It's long, dangerous, but worth typing, to me! - page 2

I am posting this because I feel we need to get real! I just realized today why I am suffering from nursing burnout. It's because the patient population has change so much in the past ten... Read More

  1. by   SuesquatchRN
    Quote from missrose
    I apologize for my brutal honesty.... but these patients belong on a psych unit because their diseases are psychologically base. I am not a psych nurse. I don't want to be a psych nurse.
    Well, I would question whether addictions and obesity are choices.

    Beyond that, staffing levels are the issue, not the patients. Higher acuity should mean more staff. And an obese diabetic requiring repositioning Q2o should get more.

    My demented folks are often the most demanding simply because they're high fall risks and they keep forgetting that they can't get up by themselves. Do we cluster them near one another and get an aide to babysit? Noooo. We put on bed alarms and get lectured to about time management.

    Question the system, not the patient.

    Although I will confess that the ones who drive me nuts are often the morbidly obese.
  2. by   Tweety
    I became a nurse to help people get well. I understand the frustrations of dealing with all kinds of patients drug addicts and noncompliant patients as well. I just stick to the basics, take care of them without judgement and try to relate to them on some level.

    Patient populations and their problems change over time. I haven't noticed in increase in sick obese patients, or drug addicts but I have noticed an increase in homeless patients, particularly victums of violent assaults.

    It's hard sometimes but I try to not go there with the "they brought it on themselves so I don't feel sorry for them and like taking care of other patients better" kind of thinking.
    Last edit by Tweety on Oct 14, '07
  3. by   nurz2be
    Quote from Suesquatch
    Well, I would question whether addictions and obesity are choices.

    HUH????? Surely I am reading this wrong. OP didn't say obese patients, who could be obese, to a point, due to genetic issues. The OP said MORBIDLY obese.....Those are food issues and self-esteem issues that bring the majority of those patients to the morbid stage. They CHOOSE not to deal with their emotional issues and turn to food for comfort. They CHOOSE to not deal with their lives and CHOOSE to eat 4000 calories a day while lying in bed. Of COURSE they are going to continue to get larger because they CHOOSE to ignore their own situation.

    As far as if Drugs are choices??????? I would venture to say at least 95% of drug addicts took their first hit on their own and were not Forced, therefore it IS a CHOICE. They CHOOSE to not eat, feed their kids, work, just so they can get their next fix. It is a choice.

    Smoking is a choice. It is an addiction that is very hard to break, but a choice nonetheless.

    Every minute of every day of our lives we make choices. Those choices affect us and others. These nurses who care for those who CHOOSE not to take care of themselves have every right to be frustrated. We could all make better choices on any given day, but it's the ones who are actively killing THEMSELVES that are so frustrating.

    Take a vacation missrose...... those same patient's who choose that lifestyle will be there when you get back, unfortunately.
  4. by   deeDawntee
    I do appreciate your frustration and I totally honor your right to vent as loudly and clearly as you need to on this forum. I have struggled with the same judgments in myself with similar patients that you describe. I have gotten myself in trouble by sharing some of those judgments as well.....

    .....so PLEASE don't take my feedback as being anything but supportive. For me, I have to keep reminding myself that addiction is NOT a 'choice' anyone ever makes for themselves. It isn't easy to deal with the patient screaming for more pain medication or the morbidly obese patient who just wants to eat...but I try to remember "by the grace of God, go I" and know that addiction is a complex, all encompassing illness that makes it impossible for people to act in their own best interest, no matter how much it irritates us as caregivers.

    Do what I did, go work in the ICU, for the most part, if I patient is well enough to use a call-light they are sent out to the floor....
    (just kidding!!)

  5. by   SuesquatchRN
    Quote from nurz2be
    HUH????? Surely I am reading this wrong. OP didn't say obese patients, who could be obese, to a point, due to genetic issues. The OP said MORBIDLY obese.....Those are food issues and self-esteem issues that bring the majority of those patients to the morbid stage. They CHOOSE not to deal with their emotional issues and turn to food for comfort. They CHOOSE to not deal with their lives and CHOOSE to eat 4000 calories a day while lying in bed. Of COURSE they are going to continue to get larger because they CHOOSE to ignore their own situation.

