It's long, dangerous, but worth typing, to me! - page 3

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   leslie :-D
    Quote from cyberkat

    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.
    exactly, kat. (i'm thrilled to see you again.)
    i just don't want to downplay the op's frustrations...
    that it doesn't matter who they are, but rather, what they're doing is problematic.
    i've had problems with every type of pt imaginable.
    all backgrounds, weights, ethnicities, etc.
    it would be impossible for me to find any common grounds.
    more important, it doesn't matter to me.

    leslie
  2. by   Nightcrawler
    Quote from 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!
    I understand your frustration, but I would ask if you notice the unreasonable demands of the obese and addicts because they are more demanding as a group, or because the cause of their illness bothers you so much? Perhaps you are more understanding of demanding patients that did not "choose" to be sick? I know that I have my own biases when it comes to patient care and that I have a much shorter fuse when dealing with this type of patient.

    I think that the problem lies more with workload and acuity than it does with individual patients. If you do not feel that you have enough time to spend with all of your patients, then you need to work within the system to create safer patient loads. If you are correct that the obese and the addicted are the most demanding of patients, then there are only going to be more of them hospitalized over time, not more. There are more obese, even morbidly obese people every day, and meth is a growing crisis. Rather than becoming burned out, we need to work on the system to recognize the complex social care that we are providing to these patients and to include this in acuity assignments. At one hospital that I worked, patients over 400 pounds were given extra acuity points because of the number of staff that it took to safely care for them.

    If we do not work within the system to promote safe staffing, nurses will just continue to get burned out and seek new careers. As acuities continue to increase and patients come in with more and more complex problems, we need experience on the floor, and we need to do what it takes to care for the patients and not drive nurses away.
  3. by   nursingisworkRN
    Frustrations understood. I think that as nurses, we are encouraged to be supportive and understanding, and that we are frowned upon if we speak up about certain pts.

    If you find that this situation has become a daily thing and it is starting to affect you adversely, I would probably suggest a change. Have you considered another area of nursing?

    I have had similar experiences with "difficult" pts. I have found that the combination of being understaffed, overworked, scheduling problems, rotating back and forth between days and nights, no resources/preceptors available, lack of team work, and high level of acuity has started to affect me poorly. I stay late at work, don't sleep well or enough, have not been running/exercising, and cancel plans with my friends b/c I am so tired, and as you stated, my back HURTS! I have a change of venue next month, and am so excited for just something DIFFERENT.

    Plus, I lack the patience and tolerance for the folks who feel it is okay to throw a tray at me because of???? never ok to throw things at me, unless the pt is demented/ can't help it and then anything goes.

    And yes, having a pt back who was discharged the day before who fluid overloaded themselves AGAIN b/c they ate a bag of potato chips?? And has the nerve to tell you who completed their chf core measures with them that "I didn't know I couldn't eat that. You never told me." Zero accountability. ALWAYS FRUSTRATING.

    LOL-I also think a gentle swift kick to the rear that is well meant and well placed is effective. Many pts push the limits b/c they can. Sometimes it is necessary to remind someone that they are in the hospital, not a hotel, and some of their freedoms are limited here because they have direct adverse effects on their health. CHF/DM/PE is not getting a donut and a smoke break. And no, I am not sorry it hurts when you breathe if you take your heparin gtt into the bathroom to smoke. GIMME A BREAK!
    Last edit by nursingisworkRN on Oct 14, '07
  4. by   pagandeva2000
    I have been an LPN for a bit over a year, and while I do still have a love and passion for nursing, I am burned out as well. I am more mentally, physically and spiritually exhausted than before when I was an aide with less responsibility. I developed plantar fasciitis, and many times, my feet are literally throbbing, in spite of the orthotics I use. When I get home, I escape by reading and looking at documentaries. I don't care to get together with family and friends as often, and I am always on the make for more money since LPNs don't get paid as well (yet, I don't wish to become an RN). Therefore, I have agency work on the side when I am off, which pays better, but makes me more tired.

