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- Jun 25, '10 by highlandlass1592Quote from apocatastasisI've walked your walk, still do. I totally understand. It's a difficult situation to be in, we give so much to our patients, work so hard to help them live to find it all get thrown out the window. We get emotionally involved with their families, see them at their good and worst, try our hardest to impact their lives. ECMO, IABP, dialysis, multiple pressors, working like a dog to keep them alive for one more shift, not even taking time for a bathroom break of our own. Why, what's it all for?Hi all.
I got my RN license at about this time last year, right after I started working as a GN at a downtown San Antonio ICU. It's a SICU but we see a wide variety of medical/surgical/cardiothoracic patients. We generally have very high patient acuity. Lots of drug abuse, non-compliance in the face of multiple comorbidities, repeat offenders leaving AMA and coming back a day or two later, etc.
In some ways and on some days, I love working as an ICU nurse. I'm finally able to more or less independently care for the sickest patients that we get. Vented patients, balloon pumps, septic shock pts, CABGs, managing multiple drips, CRRT, RRTs and code blues, I do it all and the rush keeps me going.
But although I do my best when it comes to particular patients, I feel like I generally just don't care anymore. Without even going into the issue of how hospital administration and doctors' attitudes get me WAY down... patient-wise, I see the same things day after day after day. People who don't want to learn, don't care about their health, don't care that our team snatched them from the jaws of death. And then I read about the pertussis outbreak way over there in California. And then I think about my dad, who has years of untreated HTN and refuses to see a doctor and is probably gonna end up as a STEMI on a balloon pump.
And then I think, why do I bother? Why am I busting my ass and breaking my back for you, mister 34 year old, 800 pound, 6 cigarette pack a day CABGx5, when you're gonna go to the nearest McDonald's immediately upon discharge and eat 8 big macs? Or you, the violent, intubated 22 year old heroin overdose with seizures and anoxic brain damage, with a history of being intubated following heroin overdose and hemodialysis since the age of 15, whose insane mom is sneaking in opiates behind my back and screaming that the benzos we're giving him for sedation are killing him.
I feel like I used to care about my patients. Sometimes I still feel like I do. No matter my attitude on any given day, the job always gets done. Some days I go home and I'm proud of my work. I said goodbye to my alert/oriented patients in the morning and wished them well, and I really meant it.
But then there are the bad days where I go home, have a beer, put my head in my hands. And I feel like an empty human being because I don't care about people anymore, entirely dread having to go back to work tomorrow, and wonder what the point of all this crap is.
Sorry, I just had to vent. Thanks for reading.
I've found this helps me: it's for that one patient who, when all is said and down, actually makes it through it all and comes back and says to you "thank you for saving my life. my wife (husband, parents, etc) told me all you did for me and how hard you worked to keep me alive." that thrill you get when you see that person walk thru the door, that person the doc said would never live let alone walk again...and see all your hard work pay off. If I wasn't there, that might not have happened....that patient may not have made it. I MADE A DIFFERENCE IN ONE PERSON'S LIFE. And for those patients who won't make it, I make sure to advocate that their last time on this earth will be as comfortable as I can make it, making sure that NO ONE on MY shift will die alone...I'll find the time to stop and hold someone's hand as they pass from this life into the next. The time to tell them it's ok, I'm here for them as they leave this earth. And as they leave, knowing I did all I could for them....that is some small way I hope I've impacted their life in a good way.
I've just learned over the years you have to take the victories where you can and stock them up...keep them in that special place in your heart you take out when it seems like nothing is going right, nothing you do matters.
Let me share an experience that happened a few years ago: I was working in a neuro surg ICU as a travel nurse. Had a patient who was a Jehovah's witness, who ended up infarcting her spinal cord due to blood loss and the resulting low BP's. The doc was angry that the patient wouldn't accept blood and started to berate her. I pulled him off and told him he couldn't do that, she understood the risks and it was against her religious beliefs to take blood and he needed to respect that. He stormed off. I ended up spending a lot of time that night, time I didn't really have, comforting her. She was facing a life of lower extremity paralysis. She was scared, anxious..you name it. I told her to rest, I'd be with her all night and would see that she was taken care of. Well, my shift ended and I was off for a few days after that. She was discharged to a different level of care and I went on to my next patients.
About 4 months later, I was shopping at a local mall one day when I heard someone holler "nurse! Nurse!" I turned around and there was my patient from that night. She was in a wheelchair, barreling across the food court to get to me. She said to me something I've kept in that precious place in my heart: "You made a difference in my life that night. I was scared, lonely and worried for what my life would turn out to be. And that night, you talked with me till I went to sleep. And every time I woke up, you were there...making sure I was ok. I felt truly safe with you caring for me, knowing you'd be there to see that I was fine. You helped me more than you can ever know." At this point, I was crying like a baby and she was too. This precious woman, who had been through hell on earth remembered me. And she stopped enough to share that with me. I gave her a huge hug and wished her well as she continued her recovery and literally floated out of that mall. I will never forget that woman and I came to realize that doing what I did...trying to be the best nurse I could be influenced people in ways I may never be able to measure or initially know about.
On those dark nights, when it seems nothing can go right....I remember that patient. And find the strength to go on. Hang in there, everything you do affects your patients even if it seems like it doesn't. You may be planting the seed that will cause them to make positive changes. Hugs to you.
