thedeeperwell 1,454 Views
Joined: May 22, '08;
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Our mothers often "trigger" us in many ways...but I am wondering about what was really going on with your mother in this situation, and I sense that she was very afraid and unable to talk about it directly. When we are the one--horizontal--in a hospital bed, we can feel very vulnerable and not in control. Your mother may have wanted to tap into whatever power she could to protect herself, so she used your expertise as a sign of specialness or superiority. Her deep fear could have been the source of her comments.
You could have said to the nurses, "Just ignore my Mom, she likes to brag about her children. I support you in all your efforts, and please, let me know if I can help you in any way." You could have said something like this in front of your mother, and/or you could have followed up with the nurse out of the room and talked with the nurse directly, explaining how fear and vulnerability often are expressed this way by your mother.
The bottom line is....do you want your mother to have the safest, best and most expert care possible in the hospital? I tell all my friends and family to not be in any hospital without another person present to make sure that everything is done right. Care in the hospital is not what is used to be for many reasons, and all patients need good, neutral advocates.
As a nurse taking care of people, I always respected the arrogant, squeaky wheels in both patients and family, even when they were very irritating and insulting. I would tell them that I always do my best, and that I understand how scarey and nerveracking it is to be in the hospital. I did not take it personally.
Also, this situation may have been presented to you so that when you come across a patient (someone else's mother) like this, you will have a deeper understanding of the possible underlying causes for comments like this.
Many of us, who are nurses, have this urge to fix, heal and make-well the whole world. It is a good thing but it can become overwhelming. You have that compassionate urge, but it somehow has left your out of the loop. There is a "character" in you that is sending yourself judgement, which has you feeling disgust for yourself and frustration that we all are not doing enough to help each other and fix the inequities, injustices and out right meanness in the world. It could be a good move for you to "retire" this judgmental character. She is not helping you or anyone.
Each of us makes a difference in ways we cannot always see. There is a wonderful story about this in Rachel Naomi Remen's book, called My Grandfather's Blessings, about a woman, who was married to a very emotionally abusive husband, and how a stranger on a street corner in New York City changed her life with just a few minutes of truth-telling. I love this story and often read it out loud when I work with nurses who are processing their burnout. You have helped people in ways you have no clue about. And it is not about measuring your progress, or your work in doing this. There are no performance evaluations here, or productivity quotas to meet, in being kind to whoever is right in front of you, including yourself. Here is a link to Rachel's page about her book. She is an exceptional MD, and storyteller, who works in Northern California. I hope this link will stay in this comment. If it does not, just do a google search on her name. http://www.rachelremen.com/mgb.html
One last encouragement to you: take the wasted energy you used to feed that self-disgust and ask for it to be composted. Don't judge yourself for feeling this way. Keep doing the best you can in each and every moment, and be grateful for all the future opportunities that are coming to you in your life to share compassion and truth-telling. Honor all suffering, as part of the growth process for all of us. Don't think that we are not to have suffering, it is what hones us as fine human beings. Learn how to be present with the suffering, without thinking that it is your responsibility to erase it. The fine 12th century poet Rumi says, "The cure for the pain is in the pain." As nurses, we have an opportunity to just offer our presence, just being here, with the person who is suffering (including ourselves as we cry at night.) Honor your own tears and take a deep breath, and don't pour out your heart (because you need it!) and let your heart be open, strong, present, intact, and compassionate.
Facebook has its uses for talking about important issues like nursing burnout, sharing interesting articles and blog posts, posting inspirational comments. This is what I use it for. You could have two accounts, one that is totally private for real friends and family only, and another one to keep up with interesting issues and people. Always, it is good to remember that anything posted anywhere online could become public at any time (including comments here) so it is wise not to share personal information, unless you are OK with anyone and everyone knowing about it. Young people may regret some of the photos, info and comments they are sharing now, when later on they are looking for jobs, etc. Professional nurses need to remember that posting anything about patients or work can violate privacy laws. Social media is here to stay, and many people use facebook instead of email, by using the private message system on facebook instead of posting directly on the wall. It is a mixed bag, neither really bad nor good. But it can be a useful tool, if you are careful and sensible with it.