    We do deal with unappreciative families, patients, administration and policies that police the nurses for silly reasons. I do understand that we have more narc-seeking patients, obese and sicker patients than before (or it may be in my case, that I am more responsible for them). More time is taken into covering our butts than it is focused on the actual patient, making it worse. I do feel your pain. These days, I just cherish the ones that do say that I made a difference, may it be patient or co-workers. And, I make it my business to rest when I have time off, and do not deal with unnecessary drama when I am off of work.
  5. by   AlwaysTired
    I work in crisis stabalization drug/alcohol detox and deal with addicts daily. As a matter of fact I just got home from a very frustrating 12 hour shift and the patients were particularly rough today! And yes I get very tired of their demanding, manipulative, downright mean behaviors but am I one of the few who actually see these people as being very sick?? Addiction (drugs,alcohol,food,etc) IS an illness. Yes, they chose to partake in the behaviors initially but there is this invisible line they cross (or a black hole that they get sucked into) and experimentation or pleasure seeking or whatever the initial thrill is turns evil, ugly and dark and the behavior becomes uncontrollable by a sick, unhealthy body and mind. I wish I could explain it better; it's an abyss of some sort and no healthy, well person would choose to look like these people, smell like these people, and in most cases act like these people. I just have to take a step back and realize that. And yes, they deserve great nursing care too. If you can't have at least a little compassion and sympathy for the most nasty, hateful, smelly, overweight, abusive patients then I'd say nursing isn't the place for you. It didn't say in my nursing oath to only care about and tend to those who treat me (and themselves) kindly.
  6. by   Babarnurse
    I am disgusted by the OP. I hope like heck she never has to battle the demons of addiction. If she does, I hope her nurse is not as judgemental as she is.
  7. by   pagandeva2000
    Quote from AlwaysTired
    I work in crisis stabalization drug/alcohol detox and deal with addicts daily. As a matter of fact I just got home from a very frustrating 12 hour shift and the patients were particularly rough today! And yes I get very tired of their demanding, manipulative, downright mean behaviors but am I one of the few who actually see these people as being very sick?? Addiction (drugs,alcohol,food,etc) IS an illness. Yes, they chose to partake in the behaviors initially but there is this invisible line they cross (or a black hole that they get sucked into) and experimentation or pleasure seeking or whatever the initial thrill is turns evil, ugly and dark and the behavior becomes uncontrollable by a sick, unhealthy body and mind. I wish I could explain it better; it's an abyss of some sort and no healthy, well person would choose to look like these people, smell like these people, and in most cases act like these people. I just have to take a step back and realize that. And yes, they deserve great nursing care too. If you can't have at least a little compassion and sympathy for the most nasty, hateful, smelly, overweight, abusive patients then I'd say nursing isn't the place for you. It didn't say in my nursing oath to only care about and tend to those who treat me (and themselves) kindly.
    I understand your points, that all people deserve nursing care, but, I think it is healthy to voice concerns and to be honest with ourselves in the safety of a forum such as this as long as no harm has come to the client due to negligence because of our personal biases. I don't believe that a people who admit to themselves that they have private issues with a certain group of people that nursing is not for them. Maybe they need to transfer to another unit where the number of those certain patients are less, but, it doesn't mean that this person or others are not effective, compassionate nurses. It may come from frustration of not knowing how to reach them that is the problem.

    I remember in nursing school where a professor stated that we have to come to terms on how we feel about certain issues before we walk into the patient's room quickly. This means saying to ourselves what and who we don't like so that we can be ready to interact. She used the example of a woman having an abortion. We may not agree personally, and may not participate in the actual termination process, but when we walk into that room, we have to first say to ourselves "Okay, I totally disagree with what she did" but then walk in there and do what we have to do for them NOW.

    I KNOW that I am no saint or Florence Nightengale...I can easily admit to myself that many of my patients get on my LAST nerve. I will be as thorough as I can when caring for them, but, I can still walk out of that room and be glad that the session is over.
  8. by   leslie :-D
    Quote from Babarnurse
    I am disgusted by the OP. I hope like heck she never has to battle the demons of addiction. If she does, I hope her nurse is not as judgemental as she is.
    sorry you feel that way.
    i think it's very natural to vent about our very demanding pts.
    anyone who says that it doesn't bother them-ever-is not being honest with themself.
    i'd much rather hear someone vent, rather than keep it inside, and eventually explode.
    we have a darned tough, tough job.
    and to pretend that we're a bunch of Mother Superiors, is bunk and very unrealistic.

