Compassion....Why is it lacking?

widi96 · Apr 21, 2008

Sounds like you're right about not being able to keep your mouth shut and that you are pretty judgemental of people you will soon be joining the ranks of. There are more decisions that go into when a patient can receive meds other than they want them. I had a patient last night who was crying she said her head hurt so bad (still talking on the phone with the TV on) who had Dilaudid ordered q4 hours, but her blood pressure, even with IVF going at 75, was SBP in the 80's-90's. I spoke with the dr about her ongoing pain and low bp and there was nothing else he was willing to give her for a HA. The patient told everyone on the unit how horrible we all were for not treating her pain (we were still giving her 0.5-1 of Dilaudid Q4 with some Ultram inbetween). So yes, there may be a few nurses out there who are slow on pain relief, but make sure you know the whole story before you start picking a fight with nursing in general.

handyrn · Apr 21, 2008

First and foremost I will say that, yes, there are some nurses that lack compassion. That being said, I think there are so many more things to explore before just saying that these nurses are not compassionate. First of all, are the patients drug seekers? Remember, not all drug seekers look like homeless people. Is the patient being released tomorrow without pain meds and needs to be weaned off? Do you know that it is the proper time for the patient to have the pain med? Have you asked these nurses why they are waiting to give the med before posting here? There could be valid reasons but all you are seeing is the interpretation that they just have no compassion. Don't get me wrong, people do need pain medications, but every situation is different and what you have described is a generality that one cannot give a fair and objective answer to.

bagladyrn, RN · Apr 21, 2008

I've been working as a student nurse for the past couple of months and will soon graduate. I've seen nurses that lack compassion and it's really disturbing. Some nurses want to hold back pain meds until there dammm good and ready to give them. I've seen pts throwing up in pain...and still, the nurse takes her sweet little time or wants to take her break first. This makes me sick! Is this some kind of control issue that nurses have??? I'll say one thing....it's going to be very hard for me to keep my job because of this. I'm one who can't and won't stay quiet!

If you don't want to have to look back someday and cringe at the things you have said, promise yourself that you will spend the first year of nursing observing before critiqueing others. You can still practice as you see fit, but take the time to really understand before you talk.

As said above, there can be many reasons experienced nurses take the actions they do (and yes, some may truly lack compassion, but not the majority). Some of the nurses who may seem the "toughest" or harshest to you may be in reality the most caring and those who are quietly doing the most to insure the wellbeing of their patients, even if it means making that person "unhappy".

RedhairedNurse, BSN, RN · Apr 21, 2008

I knew the whole story on this pt. I wasn't being judgemental, I was witnessing a nurse that chose to go on her break before getting this pt out of her vomiting pain when her pain med could have been given. I also see nurses who will gossip about pts and and how they hate the "needy" ones. I just can't believe what I've seen and heard. To me, it's very sad. I hope and pray that these nurses are never in a situation to have to rely on some one such as themselves.

RedhairedNurse, BSN, RN · Apr 21, 2008

If you don't want to have to look back someday and cringe at the things you have said, promise yourself that you will spend the first year of nursing observing before critiqueing others. You can still practice as you see fit, but take the time to really understand before you talk.
As said above, there can be many reasons experienced nurses take the actions they do (and yes, some may truly lack compassion, but not the majority). Some of the nurses who may seem the "toughest" or harshest to you may be in reality the most caring and those who are quietly doing the most to insure the wellbeing of their patients, even if it means making that person "unhappy".

Thanks for the advice. I will observe and try to learn.

mamason · Apr 21, 2008

As long as the pt could have recieved the pain medication without it compromising their stability or if enough time has passed for the next dose, then, the nurse should have given the med before going to lunch. I remember being taught in school, "You are not the one feeling the pain." "Pain is internal and is preceived differently by everyone." Just my 2 cents. I do agree with the other posters with their analogies of the situation. There are very good reasons why we nurses withhold pain meds. The majority of us do not do this so we can be mean or in control. A lot of times it has to do with safety. Or as other's have stated, manipulation by the pt. I think you've obtained a great learning lesson from your clinical experience. :wink2:

chenoaspirit, ASN, RN · Apr 21, 2008

I work with a few like that. I agree with all the other posters though, that there are situations and reasons to with-hold a pain medication such as low bp, dose time, weaning, drug seeking, etc. But I do work with 3 nurses who will refuse to give pain meds because they are in the middle of eating a snack or because they want to rate the pain for the patient. One nurse in particular felt that if a patient was able to go smoke, they didnt need pain meds. I walk everyday in pain, but to look at me you wouldnt know it. I smoke and use smoking as a way to cope. But you need to focus on the quality of care that YOU are providing and not so much on what other nurses are doing. You sound like you have a good base to start your career (caring). Good luck to you.

