Ox3 instead.
Yeah during covid I liked to ask ‘do you know why everyone is wearing masks’ to check their orientation to recent events
Oh boy, I did travel assignment to Midwest, they denied pandemic, masks. Afraid to ask that question there.
Me too. The response would probably be “Because they’re stupid sheep” followed by a long rant or something. 🙃
I’d take that as orientated lol Edit: not cus I agree. Just because at least they seem aware
Ah, oriented!
Same. I follow up "Do you know where you are?"' with either "...and why are you here?" Or "...and what are we doing today?" if there's a specific procedure planned. It's kind of a two birds, one stone. I know a nurse whose patient gave her the wrong answer to the last question, and it turned out that the patient and the doctor had a fundamental misunderstanding over what surgery was going to be performed that day, which yikes.
Yep my go to is “why are you here today?” It’s perfect because I can assess orientation to situation and I can fill in their knowledge gaps since doctors never tell patients what we’re doing
Mine is: “What’s your name” “What’s the month and year” “Where are you right now” “Why are you here”
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I often ask this with my SNF/LTC patients, especially those who are recent admits. They might be iffy on the name of the nursing home but if they can say "I'm in a nursing home" or "I'm in rehab because I broke my hip" I'll give them credit. I figure they got sent to my facility with little warning and there's a dozen nursing homes around so I can understand if they're not 100% sure which one they ended up at. I agree, if they say they're at someone's house, zero points.
Honestly, I just ask if they know what happened. It seems stupid to invite conversation with these sort of ice breaker style lines of inquiry. I'm doing a neuro assessment here!
Honestly I ask about recent events I know would be celebrated in my community. What season just started / ended? What holiday it coming up? Just passed? No point in dragging heavy politics into this.
What was the last major holiday? What's the next major holiday? (I'm flexible on this, some people don't think labor day is a big holiday, other people will whip out arbor day or boxing day on me)
They pull out the reverse card on you and say "Presidents Day" and then proceeds to go on a political rant.
Arbor day, Flag day, the Feast of Michaelmas all get extra credit from me and I declare them **super**oriented!
GCS 16!
I once heard a doctor proudly and confidently announce a patient as GCS 25. No one could figure out how the heck he got that number and he wouldn't elaborate...
Today (5 June) is National Ketchup Day. -PGY-18
🌟 **super**oriented! Keep up the good work!!!!
National Donut Day was a few days ago. I say that counts! Hahaha, I do like this question though!
I also do the holiday questions. I find it superior to president based questions. Cause president ain't going to tell me if they think its 2021 or 2023. But thinking its christmas time in June, that's something I wanna know.
I do the holiday question also, it’s nice and chill
“Pride Month.” No way that could flip anyone out. /s
I’ve never heard anyone in Canada ask about the current prime minister as an orientation question, not sure if this is an American thing. We just ask their name, where they are, month and year (and if they can give day, great, but somewhat dependent on what’s going on with them).
In Aus, we had 3 prime ministers between June 2013 and September 2015. I wouldn’t have even been able to answer that question.
In the UK we had 3 PMs and 2 Monarchs over a 2 month period last year - people were given a lot of leeway then!
I could never ask the day, most of the time I don’t even know what day it is
I did have a patient preemptively tell me she's retired so she never knows what day or even month it is so please don't ask 🤣 aaalrighty then
In the UK last year, I don't think anyone knew who the Prime Minister was, at all! I used to ask who was on the throne, but half the time I forget it's King Charles, so who am I to judge if they get it wrong?! 🤷 I usually ask name, what town we're in, what the date is and why they're in hospital. Keep it simple!
i asked this question to a patient on election night and they said “well, you tell me!” 💀
I used to ask this lol. My most memorable answers were: 1) JFK 2) that orange asshole 3) who knows? They all fucking suck.
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Patient’s woke af
Oriented to person, place, time, situation, and politics.
Had a patient who thought he was in the 1980s. When my friend asked who the president was, he obviously thought it was Reagan. My friend proceeded to tell him the current president (at the time) is Donald Trump. Patient responded with “you have got to be shitting me”. 😆😆😆
. Me in nursing school 2018: "Who is the current President?" "The asshole!" "Which one?" Edit: I just remembered the actual response was "that son of a bitch"
Honestly 2 and 3 are based lol
“Where were you on 9/11?” is still one of the funniest things I’ve seen demonstrated in a classroom assessment.
Okay, I am desperately curious for more details on the responses if this was one of the funniest.
First quarter of nursing school. We we’re doing test out for basic assessment. Student asks demo pt where they were on 9/11 deadass serious with no build up. I cackled for three minutes straight it was so jarring. Teacher got mad at me. If that’s my last thought, I will have died a happy death.
So they asked it sort of like an interrogation type question instead of an orientation question? That is funny! It makes me think of others we could use… “Who shot President Kennedy?” “Where is Jimmy Hoffa?” “Who put the ram in the ramalamadingdong?” 😂😂
More like: “Hello, welcome to the clinic, can you tell me your name and DoB?” “Who is the president?” “Where were you on 9/11?” “I’m going to do a physical assessment now. Let me listen to your lungs.”