    As far as if Drugs are choices??????? I would venture to say at least 95% of drug addicts took their first hit on their own and were not Forced, therefore it IS a CHOICE. They CHOOSE to not eat, feed their kids, work, just so they can get their next fix. It is a choice.
    You arugment is full of fallacious reasoning.

    "John eats too much. John is obese. If John stopped eating too much he would lose weight. Therefore, he chooses to be obese."

    is as tautologically fraught with error as is

    "John is a man. John is an American. Therefore, all men are Americans."

    And nowhere did I say she didn't have a right to be frustrated. I simply pointed out that the target of the frustration was misguided.
  6. by   EmmaG
    Quote from jojotoo
    I think that I "get it". You don't like to take care of patients that are hopitalized because of something that they have done by "choice". So does that include:

    MVA trauma pt that has injuries R/T not wearing a seatbelt?
    How about if he had a seatbelt on, but was foolish enough not to have chosen a car with airbags? How about if it only had front airbags and his injuries were from a side impact?

    How about a 16yo football player with a C-spine inury? Even though he was wearing a helmet, he did choose to engage in a risky sport.

    How about a young woman who has foolishly vacationed overseas and did not take her anti-malarial medication as prescribed, and now has - guess what - yep, she's got malaria. Maybe she should have chosen to visit Canada instead.

    What about a police officer that gets shot in the line of duty? There are many, many safer occupations he could have chosen.

    Would you want to take care of a nurse that has complications from HIV or Hep B that she contracted through a blood exposure from a patient? Surely she should have been careful.



    Are these ridiculous examples? No, I don't think so. They are all about choices. Just as are obesity and addiction problems. Some are little choices and some are big choices. Some are easy choices and some are hard choices. And what may be an easy choice for you or me, may be a hard choice for someone else. Or vice versa.

    I am 100% positive that I will never need a knee replacement because I blew out a knee playing basketball or from landing wrong while sky diving. These are not my activities of choice. Will I ever need one because I've stressed my joints from being overweight? I hope not, but I'm not as sure.


    I guess I could understand (and agree with) your frustration a little bit more if your complaints were directed at specific patient behaviors than at specific patients.
    Perfect response. I only wish I could "thank" you more than once.
  7. by   missrose
    Thank you for your understanding, advice, and kind words of support! After reading the replies (and after a much needed vacation with family and friends in Montana!) I will return to a new assignment with a better attitude. I have always and will always treat each patient with respect and kindness, regardless of their diagnosis. I do find that the patients who treat me with the least respect are the drug addicts and the morbidly obese. I can't change that, can't fix them, and will remind myself not to take it personally. I just want to continue doing what I've been doing for 12 years.... and that's enjoy being the best nurse I can be! Again, thank you!
  8. by   SW_07
    I work in a psych hospital. I see addicts everyday all day. Some are repeat offenders that stay a few weeks then leave and then come back and just cycle through. It can be the most aggravating thing in the world. We give them the tools to get better, we set them up for counseling to help them once they leave and yet they come back through. With that said, looking into someone's face and seeing absolutely no hope is one of the most humbling and saddest experiences I have ever had. Yes, the choices they have made got them to where they are but choices rarely are why they stay addicted. I have never had a patient tell me "I love being addicted to meth, why would i ever stop". Addiction whether it be to food or drugs or what have you is a sad and tragic thing to happen to someone. It is a disease. Something they can not help. No one smoked meth hoping that they lost their family, lost their job, became homeless, got raped on the streets and then sent to my hospital. We all make bad decisions in our life, not everyone has the built in tools or the know how to get help dealing with issues like self-esteem or anxiety or any other problem in life that could lead someone to be so desperate for relief that they put their own life in jeopardy with food or drugs or whatever it is. Hindsight is 20-20 and recovering addicts have the best vision.
  9. by   confused101
    Missrose I feel you. I work on a floor that deals with the detox pt.'s along with whatever they want to throw up there. You name it I deal with it other than ICU and cardiac drips etc. So, yes the pain seeker gets more attention than the person with cancer with mets. Yes, it frusterates me too. Do I wonder if I have done a good job as I walk out the hospital? Yes, but I did as much as I could with what I can do. I had to take a look at myself and say, I am ONE person, with TWO hands. If three people ask for pain medicine at once. I say I have two people ask before you and I am in the middle of taking care of them. Most people are ok, with just knowing that you have talked to them and know it is coming. Is this everyone NO. Yes, I have the same views as you do Missrose. Take a deep breath and say another day will hopefully different.
  10. by   Katnip
    Quote from missrose
    YES!! The patient who is not hospitalized by an afflicition of "choice" or lifestyle is appreciative of the care they receive! If a patient with a brain tumor happens to be obese, they aren't usually in the hospital because of their obesity, but because of their brain tumor.... you get it?
    I beg to differ. I've had many thin, non-addicted patients who were not appreciative of care, and many obese patients who were. What about the demanding, nasty appy patients? The demanding nasty brain tumor patients? The skinny smoking patients?