correctlywrong · Apr 21, 2008

As a nurse who is frequently complimented by patients and their families, I have often wondered about what I do differently than the nurses on my unit who receive mostly complaints instead. Compassion is the big difference.

Most nurses care deeply about their patients. Two or three of the ones on my unit will admit that they don't. They are in the profession for money and if they don't burn out early, they will at least be moving on from our unit sooner than later. Where I and other nurses are requested by patients, these few are dreaded, and patients ask not to be assigned to them again. The unit director does take notice of that.

It is important to be professional in dealing with these things. It is important to give your colleagues feedback in an assertive way. Share the thought processes that lead you to empathize with the patient, in hopes that you can help that other nurse grow as a professional and develop the compassion that guides you. But don't be surprised to find that some people who enter this profession are not emotionally suited for it. Do your best for the patients in your care and take comfort in the knowledge that nursing is too demanding a profession for those who truly lack compassion to succeed in the long run.

casi, ASN, RN · Apr 21, 2008

I think the nurses that burn out quickly are the ones who care too much. They'll put their patients needs before their own and take home all of their patient's burdens.

A good nurse is able to say "before this, I have to pee" or "before this I have to eat" or they can ask for help too.

pagandeva2000, LPN · Apr 21, 2008

If it is deemed safe, I try to give pain meds to the patient as soon as possible. In terms of compassion, unfortunately, sometimes, a nurse has to prioritize, and what looks like a lack of concern, it is actually that the nurse is trying to concentrate to give care to each and every one without making mistakes. I had been accused of that a few times, but they didn't understand the circumstances. I work in a hospital clinic that serves a population of patients who have no health insurance, so, the daily volume is HIGH. It is not a surprise that many have waited 4 or more hours for a visit.

Once, I called a demented, elderly patient in who had to be sent to the ER immediately for a blood pressure of 240/132 even after two doses of clonidine 0.1 mg STAT. While rechecking vital signs and giving report to the ER nurse, another elderly patient barged into my room and demanded to know when she would be called. I told her that as soon as I finished, I would check to see where her name was. She asked me what was wrong with the patient I had, that I was 'taking too long with her'. Meanwhile, the demented patient was becoming agitated, and I had to speak to this woman with force to get her to leave the room (she actually came all the way inside of this room and would not leave). The woman wanted to report me to the clinic manager because of the way she felt she was treated, however, I had to concentrate on this woman whose congnitive abilities were diminshed, make sure she didn't stroke out while waiting to be transferred to the emergency room, explain to her what was happening in terms that she understood and respect her privacy. I knew that the other patient has good reasons to be upset, but it didn't change the fact that I had to complete that transfer to the ER. No matter what, this clinic will always be crowded. I still have to practice safely, in spite of the circumstances.

racing-mom4, BSN, RN · Apr 21, 2008

I worked this weekend with a 20+year exp nurse who was gripping about my pts yelling out. My pt had an abdomen distended 3x normal size, had major cirrhosis and various open wounds in multiple stages of healing. This sr nurse said " I just have a hard time taking care of people who did this to themselves". r/t pts alcohol hx.

At one point sr nurse said "we may need to play bad nurse-good nurse, but this yelling has got to stop, I am not going to listen to this all night". FYI my pt was partially sedated, his yelling was more of a chanting, he was not yelling on purpose he was hurting. I told him the yelling was not the problem the fact that he was in pain was the problem, deal with the pain and we will solve the yelling.

I had to remind sr nurse we are paid to do a job, that job is to take care of people and it doesnt matter why they are in the hospital.

FYI after a call to the Dr, and some position changes pt quited down.

Also might want to note, this nurse is the exception to what I normally work with. As a whole I do not see nurses lacking in compassion, I may see them get stressed and we as a team need to jump in and help when that happens.