Getting attached to patients

[NelleMarie]

I am in cna classes. Tomorrow is my second day of clinicals. On my first day of clinicals in the nursing home, I took care of a woman who reminds me so much of my mother in law who passed away 8 months ago. We were very close and her passing was completely unexpected. I'm not usually emotional about anything but seeing the woman who reminded me of her really got to me because she was crying saying everyone had forgot about her. I was instantly attached. I cried like a baby when I got home because she wanted me to stay with her. How do you deal with that situation without cutting off all emotion?

[jadelpn, LPN, EMT-B]

Boundries.

Work is work and the best thing that you could do for a patient is to suggest things that perhaps will help a patient. For instance, if a patient is lonely and has no one, then that should be the one who you suggest has a volunteer companion to sit for a spell.

We all have patients that remind us of other people. If a patient reminds you of someone, take the good things you remember, and make light. For instance, if a patient has a wicked sense of humor, laugh, gently joke back, makes work quick and non-awkward.

Then, when you get home, you need to concentrate on your life. So that you are refreshed and ready for your next shift.

[KelRN215, BSN, RN]

I am a pediatric visiting nurse and my primary population is oncology. I get "you must really get attached to your patients" all the time when I tell people what I do. Honestly? I don't. Treatment for the most common pediatric cancer- ALL- is over 2 years long. Over this 2 year period, I spend hundreds of hours in these children's homes, I get to know them, I get to know their families, I get to see them grow. But, when their treatment is done, we say good-bye and that's that. It's a good thing that they have reached the point where they no longer need a visiting nurse.

I usually stop seeing these patients when A) they finish their treatment or B) they die. I do not remember the last time I cried about a patient's death. It was probably at least 5 years ago. Several of my patients died earlier this year and I didn't even feel sad about it. Their diseases had wreaked such havoc on their lives that their quality of life was so poor and death was the kindest outcome. I think of them when I drive by their houses, I hope their families are doing ok, but I don't lose sleep over it.

It gets easier with time. Make sure you have things in your life that are yours/separate from work. I play 3 sports and travel a ton. I don't have time to think about work outside of working hours.

[NelleMarie]

You have all been very helpful. I finished clinicals last night and the tips I have received here have helped me so much. Thank you

[Here.I.Stand, BSN, RN]

((((Hugs)))) I'm very sorry for the loss of your mother-in-law.

You're clearly a compassionate person which will be an asset as a CNA. But like other posters have said, you need to maintain professional boundaries--both for your own mental/emotional well-being and for the sake of your other patients who must be treated with the same care as those you would become attached to.

[dudette10, MSN, RN]

A friend of mine once said that the care of another human being is a highly personal and intimate act that requires the giving of self. As others have mentioned, boundaries are key. The question you pose is how to create these boundaries.

Before I give my answer, I have to point out that boundaries are important not only to prevent inappropriately familiar relationships with patients, but also for the HCW to handle those patients who DON'T like you. I've been "fired" by two patients--once early in my career and once later. The early "firing" really got to me because I thought I had given my all, and I wasn't sure why this patient didn't like me. It took a day off to get over it. The second time, I was more seasoned, and although the firing came at a very bad time for the patient (right as the pt was being transferred to ICU), the boundaries I had learned to build helped me continue to coordinate her care in the background with nary a thought to what the family felt about me. I was still able to get the job done.

if you are concerned that the pt is becoming too attached to you with your emotions firmly in check, you can help them build trust in other HCWs that participate in their care. Help them spread the love, if you will. You don't want the pt to feel overly vulnerable when you are not working. Up manage (got that term from another thread) the off going and oncoming CNAs with an observation of a skill that you genuinely feel the other person is good at. "Sue was my trainer. She knows how to use all the lift equipment in the facility. She's the go-to person for difficult transfers." You get the gist.

If the situation is that you are getting too emotionally attached--which is probably more of an issue in LTC than relatively short LOS acute care--you need to make sure that your care and attention for this individual does not monopolize your working downtime. In that case, YOU should spread the love a little. Instead of spending working downtime with your favorite resident, go sit with a different one. After a while, your appropriate boundaries will develop, and you won't need to take such conscious action.

You sound like you are just where you need to be at this time in your professional life. Good luck to you!

[NelleMarie]

Thank you so much

[caliotter3]

If I feel the heart strings growing too taut, I simply force myself to recall many of the not so pleasant comments about previous nurses that are made by clients. Very enlightening to realize they will have nothing good to say about me, too, when the next nurse comes along.