    Yes, some people can be extremely frustrating to deal with on a day to day basis, but your lumping two groups of people into a very defined, negative pigeonhole, when it's not always true.

    Maybe you should step back a bit and think this out a little more. There are many complex issues involved in obesity and drug addictions that go beyond simple lifestlye choices.

    People don't choose to become addicts or to become obese. True, they don't always start out making the right choices, but things can spiral out of their control very quickly.
    Last edit by Katnip on Oct 14, '07
  11. by   leslie :-D
    i very much relate to your frustration of dealing w/demanding, needy pts.
    so far though, i have not been able to stereotype any particular population.
    i think the bigger issue is, how to deal w/the demands.

    maybe it's not "nursey", but i don't have any problems telling these pts that i have others that are much more critically ill:
    and i would appreciate tending to all their needs now, rather than running in and out at their beck and call.
    it's definitely a form of limit-setting.
    i let them see i am not happy.

    i don't know anymore.
    i'm really becoming convinced that i am THE nurse monster, because i just don't have these problems.
    once i speak up, there's never another problem (unless they're confused).
    but still, i continue to have awesome relationships with them.
    maybe these pts really do need a kick in their butt? (ever so gently, of course)

    leslie
  12. by   twinmommaRN08
    [/quote]
    Every minute of every day of our lives we make choices. Those choices affect us and others. These nurses who care for those who CHOOSE not to take care of themselves have every right to be frustrated. We could all make better choices on any given day, but it's the ones who are actively killing THEMSELVES that are so frustrating.
    [/quote]

    You forgot to mention that every nurse made the CHOICE to enter this profession and is obligated to give care to those in need. Not to judge their lifestyle and stereotype groups, but to assess needs and look for opportunities to teach and make a difference.

    I don't believe the OP is wrong for feeling the way she does, but IMO it came off as judgemental.
  13. by   Katnip
    Quote from earle58
    i very much relate to your frustration of dealing w/demanding, needy pts.
    so far though, i have not been able to stereotype any particular population.
    i think the bigger issue is, how to deal w/the demands.

    maybe it's not "nursey", but i don't have any problems telling these pts that i have others that are much more critically ill:
    and i would appreciate tending to all their needs now, rather than running in and out at their beck and call.
    it's definitely a form of limit-setting.
    i let them see i am not happy.

    i don't know anymore.
    i'm really becoming convinced that i am THE nurse monster, because i just don't have these problems.
    once i speak up, there's never another problem (unless they're confused).
    but still, i continue to have awesome relationships with them.
    maybe these pts really do need a kick in their butt? (ever so gently, of course)

    leslie
    Well said, as usual Leslie.

    I guess my point was that any patient can be irresponsible and a pain in the tush to take care of. And I do set limits. But I don't cast blame on the patient for being there.

    I've had my share of patients I've had to set limits on, like you so I guess you and I are monsters. And they can drive you nuts, but to me it's because of their behavior in that moment in time, not of what they've done or not done in the past, since I know nothing about their circumstances.

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