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Accept and Adapt or Warning Sign: Attention-Needy Patients Burning Me Out

Posted

Has 3 years experience.

I am a later in life RN (46 yo.) Nurse for 2 years. 1 yr hospice, 1 yr skilled/rehab unit in LTC. Hospice: too many HOURS so i switched to 3-12hrs on a rehab unit. I dont like what its doing to my PERSONALITY. Since its an ltc, a LOT of our pts are more "attention needy" than medically needy. Ex: call lights to "empty garbage" or "pick my lettuce off the floor" kinds of bs. Pts ringing like crazy for DUMB stuff or coming to nur station 30+ times a SHIFT. Not to mention the faaaamily members expecting 1 on 1 specialty treatment. Lots of pts are more hospice/LTC approp than "rehab"...Ive tried setting boundaries, pts acknowledge,apologize and then just REPEAT behaviors. Feel like im growing to HATE ppl and dont want to turn into that nasty burnt out nurse we all dread. Feel like Im dealing with a bunch of needy self absorbed, tantruming toddlers all screaming at the same time!

Coworkers tell me "its just nursing, it does that to you". Thinking about switching to hospital setting but afraid of the unknown. Any advice?

9 minutes ago, 2018RNat44 said:

Coworkers tell me "its just nursing, it does that to you". Thinking about switching to hospital setting but afraid of the unknown. Any advice?

You'll find the same behaviors in the hospital but the patients turn over more frequently. Did you like hospice nursing?

PS. I know where you're coming from. It's why I left the ED.

Edited by Wuzzie

ruby_jane, BSN, RN

Specializes in ICU/community health/school nursing. Has 12 years experience.

Consider ambulatory care? I mean...people still whine. But I care a lot less about it.

"nursy", RN

Specializes in ICU, ER, Home Health, Corrections, School Nurse. Has 40 years experience.

So far, the ONLY complaint you have mentioned is the whiny patients. Which can be annoying. How about the rest of the work...do you like your job? coworkers? schedule? If everything else is good, I wouldn't jump from the frying pan into the fire. If you read enough of these posts you will find a lot of nurses overwhemed and overworked with very little support at the bedside.

On a side note, the most appreciative patients I ever had was in corrections..every day I heard "Thank you ma'm," "Appreciate you ma'm," it was a very rewarding experience. There were other challenges, however. I'm in school nursing now, and absolutely love it.

People are whiny everywhere. I’m in ICU and we still have people on their call lights all day and I can’t even begin to tell you the amount of crazy families we deal with.

I always start my day in a good mood, but usually by 1400, I’m worn down from it all. Some days, I just immerse myself in the crazy.

RNperdiem, RN

Has 14 years experience.

Some people just can't cope when they are sick. Some of them can't handle life even when everything is going well either and really regress when sick. That is part of nursing unless you work with well clients, and even then there will always be those few.

I work in ICU, the patients are usually too sick to get overly dramatic. A small but memorable minority of patient families are the ones who wear you down. Open visitation has not improved this. ICU does have the advantage over rehab in the rate of patient turnover.

Tweety, BSN, RN

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac. Has 28 years experience.

4 hours ago, Wuzzie said:

You'll find the same behaviors in the hospital but the patients turn over more frequently.

Agree. I felt like she was describing my unit in the hospital.

2018RNat44, ADN

Has 3 years experience.

I DID enjoy outpatient hospice...it just became a 24 hr job. Way too invasive, up to 70 hrs a week at times with oncall and administrative responsibilities, charting all night at home etc. Ive always enjoyed my coworkers, that has never been an issue. Mngmt has not been an issue either.

Hospice: i just didnt have TIME for my fam (husband, teens and aging parents).

LTC: Im fried out to even BE with my PARENTS most times bc they are JUST LIKE MY PATIENTS...(dementia mom and denial dad). 😭

I guess i just wonder if the INTENSITY of BS in hospital would be a little less onslaught than LTC rehab where i get yelled at for laundry, housekeeping and even kitchen problems by pts AND fams. Ppl forget our priority is their meddddical needs.

LTC rehab.....has been ACUTE rapid fire in intensity with 24 tantrumming ppl on the unit and their 'lovely' fam members in ur face nonstop..

Hospice....... was chronic intensity at a lower, evened out pace/level.

Sometimes I just wonder if I can "do more, learn more, BE better, medically and personally speaking, with... hospital precepting and experience and a lot less trivial nonstop distraction.

4 hours ago, RNperdiem said:

Some people just can't cope when they are sick. Some of them can't handle life even when everything is going well either and really regress when sick. That is part of nursing unless you work with well clients, and even then there will always be those few.

I work in ICU, the patients are usually too sick to get overly dramatic. A small but memorable minority of patient families are the ones who wear you down. Open visitation has not improved this. ICU does have the advantage over rehab in the rate of patient turnover.

I agree, but then we get them better and sometimes they are in that limbo, of not quite being ready for the floor but not truly ICU sick. I always say if you can hit your call light 8 times in an hour, you aren’t sick enough for icu.

I see a lot of crazy family. And maybe it’s just my patient population. Tragedy can do strange things to people.