In this thread it appears there are only 2 responses that suggest you talk directly with the person who told you she was not writing her own papers. Her discomfort (or whatever she is feeling about it) prompted her to tell you about it, which I find very curious. Why did she tell you about it? It could be that she is indirectly asking for a different kind of help. Discernment is an important skill to have as a nurse. What does your gut instinct say about this person? If you sense she is without conscience, it may not matter what you say or don't say. But, if she is a flawed individual who is over her head in nursing school, there could be many factors at work here. Perhaps you could ask your instructor for a discussion about ethics and honesty in the nursing profession. You could ask this question, without giving any details, in class about what to do if you know or observe someone lying via nursing notes, giving report about a patient, etc. Make sure this alleged cheater is also in the class when you ask this. Yes, karma does work...but also, everyone and every situation shows up in our lives for us to learn something about ourselves. Sweeping it under the rug is never a good approach for a nurse or a student nurse. Nursing is a life or death profession, and being a professional is directly related to being ethical. Human beings, all of us, are flawed and are works-in-progress. This dilemma is an important one for you. Talk directly with the person involved about the ethical dilemma you have, leave judgment out of this discussion. Back to my original question: why did she tell you about this in the first place?
This article by a nurse in the Institute of Noetic Sciences newsletter showed up today The Way of the Healer: Transforming Health Care from Within | Issue Five, December 2010 | Noetic Now | Institute of Noetic Sciences and it might offer some perspective for the writers and readers here. I am particularly struck by the person wondering about her own "non-compliance from dbscandy....who feels sad reading this thread. Feeling the sadness, without judgment of yourself or others, is a good first step.
I have just read every response to this very important thread. "Walk a mile in my shoes." We truly have no idea what has led any person to make the choices they have. It is not our job to judge them. So what would be the best care plan for this "obese" (or insert whatever other so-called non-compliant condition here) patient? Are you a nurse who knows how, and is willing, to listen and communicate with her spirit? Who could access what is at the core of her pain? Because, yes, this patient in pain of some kind. She cannot just will the weight off of her body. Her body now "needs" the sugar, food fix. Where is the nurse who will assist her in this? Who will nurse her pain (now described as a vital sign, remember) and support her as she changes deeply ingrained patterns, which have invaded her life for whatever reason. Where is the healthcare infrastructure and insurance payment for this kind of follow-up?
Non-compliance is a serious issue in healthcare, but not because of so-called non-compliant patients. It is because of the judgment handed down by caregivers. If someone feels uncomfortable to take a lot of pills, and their gut instinct says it is not for them, then they are judged non-compliant. Who determines what the best healthcare course is? The for-profit drug companies?
Health is about wholeness, not following orders. Nurses have a huge opportunity to support this return to wholeness, which has to come small step by small step.
Perhaps the frustration of the nurse, who asked this important question, is also related to a feeling of helplessness, not really being able to help someone who "appears" not willing or able to help themselves? Being able to be neutral is the key. Judgment can energetically land on someone, even contributing to a need for more adipose padding to deflect that energy hit. Obesity, is more than eating food. And the fact that so many people in this country are over weight, is bigger than just the number of calories in and calories burned.
"I am not a mechanism, an assemblage of various sections.
And it is not because the mechanism is working wrongly, that I am ill.
I am ill because of wounds to the soul, to the deep emotional self
and the wounds to the soul take a long, long time, only time can help
and patience, and a certain difficult repentance,
long, difficult repentance, realization of life's mistake, and the freeing oneself
from the endless repetition of the mistake
which mankind at large has chosen to sanctify." D.H. Lawrence
Many aspects of life brought both this patient and this nurse together at this exact time....with an opportunity, a mirror (because we are all mirrors for each other) to help each other face issues in their lives. Sometimes the smallest of gestures, words, compassionate recognition of spirit, can change everything...everything.
Being a nurse is a difficult choice and a serious responsibility. Respond in the best way you can to light the way for patients in your care to find and return to wholeness. Redefine healthcare as you do this. It has become a profit-oriented business and not the care-giving, heart work that it could be. Do the best that you can in this difficult work that you have chosen to do. Heal both nurses and other people, who are called patients, as you step up to the plate.
Unfortunately, in today's "healthcare" compromised world, families may also be watching their family member (patient) like a hawk because they feel they really have to. As a home health nurse (7 years) I heard way too many true stories about unprofessional and actually, dangerous, care experienced by people in the hospital. You might try complimenting the family for being such a good advocate for their family member. Ask the family and the patient how you can make them feel more secure while you are in the room. Then realistically let them know what and how you are able to meet their requests. Acknowledge their frustrations and fears without adding to them. Always talk to the patient first, as the patient is THE person you need to have the best communication with. Tell them what and how you are going to do what you have to do.
It is very hard to set aside your own personal needs while being a nurse. Even though it may be true that you are understaffed, overworked, under appreciated, or not supported by other staff members....you are still able to go home at the end of the day and the patient is not. Nursing is a supreme service, and in this time of scarier medical issues, and less time for comfort measures for patients (nurses don't have the time to really listen to patients like we used to do when we gave bed baths in the old days), people are on edge for all sorts of reasons.