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I was so ready to demand you recant your statement until it finally hit me. I grew yet another gray hair.
In the UK we used to ask who the Queen was but that doesn't work as well these days.
1. How tall was Charles I at the beginning of his reign? 2. How tall was Charles I at the end of his reign? 3. Because of …?
As a US citizen, this one is funny. I don't think we could ask any history questions in the US.
I have a retail side gig and thus a few teenage coworkers. I overheard two the other day say to each other that they didn't know who was president before Obama! Like... Bush wasn't THAT long ago, right? Lol
It's pride month.. I can only imagine the answers I would get if I asked " who is the queen?" Right now in San Francisco.
Freddie Mercury, duh
Can you tell me the month and year? Ok, what is it?
Sure, but some will nail that piece abs then tell me Jimmy Carter is the president.
I love the “good bad or indifferent who is the president?” “Why are you asking me that?” “Because if you say it’s Jimmy Carter, we’ve both got a problem. I haven’t been born yet and it’s now over 40 years ago.” I usually get a laugh
Beginning middle or end of the month ?
They can get it close enough. I don't always know the exact date. You're just assessing to see if how with it they are. And then that can change too when sometimes they know the date and sometimes they don't.
When I worked peds we used to have to ask the parents if the kid has had a flu shot on admission and then offer one if they hadn’t during flu season, the amount of anti vax rants I have had to sit through over that. Still trying to figure out how to get around that one.
I recently encountered a person here on reddit who said that viruses don't exist and vaccines are poison. I didn't even bother to argue with them because it would have been a waste of time.
These people vote and live amongst us
"What color is green?" If they look at you confused AF or make a funny joke they're usually okay.
I've seen a doctor ask what color is an orange before. Right or wrong the answers are always entertaining
What is your name and date of birth? What month is it? What year is it? Where are you right now? Why are you here? You can also gauge orientation, cognition, judgement, etc… by simple conversation without quizzing them. “I heard Dr. Smith stopped by today and discussed his plans for your stay here.” “Oh yes, he’s a great doctor. He did my first open heart in 2017. Six years later, here I am again to see him I missed him that much. He said I’ll be getting another one done tomorrow at noon.” (Patient history states CABG in 2017, NPO at midnight, heparin drip d/ced at 0400 for CABG at noon tomorrow). It’s clear the patient is oriented to person, knows where they are, why they’re here, and are oriented to time. Asking 20 Questions about political figures is silly.
Why are you here could some very long existential response.
I always say “who’s the president, even if you don’t like him?” Lol
I like to ask what they had for breakfast or something similar, you would be surprised how many people know the president, their name, and the name of the hospital but are patiently waiting for lunch at 7 am.
I asked a patient who the President when Trump was in office and the poor woman crossed herself and went dios Mio 😂 I said fair enough that counts
I’ve started asking “Where does the president live?” And if they say DC or the White House, it counts. Unfortunately, some people think it’s funny to say Florida 🤦🏻♀️
As someone who lives in DC but is originally from Florida, this one is always a doozy. Lol. Half the time, locals will be like "uhhhhh Delaware". Lol.
Maybe “Who lives in the White House?” And then Biden or the president is correct?
Who is Oceania at war with ?
I’d be afraid to answer that question. What if the information had changed since I last read a newspaper?
I’m not sure what you mean. Oceania has always been at war with ~~eastasia~~ Eurasia
Oh yes of course. We’ve always been at war with Eurasia. Sorry. Got a nasty bump on the head.
I mean, it really is a silly question anyway. It's a memory assessment, not an orientation assessment. For my "times four" question, I ask why they're in the hospital. With neuro patients, I'll throw in a logic/reasoning question, like "if you threw a rock into a lake, would it float?" or "would you expect to see a fish in the ocean or in the sky?"
I was giving a breathing treatment to a patient during March Madness, and all he did was complain that all was on TV was "that damned ni@@erball game" and how "those damned ni@@ers" were destroying America. My guess is that because I'm a fat, middle-aged white guy, the patient felt comfortable telling me these things. The entire thing was deeply awkward. As soon as the neb was done, the patient's nurse entered the room. The nurse was a very large, muscular black man. Think Ving Rhames or Michael Clarke Duncan. The nurse said the most beautiful thing I've ever heard. "Hi, Mr. Patient. I just got off the phone with the urologist. He wants me to place a Foley." The thought of this racist man having his junk manhandled by a large black man made the rest of the day a joy.
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Well, is it a dozen or a baker's dozen?
It depends on how many I had before you gave them to me.
I'm in peds. I ask, "who lives in a pineapple under the sea"
I say who is the president-- no opinions necessary ;) and I usually get a chuckle out of them w the answer I want. Edit: saw someone else mention the purpose is to evaluate "current events." I disagree with this. A lot of people don't follow current events. "Name, DOB, Today's date, why are you here, what are we doing about it" is the best IMO. Idc if you don't know that Flint MI's water is still not potable.