I’m so glad I switched to IR and Cath Lab to get away from situations like this. I did ICU 5 years (still do it per diem) and enough was enough, in part because of situations like the OP described.

OP, maybe try to escape to a procedural area. It’s been great for my workplace sanity.

18 hours ago, 2018RNat44 said:

I guess i just wonder if the INTENSITY of BS in hospital would be a little less onslaught than LTC rehab where i get yelled at for laundry, housekeeping and even kitchen problems by pts AND fams. Ppl forget our priority is their meddddical needs.

I think the BS may even be worse honestly. Not saying the job is harder but there are just so many more players in the hospital.

ClaraRedheart, BSN, RN

Specializes in Med-Surg. Has 7 years experience.

People that are sick are often expierencing a lack of control in their lives: a lack of control over their health, their obligations, their time, their finances. I don't take it personally. It seems to me that they're trying to get control where they can find it. If it's me, then... so be it. If I've brought their requested pain medications to the room, and then answered a second request, I have to move on to my next patient; then I'll kindly state that I can come back to them in 20 minutes after I've taken care of the next patient on my list who is waiting (hopefully) patiently for pain medications, or they can hit the water button on their call light and maybe the tech can beat me to bringing their glass of water and fresh pillow case. I don't mind one (quick) trip back after the initial request, but I have to move on to my next patient and put their next request to the back of the list after that. I think that's reasonable and respectful of my other patients.

FolksBtrippin, BSN, RN

Specializes in Psychiatry, Pediatrics, Public Health.

On 2/10/2020 at 9:04 AM, 2018RNat44 said:

I am a later in life RN (46 yo.) Nurse for 2 years. 1 yr hospice, 1 yr skilled/rehab unit in LTC. Hospice: too many HOURS so i switched to 3-12hrs on a rehab unit. I dont like what its doing to my PERSONALITY. Since its an ltc, a LOT of our pts are more "attention needy" than medically needy. Ex: call lights to "empty garbage" or "pick my lettuce off the floor" kinds of bs. Pts ringing like crazy for DUMB stuff or coming to nur station 30+ times a SHIFT. Not to mention the faaaamily members expecting 1 on 1 specialty treatment. Lots of pts are more hospice/LTC approp than "rehab"...Ive tried setting boundaries, pts acknowledge,apologize and then just REPEAT behaviors. Feel like im growing to HATE ppl and dont want to turn into that nasty burnt out nurse we all dread. Feel like Im dealing with a bunch of needy self absorbed, tantruming toddlers all screaming at the same time!

Coworkers tell me "its just nursing, it does that to you". Thinking about switching to hospital setting but afraid of the unknown. Any advice?

It sounds like you need some help with setting boundaries. Setting boundaries is more than telling a patient what is acceptable.

Setting boundaries means you change your response to the behavior.

Make some rules.

Example: call light is for emergency symptoms like I can't breathe, I'm in pain, I fell. Being wet or soiled, needing help to the bathroom.

I round x times per day. That is when I pick up dropped items, chat for a moment, help with the TV, empty trash.

When you round, you ask if anything needs to be picked up, etc.

If the call light goes off and you expect someone rang it for something inappropriate, you call the room if possible and ask what the matter is. If not, one of the allowed things, you remind of the rule and you tell them it will wait until rounds. If it's not possible to call the room you stop by and ask what the need is. If not appropriate you don't indulge. Even if the paper on the floor is right there and it will take you 2 seconds. Importantly, you do these things without expressing emotion.

That's setting boundaries.

Swellz

Specializes in oncology, MS/tele/stepdown. Has 6 years experience.

On 2/10/2020 at 4:13 PM, 2018RNat44 said:

I guess i just wonder if the INTENSITY of BS in hospital would be a little less onslaught than LTC rehab where i get yelled at for laundry, housekeeping and even kitchen problems by pts AND fams. Ppl forget our priority is their meddddical needs.

I have only ever worked in the hospital and I will tell you the level of BS and non-nursing issues I deal with is astounding. But, there is always something to be said for dealing with that from fewer patients!

2018RNat44, ADN

Has 3 years experience.

Thank you so much! Yes! I am still learning and need help with boundaries! Your suggestions are very helpful! Thank you for the tangible tools :).

Have you considered trying nights? Far less BS than during days, in my experience.

TriciaJ, RN

Specializes in Psych, Corrections, Med-Surg, Ambulatory. Has 40 years experience.

On 2/11/2020 at 7:31 AM, Wuzzie said:

I think the BS may even be worse honestly. Not saying the job is harder but there are just so many more players in the hospital.

Yes, including the kitchen, laundry, housekeeping, pharmacy, etc. who all seem to have a list of things they don't do, and try to turf it to the nurse.

For example: laundry won't wash anything with poop and nurses are expected to pre-rinse before tossing into a hamper; housekeeping won't clean up body fluids or remove linens from a vacated bed, but will stand idly by waiting for a nurse to do it. Pharmacy won't call the doctor when an order is unfillable; they expect the nurse to be go-between. Imaging techs will argue with a nurse whether an image really needs to be obtained stat, but they won't discuss it themselves with the ordering doctor. Central supply people won't provide something unless you call it by the correct name on their inventory list, but "aren't allowed" to tell you what that correct name is. Etc. etc.