How do I get my caring back?

  1. I've been a nurse for about 10 years, 2 1/2 in the ER, and ever since I've started in the ER I've noticed something. I am really a less compassionate person.

    I started in oncology and was great at caring and not taking it home with me. I held hands while people died, hugged grieving family members, etc... Now after working in the ER, I have to admit I act like I care but feel nothing inside. I look at people as if to say "I'm really trying to show you I care but don't give a **** inside". I think this is terrible!! What is wrong with me? I honestly think the September 11th incident has contributed to it. I was initially stunned, then just refused to watch the TV or even think about it so I wouldn't be upset. I swear I've turned into some kind of complacent robot.

    I noticed the problem today because one of my friends, his wife and both her parents are currently having major health problems, and I don't know what to say that is of any comfort. These are people I have known for a long time and dearly love. And I feel like I have a heart of stone. This isn't like me at all, but I can't make myself care. Has working in the ER done this to me?? Any insights would be greatly appreciated.
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  2. 16 Comments

  3. by   l.rae
    l know exactly what you mean....l am a 22yr exp nurse..last 2 1/2 in ER...l don't know if it is a defense mode or what....how much energy and emotion would you have to spend to ''care'' about sooooo many things that are unfixable....l mean will crying and worrying help??? yes this concerns me too..l thought it might be burn-out...but...is there a lot going on at home??? maybe alot of stress there just depletes your reserves....l know it does mine....l also find it hard to care about other things..not nursing related...lately....??depression???...any health issues...l too will be anxiously awaiting replys on this thread.....LR
  4. by   Amberkat
    I've worked in a peds ER for a year now. I can't say that I don't care, but it's definately hard to feel real emotion for every patient I see in a day. We're one of the busiest ER's in the country (adults included) and I may see 36 patients in a 12 hour shift (6 rooms, turnover about every 2 hours). Hundreds if I'm working in triage. It's hard to feel something for every one of them. I think it's also a defense mechanism. If you get emotionally involved in a patient you're only going to see for a few hours max, you can't do your job. It's not to say you can't have empathy, which is different from caring. I look at people all the time and think "glad it's not someone I love", and "too bad these people are going through this" but I don't feel much emotion towards the actual people.
    I think oncology is a field where you really get to know the people you are treating. Coming from a field like that, I can see how you would feel like you have a heart of stone. I really don't think you do, it's just a very different environment. I wouldn't correlate your current family situation (the friend with health problems) to your job in the ER. Depending on what's wrong, you may just be at a loss for words. It's not to say you don't care.
    It sounds like maybe some counseling could help you out. I went through some of the same things when I started in the ER as a new grad. I had a few counseling sessions that really helped me get some insight. Best of luck to you!
  5. by   teeituptom
    Howdy yall
    from deep in the heartf of texas

    1> list and evaluate all the stressors in your life

    2> determine which need to be dealt with, and which can either be ignored completely or at least shelved for a while.

    3> prioritize you needs

    4> see a counselor

    5> stay away from meds, alcohol etc

    6> sleep regularly

    7> exercise regularly

    8> PLAY GOLF, beating the **** out of those little white balls makes me feel so much better. Or some reasonable facsimile
  6. by   Tiiki
    All I can think about..is that maybe the ER is not the place for you. I was sent to a neuro-rehab floor when I injured my back. This was quite an adjustment from the acute medicine floor where I was used to working. I found myself quite lethargic, uninterested. I actually dreaded going to work. I knew I wasn't giving the care the patients deserved, I was giving them the necessities, nothing more. I transferred to the ER when my back healed. It was like a rebirth for me. I adore it!! I am happy, I love the challenge, I love going to work, and best of all, I got my caring back!!! I want to be the best damn ER nurse there is. I try to give each of my patients the personal touch, so they know they aren't part of an assembly line.

    Ski....have you thought about another type of nursing?? That was the answer for me.

    Good luck!!!
    JO-ANNE
  7. by   hoolahan
    This has happened to me a few times in my career. I decided each time to take a non-bedside position job. It usually did the trick, I would always end up returning to the bedside. Sometimes you just need to step back.

    You are in a unique situation in the ER. In home health, I can't help but develop a relationship w some of my pt's. I have been there for them, and helped them in everyway I can. Sometimes, I feel like the weight of the world is on my shoulders when I see the sad situations that some people have to live in/with. And I also get tired, like this weekend, having to track down a pt who they couldn't find all week. My feeling is, look, they were feeling good enough to be out of the house all week, why are we putting them on the weekend schedule. What makes them think that the person will be home on the weekend, I'm talking those who don't have a job.