    leslie
  9. by   bagladyrn
    I can sympathize with the OP's sense of frustration. I also have days when I am frustrated by entire groups of pts. However, I usually do realize that I am being judgemental, even when I only hear myself making these statements in my head.
    I think however that to begin to denigrate pts. because of their behavioral choices which you see as resulting in their disease, is a slippery slope. How is condemning the person who is obese or addicted different from those providers who rejected and condemned HIV positive pts. "because it was the result of their lifestyle choices"? Thank goodness we don't hear THAT one so much any more!
  10. by   pagandeva2000
    Quote from Babarnurse
    I am disgusted by the OP. I hope like heck she never has to battle the demons of addiction. If she does, I hope her nurse is not as judgemental as she is.
    I don't think that the OP was being judgemental, I see her as venting. If she was being negligent or abusive that would be a different issue altogether. Of course, we don't know that, but, many nurses do feel this way. It may also be that she is furstrated because she feels ineffective on how to deal with these patients as well as her feelings about them.

    Quote from earle58
    sorry you feel that way.
    i think it's very natural to vent about our very demanding pts.
    anyone who says that it doesn't bother them-ever-is not being honest with themself.
    i'd much rather hear someone vent, rather than keep it inside, and eventually explode.
    we have a darned tough, tough job.
    and to pretend that we're a bunch of Mother Superiors, is bunk and very unrealistic.

    leslie
    I agree with you, Leslie. No one is a saint. We each have our own issues because we are HUMAN. Nurses have opinions, emotions and frustrations the same as anyone else. And, we need a safe place to vent our frustrations. This is not to say that we may not face opposing opinions; we take the risk of being judged ourselves each time we open our mouths to people. However, I can safely bet that all of us have walked away from situations angry as heck.

    And the issues are that with the mountains of paperwork, unsupportive administration and uncooperative co-workers, it is easy to burn out even if it was not our intent. Also, this nurse is speaking from her personal observations, experiences and interpetations drawn from them. I know I am no nun...
  11. by   2shihtzus
    Originally Posted by Babarnurse
    "I am disgusted by the OP. I hope like heck she never has to battle the demons of addiction. If she does, I hope her nurse is not as judgemental as she is."

    Lighten up Babarnurse. There is nothing wrong with venting, and I totally understand where she is coming from. I had a patient that weighed over 600 pounds and was furious that she was placed on a cardiac diet. Did it alter the way I took care of her? Of course not, but I am not going to adopt a holier-than-thou attitude about it either. Additionally, if I ever feel that I am becoming complacent towards certain patients (addicts or obesity or both), I will find a different field of nursing.

    Im sorry, but I do feel that in MOST circumstances, obesity IS a choice. I think that so called "food" addictions are on a totally different level from chemical addictions.

    You know, it seems like no matter where we go, there always has to be one or more people that will try to make you feel ashamed for being human.

  12. by   pagandeva2000
    Quote from 2shihtzus
    Originally Posted by Babarnurse
    "I am disgusted by the OP. I hope like heck she never has to battle the demons of addiction. If she does, I hope her nurse is not as judgemental as she is."

    Lighten up Babarnurse. There is nothing wrong with venting, and I totally understand where she is coming from. I had a patient that weighed over 600 pounds and was furious that she was placed on a cardiac diet. Did it alter the way I took care of her? Of course not, but I am not going to adopt a holier-than-thou attitude about it either. Additionally, if I ever feel that I am becoming complacent towards certain patients (addicts or obesity or both), I will find a different field of nursing.

    Im sorry, but I do feel that in MOST circumstances, obesity IS a choice. I think that so called "food" addictions are on a totally different level from chemical addictions.

    You know, it seems like no matter where we go, there always has to be one or more people that will try to make you feel ashamed for being human.

    The day that it is unsafe to vent is the day that nursing will really become unsafe. If we cannot vent SOMEWHERE; it gets pent up inside, because we don't wish to be judged by our thoughts. This leads to further frustrations, and, it may ultimately lead to us being so wired up with anger that a patient does actually suffer behind the frustrations and anxiety of the nurse. THEN...there is a problem.
  13. by   Babarnurse
    Since when it is wrong to express an opinion? What is this...I can only play if I agree with what everyone else is saying. That is a bunch of crap. I stand by what I said. yes, I have had those days and yes, I have felt that way to a certain extent. However, I don't single out one or two specific groups and voice my frustration. The OP doesn't know jack about them, what happened in their lives, etc. No one here does either. Don't judge someone else until you have walked in their shoes. No one knows why people make the choices they do.
    Last edit by rn/writer on Oct 15, '07 : Reason: Language.

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