should interaction with patients be #1 reason for nursing?

[tarotale]

Hi everyone. I have an honest question I want to ask you today, and I believed this section of forum could meet my need of some answers.

First I appreciate @TheCommuter for the article he/she has wrote (high-value vs low value patients). It made me reflect little more on what I had to struggle internally about my set ideas and beliefs.

What made you become a nurse? I think the most common answer I've ever heard was: "so I can help people" whether they were being truthful or not. I myself get asked that often, and I always tell them, "because I was fascinated by the human physiological response to pathology and medical interventions."

I will ask you this. What can a nurse do when he/she gets jaded view on the very factor which we service? I am talking about the patients and family members. Dealing with entitlement, no-insurance, and ingratitude have left my heart completely detached from patient population in general and deeply into administration/business. I was setting up to prepare pre-reqs for medical school, and postponed that because now I doubt I will ever be happy dealing with sick population. To add the insult, I deal/dealt with frequent flyers, no-insurance druggies, obese diabetics, non-compliant dialysis, etc. It's just very hard to find fulfillment at all. I am considering dental school or nursing admin/business.

I find that this is not my cup of tea. That's it, nothing worse, nothing better. Just not my glass. If you know anyone or yourself who had similar dilemma and moved on to do something else and is happier, feel free to advice me. Any input, feel free please

PS: I will politely pass the harsh words. I am making it clear here that just because I am saying it's not my cup of tea, I am not degrading the sick population or putting them down. I am simply saying it's something I do not enjoy doing and working with; doesn't mean I am crazy person with ice running through veins. If I see elderly carrying large stuff, child being abducted, car crashes without help, women/elderly being mugged, etc will gladly help. Just average Joe with average person's heart who doesn't like what he does. And nursing & interacting with patients is not for everyone. Thank you.

[jadelpn, LPN, EMT-B]

Sick people are what gives us work. That you don't believe certain patient populations are your cup of tea is common for a number of nurses--we all have a niche.

You have to look at the patient and the problem and intervene accordingly. That they don't have insurance, are psych impaired, or otherwise impaired is what it is--and you need to not focus your own thought proccesses, but not internalize and judge any patient.

Hard to do, but successful nursing starts with a clean slate, each patient and circumstance different. If it is not your thing, it is not your thing--but nursing is full of many, many different paths. Research some that are available in your area, and see if something clicks for you.

Best of luck!

[krisiepoo]

what about research medicine? case management? hospice?

[calivianya, BSN, RN]

Work with unconscious people! If the patient is unconscious and isn't talking about all the bad decisions he/she is making, it's easier to be compassionate. It's when people open their mouths and talk about how much they love to smoke, or when I see family members bringing in a giant bucket of fried chicken to a patient on a restricted calorie diabetic diet, that my compassion totally flies out the window. Neither of those situations happen when the patient is unconscious. You could always try ICU or the OR.

[Kipahni, RN]

You have to decide what kind of relationship you want with your patient. I loved working procedure/IV start team for a short stint because I could still do Nursing tasks without having to deal with the human drama.

After 3 years in to my career I finally learned that sometimes people make stupid decisions. I am not them, I don't know what psycho-social aspects brought them to their decision. So I just do my job to the best of my ability and work in an atmosphere of peer and management support.

Also I learned to not look at my job as a place to build up my self esteem (as in validation from patients ect) Once I figured that out it "hurt" a lot less. So when a pt goes all bonkers for not getting there quick enough or a doctor chews me out, I say in my mind "They are not my friends, so what they say is meaningless and I choose not to retort in their childish manner" of coorifice out loud I will say something like. "I know this must be frustrating, what can I do to make this situation better next time but also let us have realistic expectations."

Looking at bedside nursing like a game. How can I offer the most efficient and safe nursing without getting caught up in the tangled weave of pt manipulation, grumpiness, anxiety or frustration. get the players healthy quickly as possible. do your job with excellence. get the pay check to pay for your "treasures". Have fun on your days off knowing you have done your job well.

[HouTx, BSN, MSN, EdD]

Critical Care is my 'thing'. Not much food-sneaking or general noncompliance going on in there. I don't deal well with chronically ill dx - CRF is my waterloo, patient-wise. OB patients terrify me - that teeny little patient that I can't even see... .

I realized early on in my career that my biggest attraction to Critical Care was the level of control... love the challenge of maintaining hemodynamics, fluid balance, oxygenation, etc.... via interventions. Absolute nirvana for a 'control enthusiast'. Have been lauded for empathy and patient communications, but I know where the boundaries are so that I can effectively compartmentalize & leave work at work. I'm very thankful that I have never moved into that codependent craziness where I began to feel personally responsible for patients' choices & bad decisions. For me, that would be a fast train to bahootiville.

[Ruby Vee, BSN]

I don't know many nurses who don't have a somewhat jaded view of certain patient populations. Nurses are people, too. The trick is to find a patient population that you can (usually) tolerate with some compassion. I worked oncology for a number of years and found that most oncology patients seemed to be nice people. (That was over 30 years ago -- things may be different now!) Pediatric patients scare me to death -- maybe because I've never had many opportunities to interact with kids in general. Alcoholic GI bleeders -- let's just say I'm compassion-challenged there. You see the same folks come in over and over with illnesses related to their drinking, and you wonder why they don't just STOP.

I, too found happiness in the ICU. Others find in in OR, ER, PACU, L & D, etc. One nurse I know loves caring for the elderly and another likes orthopedics because, she says, it's mostly younger people with injuries they got in interesting ways. (Olympic speedskater, skiers, etc. Of course an orthopedic floor in Tampa, for example, rather than Jackson Wyoming may be different.)

There are lots and lots of choices available in nursing, and they have varying amounts and depth of patient interaction. Figure out what you like and don't like and go from there.

[LadyFree28, BSN, LPN, RN]

To answer the first question, I became a nurse because I witnessed an ER nurse handle a cursing, drunk patient and the rest of her work load well at the age of 5...she did her job, even keel, and enjoyed what she did; at least that was my perception-and that's what stuck with me.

I have encountered many nursing avenues: Sub-Acute with TBI and SCI population, LTC, Peds, Step-Down, ICU, Community Nursing-home health, clinics, Nursing Informatics. Each had it's pluses and minuses, but a I always find a way to get the job done-and that's dealing with a holistic set of what's in front of me.

Each day I have worked in this business, I have approached it the way I witnessed almost 30 years ago...I approach each pt (and life-I've learned :) ) with a clean slate; even the long term pt's; as long as I open my eyes, today is a new day; life is too short to be unhappy..there's lessons to be learned and moving forward is the best expertise in the lessons; the greatest wisdom is how we handle life's lessons. This approach has helped me build rapport with the most difficult of populations, whether it be pt family or doctor.

I also realize we, as humans can't "win it all;" it's impossible to be perfect; humans are imperfectly imperfect, sometimes painfully so. I can only focus in the moment with a lot of my patients and plan for the now and deal with goal oriented issues: pain control, spiritual distress, pooping issues, peeing issues, bleeding issues, safety, cognition/behavioral issues...I cross each bridge for whatever needs to be crossed, and let the rest follow.