How do you emotionally deal with this?

macfar28 · May 19, 2014

For me I just remember that every little bit helps...every positive message, every bit of praise and support I can give them begins to make a dent (hopefully) in the negative things they've encountered. Do I sit in report sometimes and listen to the horrible stories of these kids and become enraged? Sure. But I just keep the faith that I can help bring some sort of positive to their lives.

As for burn out...I only burn out on the BS politics in my hospital. Sure I have a group of patients here and there that might get tiresome - more the adults with whom I work - but overall I come back for my next shift ready to go. I think in time it gets easier and as you become more confident you realize you are making a difference.

It sounds like you have the psych bug. Stick with it. It's a calling and it's clear you care about your patients. Best of luck.

motor_mouth, MSN, RN · May 20, 2014

I've been lurking for a while and joined just to respond to this. I'm not a nurse yet, I'll graduate this December, but wanted to add my $0.02.

Why do you say they have a poor prognosis? Because of their history/diagnoses?

I was one of those kids born to a drug addicted mother, abused by family in various ways to make money, and developed "coping skills" that were basically self punishment in various ways. For the longest time I didn't think about my future because I didn't believe I'd have one. I thought my abusers would kill me or I would kill myself. I was hospitalized after high school for an eating disorder and in college spent two weeks in IOP (8 hours days) working on the trauma/PTSD. It probably should have been longer and/or in IP but it was out of pocket as insurance didn't cover the program.

The statistics say I should either be dead, in jail, or a hopeless case. I'm not. These kids you are working with might not be either. Sometimes it really does just take that one person to believe in you. That one person to tell you that you don't have to be another statistic. That you CAN overcome your past and be successful.

I could go on but suffice it to say that just because they had a horrible start to life, doesn't mean their life is over or they are a hopeless case.

TerpGal02, ASN · May 20, 2014

It is difficult for sure to hear some of these horrific stories or know that you will see that kid again because all the work you put into him/her will just be undone by their crappy caregivers. You develop a professional detachment along the way. You have to or you'd go home crying every day. That takes time. Not callous, you still compassionately care for Tue kids but it isn't that deep soul rending rage or gut punch that you get if you let yourself get too emotionally involved. Some patients will catch you off guard no latter how seasoned you are though.

Mine was this weekend wry a 12 y/o who was so determinted to end her life that she took an overdose that almost killed her, spent a few days at another facility, came home, then hung herself with a belt and was dusky and mottled when she was found. To see this kid, with ligature marks on her neck and subconjuntival hemorrhage in both sclera..........really got to me. What would make a 12 year old want to die that badly? Like so many of the other kids, bullying. As a victim myself of severe childhood bullying......hits way too close to home sometimes

mrnightinggale · May 20, 2014

Thanks Motor Mouth for giving me hope. I just speak with the MH counselor in the pediatric unit and ask her what their prognosis is. Are there any great stories of hope and perseverance? It turns out there are! The therapist did also say that many of these kids would keep coming back and they odds are not good for them. It is just tough to tell a little 7 year old that they are very smart and I am proud of them, only to have them disagree. I want so badly for them to know their lives can be great!

MrChicagoRN, RN · May 20, 2014

Thanks Motor Mouth for giving me hope.
It is just tough to tell a little 7 year old that they are very smart and I am proud of them, only to have them disagree. I want so badly for them to know their lives can be great!

They need to hear positive messages. Improvement comes in small, sometimes almost imperceptible increments. They don't have to believe the message right off the bat, but after hearing it from a lot of different people, it may eventually sink in.

Just be sure the praise is genuine, appropriate, and not gushing. Change doesn't come overnight.

Keep up the good work!

motor_mouth, MSN, RN · May 20, 2014

It was/is a pet peeve of mine to hear others say that so and so won't be able to achieve much in live because of what has happened to them. Obviously, I don't tell all of those people about my past, but it's very hard at times not to.

I was told by numerous professionals growing up that my issues were lifelong and I would never get over my past. I was expected to be back in IP for the eating disorder because I decided to go straight to college and not to take a semester off. I never did. I was expected to need more time at the IOP facility for the trauma, and I didn't.

I am no longer able to be diagnosed with PTSD, depression, or an eating disorder. Since the ED was a coping mechanism for the PTSD, eating triggered flashbacks, "all" it took was working through the trauma to get rid of both of them. The depression took a LOT longer to get rid but time, meds, and healthy coping mechanisms finally seem to have got rid of it to the point I am no loner on any psych meds for anything.

It's okay if they disagree when you compliment them.They don't need to agree with you, they just need to hear it. When they disagree, you could say something "Well, I think you're smart even if you don't." I still definitely don't have the best self esteem nor do I think very highly of myself.

Sorry for my tangent. As I said, it's just something I feel very passionately about and one reason I will never work with children/adolescents in psych. It hits way too close to home, especially when so many times they are being sent right back to that environment to get hurt all over again.

Mandychelle79, ASN, RN · May 20, 2014

How do I do it. I truly believe everyone can make an improvement, not matter how small that improvement is. We have a lot of frequent flyers ( as many units do) and when we have one I make sure to point out the improvement I noticed. Hey last time when you got angry you threw a chair at me, this time you asked to go into the quiet room, that's progress. And with some you never know what is going to be the thing that strikes a chord with a patient and helps them work through an issue they havent been able to before.