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.