Many nurses come into the room with chips on their shoulders, or battle wounds, from what has just happened with their previous patients. It is really not up to the patient to make the nurse feel better, and most barely have the energy to deal with what is going on in their lives. They have a huge level of fear and vulnerability which can bring out the worst in them. This does not excuse rudeness or the increased level of "entitlement disease" that is expressed by both patients and family members, but it does explain the context of how they behave.
There is no easy solution to your situation. Nursing is a very, very hard job. Period. And the behavior of fellow nurses and management doesn't help with the situation most of the time.
I offer the four agreements (from the book of the same name) as a plan for you.
1. Be Impeccable With Your Word.
2. Don't Take Anything Personally.
3. Don't Make Assumptions.
4. Always Do Your Best.
I just had a nurse email me to tell me she appreciated the daily burnout blips that I post on my facebook page, which are short messages that offer insight, hope and ways to deal with burnout in life and in work. This very experienced nurse, in a long term job position, told me how she was feeling invisible these days as she dealt with some health issues and frustration on the job. Many nurses who are experiencing burnout these days just keep it to themselves, trying not to rock the boat. It you have not experienced it, it is not so easy to understand.....but one the jobs of the nurse is to have compassion for people who are in stressful situations, including patients and fellow staff members. Often this compassion has just enough juice to deal with patients, and not much left to share with colleagues. Might be worth some "heart work" to gaze around your work space and notice the invisible ones who are doing their jobs, quietly and maybe needing some extra support.
Don't rock the boat...is a common thread for many nurses and nursing work environments. Management says they want to have input to make the nursing environment better (what they really want is more productivity for less paid hours on the clock.) And nurses don't want other fellow nurses stirring up the dust too much by sharing their frustrations. Just get through the day, do your job (perfectly) and don't tell me about what you think needs to be fixed or changed.
I have been researching burnout for years, both from an experiential perspective (40 years as a nurse) and from a holistic "healing" perspective. To realize the complicity between both nurses and the job situations themselves, is a multi-faceted discussion. How do you talk about burnout with anyone--other nurses, family or friends--without it becoming just a gripe session or getting suggestions like this article's title says to "just relax"?
There is a fundamental core issue that relates to nursing burnout and to our so-called health care crises....that is that we are not becoming healthier or "getting well." We need to send ourselves, as nurses, an authentic Get Well card. We can change the nursing profession. And I know for sure that there are nurses who realize this, envision this and long for it to happen.
This author is one of these nurses. She offers her insights and tells us that we can change our mindset about how we approach our difficult and sorely needed jobs as nurses. She has discovered a process for transforming nursing burnout, born out her own personal experiences as a nurse who cares.
I have looked at her offerings and found that we share common views on how to help nurses with burnout. It gives me hope to find such a kindred spirit. And I know there are many more of us out there, and I hope some of you will post your perspectives here. Burnout is becoming a cliche, and we are supposed to couch it in different words like compassion fatigue, almost in a kind of denial that it is still happening. Nurses are not supposed to burn out, they have been trained to be professionals who get the job done. And now, with the economic times so unnerving for many people, nurses are feeling even more stuck in jobs that they fear they cannot leave or "rock the boat" in any way.
It is a documented fact that burned out, stressed out and overwhelmed nurses contribute to a less than helpful, and sometimes out right dangerous, health care environment for patients. Nursing burnout affects us all, whether we are immersed in it or not.
We need to welcome all the voices talking about it.
It gives me hope that someone in nursing school is asking this question and researching it.
Big Pharma.....It is a conspiracy of greed and big profits.
It is not about really about helping people.
It just can't be good for people to be taking 20-30 meds a day. I saw this all the time as a home health nurse, half of my initial visit time was spent just recording an accurate med list.
Penicillin was a great discovery, but it now pretty powerless against many bacteria.
Why are prescription medications allowed to be advertised on television, as a huge expense that is passed down in the cost of the drugs? It must pay off some how.
Here are two interesting articles to read about the drug industry.
Dana Ullman: Lies, Damn Lies and Medical Research
and Dana Ullman: Unplugging From Your Medicine Cabinet: Respecting the Body's Intelligence
The first person on your list to take care of is you. If you are uncomfortable in any way, you need to communicate it and make sure you are heard. This was a very important teaching lesson for you, and it can make you a better nurse if you are brave enough to see the complicit part you played in it. You did the best you could at the time, but you did play a role in what happened. It does not mean you were a bad nurse or person. You probably had warning signs showing up inside you that you ignored, like knowing you needed to leave the meeting to start your shift. When you honor the part of you that is intuitive, and sensible, and caring---and apply it to yourself, your co-workers and your patients equally, then you can evolve as a professional nurse. It is not easy, especially when you are placed in such a difficulty situation like you had in this job.
