I'm sick of taking care of people who don't care

leslie :-D · Mar 19, 2009

An important part of fulfilling the role of nurse is being nonjudgmental. Yes, we educate our patients. The reality is, you can lead a horse to water ,but can't make them drink based on many many factors. It may be simply noncompliance, there may be others factors.
How would you feel if you were being judged based on others preconceived notions that you were given the educational now why are you doing what you learned. Remember when you were a new grad, heck you had the education, how well did you function in reality.
My point is this. We do not walk in our patient's shoes. Diabetes is very serious, being over weight is also very serious. Have you stopped to think of how expensive it is to live a healthy lifestyle and to eat the proper nutritious foods? Not to mention paying for the glucose strips. Why do you think so many diabetic patients do not test their sugars 4 times a day. If you take the time to really know your patient rather than sit in judgment you might very well find out they cannot afford to test their sugars more often. They cannot afford a well balanced meals. Yes, easy to judge, easier to get mad when people are sitting in judgment of you.

funny, that i didn't read firestarter's post as particularly judgmental, per se.

i didn't pick up on anything contemptuous or hostile.

rather, i sensed a whole lot of fatigue and resignation...

as she said, burnt out.

i was saddened to read her post, for firestarter has always been extremely passionate about her work and exemplifies everything a superior nurse should.

i find it even more interesting that we have x amt of threads, wagging our fingers at the obese, smokers, and addicts.

yet when firestarter clumps these groups together, she's being judgmental.

hmmmmm...

maybe i'm being hypersensitive, but i'd be more inclined to show firestarter some support, rather than judging her.

something's going on with her, and would be the first one in line to offer my love and support.

anyways, when i'm on top of my game, my pt's shortcomings don't bother me at all.

it's only when i'm approaching burn-out, that i notice my attitude is slipping and is symptomatic of something worth investigating.

and yes firestarter, i do understand where you're coming from.

it's really unfortunate when pts think so little of themselves, that they make their lives one long suicide mission.

i hope you get your spark back...and you know i mean that.

leslie

Atheos · Mar 19, 2009

What I see is a health care system that rewards irresponsible people. They do what they want and we all foot the bill. Look at octomom. There's no repercussions for her, nor for that stupid IVF doctor.
I see nothing wrong with calling it as it is. We need more tough love in this country with everyone. Our health care system needs to start emphasizing the responsibility aspect of the rights/responsibility code.

I don't particularly like Octomom myself. However, what is a good repercussion?

Health care and health care providers are in no position to enforce 'responsibility.' Are you suggesting we refuse to treat people until they behave? I agree she should be stuck with the bill but are you going to be able to enforce that? Deny medical care until all their bills are paid? That's not going to work very well or go over well.

Plus, everyone already suffers repercussions from their behavior. Death.

The only way to truly make people responsible is to start leaving people out in the cold as far as health care goes. Who gets to make that decision?

If we ban all irresponsible people, all those unwilling or unable to pay and anyone else engaged in behaviors we disagree with then that's going to live a large portion of the population out in the cold.

This being a Republic, those people are gonna get disenfranchised and force change that may leave the responsible ones out in the cold. Neither situations are viable or acceptable.

ETA:

Leslie

Many of us ARE on life long suicide missions. I call it the suicide layaway plan.

Nothing anyone does is ever gonna be able to stop it.

lpnflorida · Mar 19, 2009

Actually my comment was not directed at the original poster. It was a generalization to whom ever it fits.

DeepFriedRN · Mar 19, 2009

I am in no way suggesting that people shouldn't be treated, or that when I do treat them I would be anything but respectful. I don't think firestarter was suggesting that either. However, the way I read it, she was expressing a level of frustration at the lack of personal responsibility that exists in people. I'm sure every single person we treat has a reason/excuse as to way they engage in an unhealthy lifestyle. I'm sure some of these reasons are very valid. I'm equally sure that some of these reasons are BS. Look, I used to smoke. I have some great excuses--I started very young (when I didn't know better), I was very stressed, and i was very addicted. I also have asthma. So, are you all saying that since I have these very valid reasons, you'd be OK with me continuing to smoke? I doubt it. I quit, because it was the healthy thing to do, even though it was really hard and I didn't really want to. Because it was MY issue, and I had to own it. People need to stop makng excuses about things. It's a reality. So don't tell me (or firestarter) I'm not a compassionate nurse or that I need to change jobs. I am kind and respectful to my patients, and do my best to assist them in whatever way I can. But IT IS FRUSTRATING AND DEMORALIZING AT TIMES. A little support, a little, "hey, we understand, hang in there it's worth it" would be great from fellow nurses. Instead we get, "you're burned out, you need to change jobs, you need to be more compassionate". Super. Thanks.:stone

