Read on Twitter
This month a nurse went directly to my attending without speaking to me and told my attending that I was being unprofessional with a patient and let me tell y’all — that HURT.
A thread
1/10
A thread
1/10
For HIPAA sake, I won’t use any details other that teen girl with concern for pregnancy. I love these visits and they are truly my ED 
and 
. When chatting and developing rapport, I use a line from a certain Cardi B and Meg The Stallion song, referencing “pull out game”. 2/10
and . When chatting and developing rapport, I use a line from a certain Cardi B and Meg The Stallion song, referencing “pull out game”. 2/10
We all chuckled, the history and physical continues, all is well and at the end of the ED visit, the teen’s mom asks if I can be her PCP, which unfortunately, I told her I cannot. 3/10
Was using this phrase the most professionalism I’ve ever exuded? Absolutely not. Would I say that to just any mom and daughter? Definitely not. I read the situation and deemed the level of conversation to be appropriate to be more casual, considering the chief complaint. 4/10
More importantly, I want to break down WHY we think talking about “pull out game”, “cum” or other colloquial terms are unprofessional. 5/10
In medicine, we act as gatekeepers to medical understanding by using language with patients that is indigestible. It is a system build to exclude patients by using nonsense jargon that is intended to intimidate and make them complacent in their care. 6/10
In my note will I use “pull out game”? Absolutely not. But when talking to a teenage girl, I want medicine to be focused on her, her comfort, and her understanding of her body. “Pre-ejaculatory withdrawal” just isn’t the same. 7/10
Sometimes, that means I have to toe the line of professionalism, use street terms mixed with medical terms for patient understanding. Sometimes, I will accidentally cross the line. 8/10
As a new doctor, I have very few practices I will stand by, but this is one — I would rather be too conversational in 100 rooms than make 1 teen girl feel confused about her body/care for the sake of seeming “professional”. Plain Languge is the hill I choose to die on. 9/10
Lastly, it really hurt that a nurse my age went to my attending with her concerns rather than addressing it with me. I hope I can work on being more approachable so that if anyone in the healthcare team feels uncomfortable, we can talk peer-to-peer for better feedback 
10/10
10/10
Lastly lastly, please forgive all of the typos along the way. I will be eternally mortified by them but I am so appreciative of y’all’s feedback on this thread 11/10
11/10