- Jun 26, '10 by newrn05I can totally understand. I have been a nurse for 5 years. I work med/surg, tele, stepdown. I have seen a lot of the same issues and drama's. Had one the other night. I kept saying to my self why bother.
Remeber this: You will make a difference to someone almost every day. You may not see the effects or be told. Your patience, understanding, caring touch will matter to someone. It might not be a patient but a family memeber or a teenager in the hallway who you didnt know was watching.
Sometimes I have to remember the lil things to get by.
- Jun 26, '10 by CareteamRN70Still a student myself (only for 3 more months God willing), but as a tech (cna) working in a neuro/behavior unit I had more then enough experience with patients that didn't seem to want to "get with the program". Without being able to lose my ability to care and see the patient as a unique person, I was able to go on autopilot. I saw my patients still as people and treated them as such but my mind would go analytical and see them as broken machines..I could still offer care but shield myself from the worst of the sights, sounds, smells by doing this. I have been told by instructors this is a uniquely male ability to deal with the stressors of patient care and that it can be good or bad depending on how much I let the patient slip from my view as a unique individual.
"My" other probloem I joke about is I am trying to get comfortable with patient education when i really am probably the last person to do so on some subjects...I am overweight...I have no idea what happened to that 180 lb marine I was back in the day...I think I have a parasitic twin that grew and added another 90 lbs. I still smoke, but am down to half a pack a day. The only areas I feel comfortable with are substance abuse (aside from smokes) becuase i don't really drink or do narcotics. I feel guilty about my weight at times and now see losing it just isnt for my own health but to set some example for those I educate (Hard to tell a patient to cut down on the fatty foods when it looks like Ive been breast fed by a pork chop).
- Jun 26, '10 by casiAs I told a nurse last night "You can educate the patients until you are in blue in the face, but if you get to the point your turning blue it's time to give up."
I was the bad nursing student who frequently told my smokers, "I know that to quit smoking is a hard decision to make and is something you have to be ready for. If you are interested I have information I can give you."
I hate pushing lifestyles on people who have probably heard it a hundred times. People don't make changes until they are ready to.
- Jun 26, '10 by apocatastasisThanks to everyone for the words of advice and encouragement. I'm heading back to work tonight. I've been considering a change in scenery... and for now I'm taking a deep breath and looking forward to doing my best. It's all that can be done. Hugs to all!
- Jun 26, '10 by CranberryMuffinQuote from AWanderingMinstralExactly what I would suggest.In brief, I understand the O.P.'s feelings. I think all of us do. My suggestion is to try a different specialty. Maybe a pediatric ED? You won't be rehydrating 7 y.o. drunks... Or, how about public health? Having served in the Peace Corps, I really feel that you will feel like you're making a difference when working abroad (CDC, Doctors Without Borders, WHO, etc.). Good luck and chin up!
There are tons of different things you can do with your background and experience, different areas of nursing you can try. You might be surprised to find that you enjoy a different area of nursing that you never thought you'd like.
Also, if you can do some volunteer work in your community or abroad, it might help to see that you can truly make a difference!
- Jun 27, '10 by BackfromRetirementIt has been said that water seeks its own level.The serenity prayer helps.
- Jun 27, '10 by maria28Quote from apocatastasisI'm glad to read that you are giving it another go. And +1 to all the wonderful input from the contributing posters.Thanks to everyone for the words of advice and encouragement. I'm heading back to work tonight. I've been considering a change in scenery... and for now I'm taking a deep breath and looking forward to doing my best. It's all that can be done. Hugs to all!
If I could impart a small nugget that I gleaned when I thought the world was filled with nothing but utter hopelessness. It's not much, but I find it helps me cope with a broken world, filled with broken people. I hope it helps you.
I once had a conversation with a wise friend of mine who was a social worker, (who later switched to medicine) that was brief but very enlightening regarding service delivery, be it health care, community development or financial guidance services.
She told me that ours is not to impose our agenda on our clients. We cannot reasonably expect those who *OUGHT* to know better, actually know better. Similarly, we cannot reasonably expect ourselves to ensure that people - who by their own admission, via acts of omission/commission, thus are their *OWN* agents - somehow turn it around overnight, or, if ever. We can only ensure that we have done all that we can do in that precise moment and in that particular place.
People will always run around chasing windmills with their swords and hubris,and will almost always fall upon them.
Please don't allow circumstances of other people's choices impede your desire to help people. You ARE helping people when you clutch them from the brink of death. You are doing a fabulous job. (Although, I'm sure you already know that ) You have fulfilled your end of the bargain. It is up to them to decide whether to continue on the path of recovery/self-extraction from cycle of systemic violence.
May you find peace and clarity in whatever you decide to do.
- Jun 27, '10 by NCLEXaddictx3I feel that in any job, whether it is nursing, waitressing, construction, singing...etc., there are goin to be the ups and downs of the job. I feel that the original post is something that many nurses can relate to and the honesty is incredible. The one thing about nursing that one should consider is that there are so many options...I would think about maybe going PRN on your floor after finding another job that you might feel more appreciated. You do care, because you would not have written such a long post about your feelings. I hope some of what I said and others brings you comfort. I, personally am awaiting board results and loosing my mind.
- Jun 29, '10 by Yosemite, RNVent in here and to your close friends who do NOT work where you work. You're not alone in resentment! We all have coping mechanisms, you just have to find yours that, hopefully, are healthy!
Me? I'm old and jaded!