~Mi Vida Loca~RN, ASN, RN · Mar 19, 2009

That's BS. I go to the super market and see the lower income people buy beer, pop, chips, and other expensive items. That's a tired old argument.
As far as the predictable accusation of being judgmental; that, in itself, is judgmental.
What I see is a healthcare system that rewards irresponsible people. They do what they want and we all foot the bill. Look at octomom. There's no repercussions for her, nor for that stupid IVF doctor.
I see nothing wrong with calling it as it is. We need more tough love in this country with everyone. Our healthcare system needs to start emphasizing the responsibility aspect of the rights/responsibility code.

I just went to the grocery store yesterday, it would have been much cheaper for me to buy the Chips, Soda and Beer than the Oranges, apples, Banana's, broccoli, cauliflower, chicken breast etc. that I did buy. Even cheaper would be to feed my family the dollar menu from McDonalds every night.

I have been extremely poor before where only my son ate many nights. It was much cheaper to buy crappy junk food. Mac and Cheese, Hamburger helper and a 5 lb log of high fat ground beef and so on. Thankfully now I can afford to feed my family a lot healthier. I am not a nurse yet but I see a lot of the points you made in just society period. Although I disagree with some of the posters on mental illness, it can be a very debilitating thing that is almost impossible without a lot of help to NOT let it run your life. A lot of Ins. doesn't cover good mental health care either. Lots of restrictions and limitations.

But I just wanted to comment on the food part. It is cheaper to eat unhealthy than it is to eat healthy. It sucks that it is that way.

Obesity can be an ugly cycle and one that touches me to the core. I get so angry inside when I see obese children walking around with crap, children that are under 10 and weigh more than me and walking around the park with a bag of cheetos and a pop. I mean starving your child is against the law. to me when you TEACH your child this behaviour and are feeding them all the crap and are the cause for them becoming obese. you are abusing them just the same, except your long term killing them instead of shot term killing them. I know not ALL obese children are that way from food, some have genuine medical problems but I would wager to guess those numbers are not the majority. Children as young as 7 already having plaque forming in their arteries. Ok I went way off tangent, obviosly you can see it's a very sore subject for me.

I think something seriously needs to be done for people to be able to afford to feed their family healthier. Some people have the money to and choose not too, but I have met many that simply can not afford to go the healthier route. They need the 1.29 boxes of Hamburger Helper so their kids can have a warm meal at night.

whipping girl in 07, RN · Mar 19, 2009

One of my good friends, who works full time but whose husband is unemployed, has 2 kids and recently went on food stamps and medicaid (for the kids). The first month, she carefully planned her menus and was able to make nutritious meals for her family for the month on the pittance that they give her. The second month, her husband insisted on going to the store instead and bought more junk food, so they ran out of food in about 2 weeks.

Staple items such as beans, rice, and pasta are cheap and nutritious. Canned or frozen vegetables and fruits, which may or may not be as healthy as their fresh counterparts, depending on which studies you read, are not expensive. Most grocery stores put different cuts of meat on sale each week, if you shop the sales you can get good deals. Most people do not live in places where they cannot make it to a store that has sales, at least not in my area. You can trim the fat from the meat yourself. You can cut up the chicken yourself. The less processed food is, the cheaper it is generally. I can pay $7 for a bag of breaded chicken tenders and my family will finish it in one meal. Or I can spend $7 on raw chicken parts and have leftovers. I can pay $2 for a box of Eggos, or I can make twice as many waffles from Bisquick for about $2 or from scratch for about $1 and have some left for breakfast for a couple more days.

If I feed my family fast food, even off the dollar menu at McD's, I will drop at least $15 and usually more like $20-25. I know I can cook more nutritious food at home for much less and usually have some left over to either take to work or feed the kids for lunch the next day. Yes it takes more time but it is worth it.

As far as exercise goes, calisthenics and walking are free! And I've wheeled plenty of "low income" people out to cars MUCH newer and nicer than mine while they talked on cell phones nicer than mine and told me how the hospital cable sucks, they have so many more channels at home with their $200 satellite package (they don't share how much it costs but they don't need to, I know how much Dish and Direct charge). Some people have enough money, they just don't believe spending it on their health is a priority, they'd rather spend it on cigarettes, junk food, electronics, entertainment and car payments. I suppose that's their business, but I'm in total agreement with the OP who gets frustrated. I do too!

willitblend? · Mar 19, 2009

The above is the reason I will work in holistic care, or in the OR, but not really a big fan of the prospect of med-surg or the ER.