Yes, the management and the situation you were placed in were unprofessional, unsafe, and even cruel. It is a reflection of the unethical management of that nursing home where you were working. They obviously did not care about providing quality care to their patients, nor good support for their staff.
Med errors can be very serious, so you are fortunate that your patients were not harmed. At least I hope not. I was placed in a similar situation many years ago when I worked for a nursing agency that provided temp help. I was sent to a med/surg unit for the day. I was not introduced to the staff very well (who were not wearing name tags) and the person who I thought was another RN or LVN and was to be giving meds to half of the 40 bed floor, turned out not to be a nurse at all. I did not know that I was to have been giving meds to the other half of the floor until 3 hours into the shift. All those meds were given late by me. I never went to the bathroom or ate anything during the entire shift. I was concerned about getting the job done, and I neglected myself. I did ask to see the supervisor, but no one ever came to talk to me. When I gave report, I explained everything that had happened. I also called my boss when I went home and told her what happened and said I would never agree to go back to that hospital.
My best advice to you is to actually consider not putting this place on your resume at all, since you were only there for 3 months. And I also suggest that you do not use this DON for any kind of reference. Since she did not support you during the time you were there, why would you want her as a reference? If someone wants to know why you have not worked since nursing school, just say you needed a respite after school because of personal reasons, and now you are ready and excited about beginning your nursing career.
Look for a job in an acute hospital where they have a good mentor program and a decent orientation period, and where there is more than one licensed nurse on duty at all times. Give yourself some more on-the-job training. Nursing is something you learn by experience, and you have to be your own best teacher and supporter. When you know that you are in a unsafe situation, then you have to be the one to speak up loudly and if necessary, remove yourself from the unsafe situation.
You have been given the gift of an incredible learning experience from this experience. There is not much you could have done differently in trying to do the tasks you needed to do. A person can only physically do so much in a certain amount of time. Meds take time to give accurately and safely. There is no fast or better efficient way to do it. Same with tube feedings. Give yourself a break on this part, and just look at how you put yourself in that job in the first place.
Be the kind, compassionate person you are, toward yourself. Then find a place where you can continue to grow as a nurse. Don't give up.
from Elsah Cort, RN
PS Tomorrow is the 41st anniversary for me graduating from nursing school.
In the State of California, you can practice craniosacral therapy as an RN. Your RN license gives you the legal ok to put your hands of people. Many massage therapists and physical therapists practice it too. There are no direct licensing or credentialing ways for craniosacral therapy in particular. I have practiced craniosacral therapy as a private practitioner for 10 years, but not in my regular nursing job. It depends on your employer. Some do not consider it part of the nursing scope of practice. I can recommend two websites to learn more about it, milneinstitute.com and dynamicstillness.com. I offered a CE class for nurses in introductory cranial work, but only taught it 3 times. I could not get enough nurses to sign up for it. I think it is best to study it with one of the two schools I have mentioned above. I do plan on writing an online course on it just for nurses, it is still in the works. I do see a day in the future when cranial work will be a normal, necessary and enriching healing practice offered to every patient in the hospital. I see the "cranial wave" as the first vital sign.
I have been a nurse for 39 years and during most of these years I have been working hand in hand with burnout. Nursing is hard work no matter what kind of nursing you are practicing.
I have a theory that nursing burnout is an off shoot of the "non-healing" aspects of what we call our health care system. We do not invite our patients to tap into the core healer within themselves, or within ourselves for that matter. We see them as ICD9 codes or room numbers or "that grouchy old man or old woman" or another mess for us to clean up or the patient with 30 pills to swallow a day. We decide what is best for them. We label them as non compliant or trouble makers. We take their power away, we ignore their dignity, and we find our own power and dignity diminished.
We don't touch our patients. We don't give them baths which allows us time to give them some kindness while assessing skin integrity. We don't even touch them to do vital signs anymore, letting machines do it all.
We don't look our patients in the eyes.
We are in one patient's room with our task list to do, while thinking of all the other patients on our list, so we do not actually spend time in the present moment with our patient (not so good on our adrenal glands either.)
We have lost the human spirit element of nursing because we are just too darn busy, short staffed, and exhausted.
And we don't treat each other with kindness..............
So, what to do??? Start with yourself, offer kindness to yourself. Listen to yourself. Give yourself honest feedback. Learn about the essence of service. Don't let yourself get away with meanness or complacency or disrespect or apathy.
Start with small steps and small smiles and slow breaths and change your day one tiny minute at a time.
We nurses are the ones who can change our burnout. As the Hopi elders tell us, "We are the ones we have been waiting for........."
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