Nurses who don't take the time to care: have you seen examples?

susanna · May 9, 2004

"Just don't care" "Only care for physical needs" "Not caring nurses"

Hold on. There are two types of caring that are being talked about and I'm not sure which one some of you are referring to.

There's caring (1-passive) which means letting someone's condition touch you emotionally and psychologically, which is what I think some of you mean when you say, "Some nurses just dont care!" (and thus they do the bare minumum or act coldly)

And then there's caring (2-active) which means, disregarding how you feel psychologically, doing what you can to get the job done right in the best interests of the patient.

For me, I'm not a nurse yet, but I don't think I could be one if it demanded that I do caring #1. That we just be to much stress for me to actually let every patient's personal situation touch me psychologically. I dont think I could go on living every day if I tried to do that because if you think about it, nurses work in the most depressing environments in the world!!!! I plan to learn and be very good at caring #2 though. I think its possible to learn to help someone without actually being compassionate with their pain. Would I be shunned/looked down upon by other nurses for not wanting to do caring #1?

NOTE: Hee hee, sorry for the confusing phenomonology I made up....

RN_Amy, RN · May 9, 2004

"Just don't care" "Only care for physical needs" "Not caring nurses"
Hold on. There are two types of caring that are being talked about and I'm not sure which one some of you are referring to.
There's caring (1-passive) which means letting someone's condition touch you emotionally and psychologically, which is what I think some of you mean when you say, "Some nurses just dont care!" (and thus they do the bare minumum or act coldly)
And then there's caring (2-active) which means, disregarding how you feel psychologically, doing what you can to get the job done right in the best interests of the patient.
For me, I'm not a nurse yet, but I don't think I could be one if it demanded that I do caring #1. That we just be to much stress for me to actually let every patient's personal situation touch me psychologically. I dont think I could go on living every day if I tried to do that because if you think about it, nurses work in the most depressing environments in the world!!!! I plan to learn and be very good at caring #2 though. I think its possible to learn to help someone without actually being compassionate with their pain. Would I be shunned/looked down upon by other nurses for not wanting to do caring #1?
NOTE: Hee hee, sorry for the confusing phenomonology I made up....

I totally agree... well said.

I think some people try to be the token "perfect nurse" when in fact not even patient wants to share everything in a psychological sense, they just need assistance with there physical needs in terms of hygiene etc.

I myself am a very introverted person and wouldn't want to talk about my illness and hows its effecting me etc. I have my own way of coping and some people don't understand that, alot of the time I want to be left alone. I think the key to being a good nurse is recognizing this and being senstive to the needs of each individual patient.

Also, have you noticed that whenever a competent patient for whatever reason refuses care, medications etc. is labelled as "non-compliant" yet when they ask for "too much" that are labelled "demanding"? :uhoh3:

jayna, RN · May 9, 2004

Very interesting article I SAW ONLINE about The supports and constraints of caring in nursing

http://www.mills.edu/INTRO/AAMC/QUARTERLY/mq_spring2003/Spring03.20-28.pdf

Staing there are caring for and caring about in nursing..Read on.

CCU NRS · May 9, 2004

I thought all of these 5 were pertinent and accurate except for the part about havning too many Pts and complaining to the union etc. we don't have union here in OK

1.) Knowing the patient is fundamental:

"Knowing and doing what patients need";

"Problem solving along the lines of relationships,

spiritual concerns, physical concerns,

and family dynamics"; "Constantly talking

to them and listening to what they are

telling you"; and "Creating a relationship

with the patient so they can trust you."

2.) Having a presence with the patient:

"Being able to give each patient some type

of indication that they matter"; "Making the

patient feel like you are present"; and

"Sometimes sitting there to let patients

vent because they are frustrated or scared."

3.) Doing for the patient: "For me, care is

like an action word. I consider it a response

to patients' needs"; and, "Doing what they

need and making sure they don't feel any

worse than they do about being dependent."

4.) Advocating: ". . . Knowing when to stand

up"; and: [When there were too many

patients to care for adequately] "[We] were

putting out fires a lot and just sort of got

through the day throwing pills at people

and hoping there were not any major emergencies.

Then we would use the union as an

avenue . . . and let people know this is not a

safe condition."

5.) Supporting: The following are examples

of supporting that emerged from the data:

"You are providing a place for them that is

safe and one in which they can get well";

"The patients feel trust in that you are

going to take good care of them"; and

"Delivering on that care in a friendly and

reassuring way."

mattsmom81 · May 9, 2004

Can we begin to see why there is such a lack of cohesiveness in our profession...when the students are already being trained to critique those who will nurture them

border rn · May 9, 2004

I agree with most of this thread. We are trained to care for the pts holistically. I know that for the most part I am a caring nurse who goes the extra mile. I get my job done and my pts are well taken care of. Meds on time or before requested, drinks at the bedside with each round, and try and make appts ;with my pts for dressing changes ect. Some days you just can't please everyone and I leave work feeling like I have let people down.

The most recent example I found of a fellow worker ignoring the needs of a pt was:

A spanish only speaking pt kept ringing the call light and calling her nurse in on night shift. The nurse brought a few things to her but could not understand what she wanted. She sat down in the work room to read and her pt called out again, she stated she was not going back in there until her next set of rounds because she did not know what else the woman could want. I thought how horrible this poor woman does not understand us, we don't understand her and her translator and all her family was gone. I went into the room and took my spanish translation book with me, unfortunately this women could not read spanish either. So I finally called the ATT operator to translate for me -- all the women wanted was to know how often to feed her baby. We took care of the problem and did some more teaching while I had the use of the translator. The women was so very grateful. I cannot imagine how scary it must be for a pt not able to communicate their needs to us. I was appalled by the lack of respect my colleague had shown this women, just because she was too tired to deal with it. I know we all have bad days, but it should not be taken out on the pt. This nurse only had 3 couplets that were 2nd day post partums, so not a huge assignment. BTW the pt never rang the call bell again that night

NursesRmofun, ASN, RN · May 9, 2004

The challenge is to get the esential work done along with all the caring. Nothing worse than working with someone who is 'so caring' they sepend all their time hugging family, etc...while the rest of the staff must do the work for them. Lots of codependency out there and nurses must learn how to balance caring with professional duty.

