First and foremost I'd like to say, I really do love my residents! But I often wonder, what is considered professional and what is not, where do we draw the line? I give hugs often when one of them is feeling down, a pat on the shoulder/back/arm (can you imagine the kids you raised just dropping you off one day and only visiting for 15 min once a week-month?!). I try to say goodnight to everyone when they get "tucked in"/with HS meds (3-11 shift), and honestly sometimes even finding myself saying things like "if we didn't love you we wouldn't need to do this" (safety issues, IVs, medications etc.). Hoping I'm not alone here, but def curious where you all consider that magic line is drawn. And I don't mean a DOH/state survey line, I mean a warm comfortable home-like atmosphere while still being a professional nurse - line?
This is something I've also been struggling with lately. I'm a hugger. I let residents take my arm, kiss my hand, and tell me I'm loved. That's why I'm in the field. I'm told I'm the best by residents and families because I don't just monitor numbers and side effects but mind and spirit, too. Nursing homes aren't great places, but if I can bring a little sunshine with the medpass- I'm making the world a better place.
On the other hand, sometimes "being there" for the residents takes it's toll. They can become overly dependent on caring staff to coddle them when they need to learn to buck up a little. I actually had a mini-mental breakdown last night when I had worked a double (Rehab unit 1st shift, 30 residents on my regular ltc unit Pm shift) I don't normally do Pms so I didn't have the flow memorized.
Yesterday sucked absolutely (seems to be the whole 210 bed facility lately). There was a readmit at 5pm, accompanied by her 2 very sweet but very anxious daughters, she had constant emesis upon arrival until I left at 2am, she had a new stage II pressure ulcer on her coccyx, open area to abdominal fold, and irregular pulse, hypotension, and orders would not be finished for her until 8 pm. The NP wrote a bunch new orders for 8 people at 3pm, causing pharmacy to keep stealing my MARS and have me sign for new meds, pulling cartriges etc (all during the 1700 medpass) a lady who arrived 2 days ago is actively dying but fairly comfortable, another just arrived a week ago and is confused and ****** off and risking a fall with her behaviors, another was readmitted 1 day ago and c/o burning, his shower check revealed a host of scratches to be documented, another shower check revealed a new stage I/II pressure to rectal area, another lady started coughing with blood while family present, an obese lady who fx her arm 2 weeks ago is on the light q 15 minutes c/o pain (crying "I want to die) but no interventions (ice, perc, fentanyl patch, repo, 1:1) will work and she is barely eating now- her daughter is extremely anxious.
Yes I had flights of suicidal ideation that night/day. I eventually went in at 1030 put a patch on my favorite resident Fred, and started to just break down. It felt SO cathartic to just tell someone "I can't do this. I'm stretched so thin, there's too much work for one person to do safely, I don't even feel like a human sometimes." He said, "Honey, you'll get through this." He had tears in his eyes as he listened to my story. And reached out for me like a real Grandpa would and hugged me. It was such a genuine feeling that someone cared about how bad of a day I had. Cared that I was hurting. Just 5 minutes made me feel so much better, let me blow off steam and feel like a human for a second. I also think Fred felt good having the opportunity to talk with me- a sense of purpose if you will.
I don't know if I can do this my whole life (i'm one year into the nursing career). I think I'd like to be my own boss someday, run some kind of business. I love the elderly and know that they need better care than they get in this cold-hearted god-forsaken healthcare industrial complex.
Last edit by Naturess on Apr 12, '12