To the OP... maybe you should take up something restful and look for a way to get some holistic PT work.. might help you rejuvenate and perhaps transition into something more meaningful and fulfilling.

Best of luck!

Virgo_RN, BSN, RN · Mar 19, 2009

Different people place different values on their personal health. I grew up in a health conscious household, and I am a label reader, I buy fresh fruits and veggies, lean meats, non-animal proteins, and I exercise regularly. I do not smoke and I drink in moderation. We were poor, and I mean poor. Yet we still ate healthy.

I remember most of the other kids I went to grade school with ate sugar cereals for breakfast, had baloney sandwiches on white bread with chips and soda pop for lunch, and for dinner, had Hamburger Helper. Their parents smoked cigarettes and drank soda pop instead of water.

We learn what we live. Yet, at some point, once we are adults and responsible for our own lives, we have choices to make. Some people never gain that insight and choose differently. Some people have an external locus of control, meaning that things that happen in their lives, including their health status, are things that are happening TO them. Other people have an internal locus of control, meaning that they make conscious choices about things that they are able to control, such as what they are going to eat and whether they are going to move their body or be sedentary.

These things tend to be multigenerational. I recall caring for a woman, only in her sixties, who was dying of respiratory failure. There were four generations of women in that hospital room, from the woman's mother, to her daughter and baby granddaughter. Every single one of them, with the exception of the baby, of course, smoked cigarettes and had gigantic cups of soda planted around the room. What do you want to bet that the baby granddaughter will grow up to be a smoker and soda drinker, and will end up just like grandma?

Unless something happens in that child's life to interrupt this cycle, she is a future COPD patient.

It is extremely frustrating to take care of people that are not invested in their own health. They don't want to get out of bed and move, they don't like the diet the doctor has ordered, they don't even want to know what medications they're taking and what they are for. And yet they can be some of the most demanding of patients as well, behaving as if they are owed something by everyone else. It is easy to get burnt out on taking care of these folks.

Yet every once in a while, you get someone who asks questions, someone who wants to know what these pills are, what they should be eating, and who gets up out of bed and wants to do as much for themselves as they can. These people are responsive to my teaching, thanking me for taking the time to talk to them, and are hungry for more information. These people make my heart sing, and is what makes nursing worthwhile for me. This is where I focus my energy.

I offer every patient the opportunity to be active in their own plan of care. But if I can see that a patient is not invested, they're not responding to my invitation to participate, I don't continue to invest myself there. Their demands, unless it is for something clinically important, fall low on my priority list, because I am focusing on those that want to get better, or even those that aren't going to bet better no matter what we or they do, like the little old ladies in end stage heart failure. I love to pamper them.

FireStarterRN, BSN, RN · Mar 19, 2009

Incidentally, my original post wasn't directed at only lower income people, but at anyone who doesn't take personal responsibility for improving their health. We are all paying for the folly of these people, whether they have insurance or receive government assistance of some sort. All forms of pooled resources cost the whole society, driving up either taxes or insurance premiums and copays. Also, there are non-economic costs to the reckless behavior of people.

Tweety, BSN, RN · Mar 19, 2009

Our health care system isn't very preventative, but insurance companies are trying to change that. My insurance company has something going every month at our place of employment that encourages wellness care, rathter than sick care....problem is most of us health care workers aren't even interested.

Most people are decent hardworking good people and when we get sick try to get well, even if we don't diet and exercise like we should. I don't let the non-compliant ones discourage me.

LesMonsterRN, ADN, RN · Mar 19, 2009

I have seen posts on both sides of the issue that I agree with and I can say that I have felt as the OP does from time to time; having said that, even though I know people are going to make bad choices, just as I have at different points in my life, they still need/deserve my nursing care when they become my patient and no matter what my opinion of their health management system may be privately I need to be there for them. It is an intensely frustrating and challenging issue that more nurses than not have come up against, I would guess.

Susan9608 · Mar 20, 2009

I get really burned out picking up after other people's messes, too.

But I still want to be able to make a mess of myself, if I so desire, and know that someone will be there to help pick up my messes.

I guess that makes me a hypocrite. But I'm pretty much good with that, as long as it doesn't get to the point where I can't do my job. So far, it hasn't.