So, so true! Amen.

leslie :-D · May 10, 2004

I totally agree... well said.
I think some people try to be the token "perfect nurse" when in fact not even patient wants to share everything in a psychological sense, they just need assistance with there physical needs in terms of hygiene etc.
I myself am a very introverted person and wouldn't want to talk about my illness and hows its effecting me etc. I have my own way of coping and some people don't understand that, alot of the time I want to be left alone. I think the key to being a good nurse is recognizing this and being senstive to the needs of each individual patient.
Also, have you noticed that whenever a competent patient for whatever reason refuses care, medications etc. is labelled as "non-compliant" yet when they ask for "too much" that are labelled "demanding"?

i agree that an effective 'good' nurse is sensitive to each of their pt's needs. what works well for one won't necessarility work well for another. i also do not like when people are labeled, i.e., non-compliant, med-seeking, demanding; but you see, that's where a 'good' nurse would go the 1 step further and find out the reason for the issues at hand. patients don't act a particular way to be difficult purposely. 'nurses who don't take the time to care' is NOT synonymous with nurses who don't have the time to care. now that's a real and legitimate barrier.

CCU NRS · May 10, 2004

i agree that an effective 'good' nurse is sensitive to each of their pt's needs. what works well for one won't necessarility work well for another. i also do not like when people are labeled, i.e., non-compliant, med-seeking, demanding; but you see, that's where a 'good' nurse would go the 1 step further and find out the reason for the issues at hand. patients don't act a particular way to be difficult purposely. 'nurses who don't take the time to care' is NOT synonymous with nurses who don't have the time to care. now that's a real and legitimate barrier.

Forgive me if I misunderstand but you say Pts don't act a particular way to be difficult, If this has been the case for you, you have been truly blessed, because some Pts do act just the way they want to act to be difficult and hateful and drug seeking and non-compliant. I have had all of these types of Pts and they are usually completely coherent and aware that they are being rude and demanding and only want the drugs they want and will use foul language and curse at nurses and tell you exactly what they will and won't do! The nursing care is not always the issue you may be the most wonderful nurse in the world and a Pt can be un reachable to any compromise or common sense and continue to be a rude drug seeking, non-complaint a-hole no matter what or who is caring for them.

leslie :-D · May 10, 2004

Forgive me if I misunderstand but you say Pts don't act a particular way to be difficult, If this has been the case for you, you have been truly blessed, because some Pts do act just the way they want to act to be difficult and hateful and drug seeking and non-compliant. I have had all of these types of Pts and they are usually completely coherent and aware that they are being rude and demanding and only want the drugs they want and will use foul language and curse at nurses and tell you exactly what they will and won't do! The nursing care is not always the issue you may be the most wonderful nurse in the world and a Pt can be un reachable to any compromise or common sense and continue to be a rude drug seeking, non-complaint a-hole no matter what or who is caring for them.

TOTALLY agree with you CC. i've had the worst of patients, just like everyone else. and quite honestly, i haven't always felt like being a 'good nurse' to them. i just think that those pts that do so much acting out, aren't doing so to be totally antagonistic....they just don't give a damn. but what i've discovered is that the ones i've ended up despising (yes, despising) have surprised me with admissions of insight into their behaviors....e.g., "i know i've been an a-hole" and then you'll find out why they've been acting as such. it softens you a bit and makes you want to work with them, until of course, they start their crap again. i just personally think that when a patient is your worst nightmare, there's usually a reason behind it.

CCU NRS · May 10, 2004

Can we begin to see why there is such a lack of cohesiveness in our profession...when the students are already being trained to critique those who will nurture them

I agree whole heartedly. The biggest problem with this particular site is that people that are students and have never done any Pt care outside of a very controlled environment and only one or two at a time come here and ctitique people that have been nurses for any number of years.

In fact and this is one that really burns my bum is that some of the people may not even be students yet or even considering a nursing career and they have all the glorious opinons and idea's about how and what nursing is and should be.

Just my little Rant, I did not mention anyone in particular(notice) so if you flame me you will be making yourself be seen as one of these very people, I am aware that everyone has an opinion and they are entitled to it, what I would suggest however is that until you have actually performed Pt care in a real setting without it being controlled by your instructor or basically just one or two Pts at a time (unless you are CCU etc)you should perhaps temper your judgement of what the actual situation is until you have had some actual experience.

Thank You Very Much

CCU NRS has left the building!

PeninsulaRN · May 10, 2004

Meh, this is a strange question. Nurses by nature care, we are healthcare providers. That means that I care for my patients, holistically, attempting to meet all of their needs.

In these days of high acuity and decreased staffing, though, that's difficult to do. That's why there are other disciplines (PT, OT, social workers, case managers) to assist us in doing so. Its ridiculous to expect the nurse to do everything for every patient, unless we are performing primary care at a much reduced ratio, and we all know primary care costs too much to be implemented outside of critical care.

It is also a matter of prioritizing. As much as I would like to spend extra time with my newly diagnosed patient doing a bit of psychosocial work, if I have another patient who is hemorrhaging, or one going into anaphylactic shock, or one with a vesicant infiltrating, that takes priority.

So what you call "not taking the time to care", I call prioritizing and attempting to go home at the end of the day with my license.