    Please send me to people you know are home. I don't mind going into a drug/gang neighborhood, but damn it, it better not be for a wild goose chase!! I found myself thinking I wish I could quit my HH job totally once I start my worker's comp CM job, but I want to be sure I made the right decision, so I want to stay per diem for a bit longer.

    Anyway, my point is, that you cannot form bonds in so short a time, and sure you get tired of hearing yet another female come in with "cramps." You are seeing so many uneducated and ignorant people in the ER who use it as their primary physician, naturally it's frustrating.

    But, the thing about your post that is telling to me, is that you are finding it difficult to feel for close friends. You are afraid to form bonds b/c 9/11 has made you realize how tenuous relationships can be. You may actually be suffering from PTSD. I really recommend you talk with someone, a professional, about it. Maybe you can start with your employee assistance program. They usually will pay for like 6 counseling sessions. If you don't trust them, then read a bit about ptsd.

    I did an inservice on PTSD after 9/11, and this web site is fantastic. See if you see yourself in the signs...
    http://www.ncptsd.org/

    ((((((((skibum))))))))
  8. by   Faby
    hi. I think it's normal since in ER we are in contact with death and pain all the time . I've been in ER so long and then passed to ICU for about 4 years, and I dind't notice until I began to study at the schol of art. The sensibility exercises we did made me see how hard and tough I was toward all the emotional things in life from colors to pain, death, etc. I think it is a kind of mask that we create to cope with the situations. it isn't bad at all, it is neccessary in some way, if it doesn't disable you caring to your patients.
  9. by   ceecel.dee
    I think some of that is actually healthy...maybe not the heart of stone, but not personalizing every case.

    Our hospital/community is small, so there is a good chance that you know the person or at least know of him/her, which makes it very hard to not care. It becomes emotionally exhausting if you have a busy ER day, to give such personal attention to each and every patient (it's hard to give much energy and TLC to the ear infection kid who goes to preschool with your neighbor's kid when you have just stabilized and air-ambulance transfered your kids teacher who's heart is infarcting right before your eyes.)

    What I'm trying to say is, it may be survivial. However, if you don't like yourself (complacant robot comment) in that dept, time for some introspection.

    Did you love your job more as an oncology nurse? Did you like yourself more in that role? Maybe it is time for a change....the beauty of a nursing degree is it's flexibility. Positive thoughts and good luck to you!:kiss
  10. by   teeituptom
    Howdy yall
    from deep in the heat of texas

    I think plaing more golf is a good idea
  11. by   MollyJ
    I DO AGREE that Tom's rules rock.

    I think ED nurses are feelings supressed. (As a former one) you just don't have the time to deal with all the emotional stuff that comes your way, so you don't. Tom's list is actually a reality based way to do that.

    As I moved out of the ED and into other forms of nursing, I was confronted by the fact that in the ED, you saw the "tip of the iceberg" signs and symptoms of some really sad stuff. As I worked public health, I came to realize that the people I saw in ph were often the same people I saw in home visits. The same in case management and most recently in drug abuse prevention.

    In the ED, you sense the sadness, but it's in the background and in the foreground is all the work and the people yelling at you and your own priority list. So you suppress it.

    I wish nurses did more support groups. I think it would be good for experienced and new nurses. However, support groups need to be balanced against the need to simply get away from work, not work OT and have a life independent of being a hospital nurse. When I was a hospital nurse, that's what I did: no time for hobbies, no time for community or church participation, (and especially on nights) just an unending search for "enough" sleep.

    Sooner or later, feelings will out. I think that is alot of what people do here; they process their feelings.

    But like Tom said, SPORTS is a great way to cope with feelings.
  12. by   teeituptom
    howdy yall
    from deep in the heat of texas

    Thanks for the kind words ms molly
  13. by   schrandt
    First of all Tom, I love reading your replies. I too, have experienced this feeling of uncaring. I think I know where it came from. I lost 2 very good friends to retirement last year and have felt adrift ever since. The new younger nurses just can't relate to some of the things (life stuff) that I discussed with the other 2. I am old enough to be their mother, and I honestly think I threaten at lest one of the new ones-simply because of longevity. This is part of the reason I have worked my fanny off to put myself in the position of becoming qualified to teach. At this point in my career, I feel I could make more of a contribution to nursing. In our small hospital, there just is not any room to move up the ladder & I just hate the feeling of being stuck in the same rut. Thanks for a place to vent.
  14. by   AngelGirl
    Hey, Tom!

    I made a list of your rules for stress reduction. Plan on using it personally. Thanks!

    The idea of nursing support groups is a great one. Apparently that's the crux of this Website. I find it extremely therapeutic!

    Thank you all.

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