Self-Care or Bust
A pressure is building up near my temples and my face is becoming flushed. I nod again at my patient's daughter, although I have stopped listening to what she said about 20 minutes ago. My chest is becoming tighter as I realize that I am late for my next patient.
My thoughts start racing as I realize that I am supposed to be at my next patient's home already. I have so much charting to do, I think to myself. "Oh my god I am drowning," I mumble so no one can hear as my eyes start to well up with tears all while still trying to appear professional and smile. I look at my patient just sitting and rocking, quietly in her giant, green chair that appears as though it is swallowing her. I glance over then at the daughter whose lips have not stopped moving for what seems like an eternity and nod again. She incessantly taps the pen she is holding on the notebook in her lap. I start to spiral and envision myself ripping the notebook and pen from her hands (why do they all have a notebook?) and writing in giant letters, "I am not here to correct your childhood, fix your divorce, or change the fact that your dog is dying! I’m the nurse!" And then envision myself throwing it across the room and walking out the door.
I have to change my patients dressing and perform an assessment and go. Somebody help me.... I look at the clock again and then decide to just start my tasks as she keeps talking. Right leg arterial ulcer dressing changed. Vital signs done. I interrupt the daughter who is now talking about some type of competition her son is in, and begin asking questions to my patient. "Any pain? Bowels ok? Urinary issues?" All no's. I look over at the daughter and tell her kindly that we will address her issues regarding her mom throughout the episode of care and assure her as a team we will take good care of her. I ignore all of what else she said that is not in regards her mom, my patient. She shakes her head annoyingly and puts her notebook down. "That’s it?" She says.
Can't solve all of your life's problems in a day, I think.
"I will be back on Wednesday," I say and smile while saying my good byes. I walk out the door down the stairs and jump into my car. I look over and the daughter is standing on the porch just staring at me. I wave and smile and race to my next patient.
My day doesn’t get much better from here. Many days are like this one as a visiting nurse or any nurse for that matter. Racing to patients, the phone is ringing incessantly, emails are piling up, and charting, oh my god, the charting. We are all drowning. I think the number of patients that we are expected to care for in one day and let's not forget, chart on them, although we would like to; The ratio may be actually 5 minutes with your patient and 45 minutes to document the 5 minutes that you spent with them to complete your day in 8hrs with no overtime. I would love to say that I am exaggerating ,and I may be slightly off, but not by much.
I arrive home after my last patient and a fender bender later. I wasn’t paying attention as my phone was ringing and vibrating incessantly which caused it to fall down in between my seat and the console. Love when that happens! I looked down for a brief moment and tapped the car in front of me who was stopped at a stop sign. Best day ever. Now home and time to make dinner and help with homework. My son asks why I am so cranky as my husband and he both look at each other and shrug their shoulders when I don't respond. I am looking for a pot in the cabinet and moving things around with a little more force than necessary mumbling to myself trying to refrain from snapping at them. If I am really honest at that moment I would have liked to throw a pot across the room but I some how managed to practice self-control. I envision myself being hauled off to the psych ward if I had acted on any of my impulses of the day and this manages to keep me restrained. I use this tactic often. After dinner, homework, three arguments about homework and then a temper tantrum, thank heavens, it's bed time. I open my computer and stare at the screen realizing that I have about two hours of charting left to do and a never ending column of new emails to look at. My head hurts again and I start to cry.
This is just too much...
I know that I did not become a nurse for days like this. I do not think that any of us did. While this day is in fact fictional it is all to familiar. I have spent many days like this. Too many.
We became nurses to provide excellent care to our patients and never want to feel we are rushing them, not to them and not caring. Our job is to care and that is what a patient expects from us. I think, however, that they sometimes expect a little too much or maybe we as caregivers, or the medias portrayal of us, mislead them in to thinking we can provide much more than we can. We cannot solve all of your problems. We are not sponges that are going to absorb all of your issues while smiling compassionately and mastering a grand plan to make it all better. I feel like as a nurse and a woman, that is what not only what my patients sometimes expect, but my own family I feel thinks my very existence is for at times. This is why it is vital in this profession to have a consistent plan for self-care and to practice it. We need to think of ourselves as priority number one so that we can be all of these things to our patients and families to a certain degree while being our own best friend also. I know that so many days I feel like I am just mediocre in all of my life's roles as I have so many of them. Don't we all? How do you thrive in all of them? It seems impossible, and I feel like I am drowning and want to give up far too often. I know that this feeling worsens especially when I have too little sleep, am not eating right or not getting any exercise… All of the things that I need to do for me to stay on top of my game.
A self-care plan is something therapists have been using for years with patients to help them achieve a better and more balanced, rewarding life. Many good self- have a variety of components in them that are important in our everyday lives for balance. These can include workplace, spiritual, relationship, psychological and physical categories.
But you can create a custom plan for your specific needs making it as small or large as you see fit. For example; the workplace component could include setting up boundaries and attending professional development groups. In the physical component, it may be important for you to have to go for a walk at lunch time and to remember to use your vacation time. The emotional piece may be something like writing down 3 things that you are grateful for each night. There are many options and no limits. Also, there are so many places online to get ideas from. Taking the time to sit down and create your own care plan is the first step. You do it every day for others. It's your turn You are worth it and you will be better in all that you do for it.
Dianne Cabelus Braley is a registered nurse residing in Hamilton Massachusetts. She has a lengthy nursing background in critical care and emergency and surgical medicine. Dianne has spent the bulk of her career in home care and is now a nursing supervisor at nursing agency north of Boston. Dianne also holds specialty certifications in aesthetics and nutrition.
Joined Jul '17; Posts: 5; Likes: 7.Aug 11Take 3 minutes every few hours to close your eyes, breathe deep and slow, and envision the Napali coast on Kaua'i. You're swimming with wild dolphins. They treat you like one of the pod. Be your inner dolphin, it feels great! You'll open your eyes refreshed and ready for the next few hours.