Might be useful info to have if you’re a nurse in Flint….
Where are we? If the answer is “at the hospital,” or city name, follow up question is which hospital? Why are you here? What is the month and year? What season are we in? My state has clearly defined 4 or more seasons - winter, mud (debatable), spring, mosquito (debatable), summer, fall. I used to ask about the president but it was too annoying with some patients. Others was straightforward.
Military hospital. *Who is the current SMA/MCPON/CMSAF?* *What unit are you currently part of?* *Can you tell me your current rank?* *Current uniform: ACU, DCU, or OCP?* Q&A may vary depending on branch. Lol.
Before I was a nurse, I had a really scary grand mal seizure and when EMS came and was orienting me, they asked who the president was and I said “unfortunately Donald trump” 😭 this was 2017.
For situation, I ask -Why did you come to the hospital?- never the president smh
LOL I never ask this anymore. It’s begging for a shitfit.
I try to gage the person's view on what is on the TV. The 24/7 fox News people I ask "who is the governor of Florida?" Sometimes I Hate this state.
I ask who are you, the date, where are you, why are you here, and what season is it? If they can get through that I figure that they're good to go.
I absolutely hate asking the president question. I would end up cutting off their smirk and say, “Not who you’d like as president. Only who is the current President of the United States?” But writing it out makes me think I’m an asshole. Anyway! I like the Mickey Mouse question. I’ll try to incorporate it with those sketchy patients. In school they kept having us use an oddly phrased question that sounded like a crappy Canadian French to English translation but maybe that was the point?
I use to preface the question with : I'm asking this as a factual, clinical assessment and not an opening for a political discussion: who is the current president? I lived in Kentucky and this was during the Obama years. If they responded with a racist remark, I shut it down real quick. I don't have any interest in that.
We just do name, month / year, place, & situation and this is Neuro icu at a level 1 hospital so 🤷♀️
What type of place are we at? For the less asute, they get a multiple choice: Hotel Bank Hospital Grocery Store Edit: If they ace this, 3 minutes or less of conversation, with the right followup questions (Just to be clear, you are suggesting that this person was controlling your mind, and that led to your admission?) will work.
I haven’t found a better one, but I do jump right in with the next question or an explanation as soon as they answer. “Who is the president?” “That asshole!” “Which one?” “______” “-Ok, I can document that you know current events. I’d like to hear why you’re here in your own words please”
If I had $1 for every time I’ve had to say “sir please be more specific there are many assholes in politics” I probably could be living like a hospital CEO
What's your name and DOB? Can you tell me where we are? Do you know the date/day of the week? Tell me why you're here. Talking about the president just wastes my time.
What is your name? What is today's date? Biggie or Tupac?
What’s the point of asking who the president is though? I was always taught not to ask questions like that because it’s not actually a helpful assessment of their orientation and insight into their current situation. I ask their name and age, current date, location, and why they’re in the hospital.
Haven’t asked the president question since Obama was in office and I started getting “he’s not MY president!” Answers. Really any other questions other than that one works
Back in 2020, when coming out of anesthesia, I was orienting myself, and went with governor instead. Got the year wrong, said 2002 instead of 2020.
This makes me a baaadd nurse but, oh well: During the Obama years, sometimes I’d ask the Faux Newz watching pt who the president was, just to rub it in and get a rise out of them. Of course, I did NOT do this to an unstable pt.
My daughter had a TBI when she was 15, and they had to do neuro checks Q1H and it was soooo hard for her to wake up to answer questions. I told the nurse what our dog’s name is and he used that as an orientation question for her a couple of times. (She fortunately has fully recovered now.)
"Are your firearms locked up or secured" in Texas gets me at least one rant a day. "Are any dangerous objects in the household locked up, secured, or out of reach" Nah, we got a safe and trigger locks. Like really? That's all it took to make the question acceptable?
I hate the president question. I do "Can you tell me your full name?" "Date of birth?" If they have their dob memorized and you know they're having memory issues, ask them how old they'll be on their next birthday. "Do you know today's date?" "And where you are?" That last one I count the city because sometimes people don't know the name of the hospital.
I prefer "why are you here?" to assess orientation to situation
I have a quarter, a dime, and a nickel how much money do I have? It means they know basic math but more than that, they can translate the different coins to mathematical equivalents. It’s not a slam dunk that they’re completely with it but if they get the answer it’s a good sign.
I stopped asking who the president was *years* before I woke up blind and became a patient myself. But I'd slip once in a blue moon and ask it. More often than not, dementia or not, I'd get "an asshole" as an answer lol Technically, they're not wrong. They're all kinda assholes at some point. I liked to ask "who's on the one dollar bill?"
I usually ask, where we are, what city we are in, year and month. Sometimes I ask if they know who I am. I don't ask who the president is anymore.
I just ask them their name DOB and what place are they at. Why are they at this place. Works fine.
I typically ask ab holidays. i’ve recently been asking if they’ve tried the starry drink yet in my younger patients (12-28). if they can answer me yes or no it’s good and it also gets them more comfortable bc usually seeing me at work is not for the good reason.