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Discussion

Advice from psych nurses

I haven't done any psych nursing since nursing school. At the time, I actually did very well at it, and it was a definite option, however, I decided it was too much like my previous job and I wanted something different.

Here's what I would be grateful for- some tough love advice. I hope this is useful for other nurses, and I really do not know who else to ask. I recognize that mental illness is indeed an illness, and has all kinds of pain, suffering and maladaptation. I was always able to retain the "unconditional positive regard" with my patients. I saw their suffering, their distance from their families, and how it decimated their life and I tried to help. I know it's often the result of biochemical imbalances, genetic disorders passed on, and maladaptive responses to life. I know all this.

However. I find that a person close to my spouse, whom he cares for a great deal is apparently mentally ill- bipolar and an alcoholic. I have never liked this person, I have always found them infantile, selfish and with that ever present "poor me" mien that is inevitably irritating- and that was before it was discovered that they were an alcoholic. This person has done a lot of destructive things, and currently is causing a ton of pain in my spouse's world. This person has a family and is currently destroying its fabric. I am finding it really hard to do anything but despise this person, and I realize that, that fact is indeed a character flaw on my part.

Please help me re-acquire the nursing regard, the constructive way to see this person. Slam me for not seeing what I should see, I really want to be constructive and help, not be judgmental and a silent source of negativity. If this person had not really hurt those that I love, I guess it would be easier, but as a nurse, I find my loathing unacceptable. I would be grateful for an experienced psych nurse's view on this. Thanks.

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    I have family members with MI. BPD, addiction, I have no sympathy for them anymore. They've burned me too many times during their selfishness.

    But it's completely different for me at work. I empathize with my clients. It's just not the same as the way I feel about family. Perhaps it's the professional distance I maintain.

    I do think about my ill relatives as I provide compassionate and quality nursing care. I really care about my Pts and see them as their behaviors not being their fault. I see their behaviors as the fault of their illness.

    I think of it as the same way that I could provide quality care to my Pts at a prior workplace with dementia. I could love them and see past their behaviors. But when my own relative developed dementia, it was much harder to deal with.

    However, my experiences caring for people with dementia came years after my experience with my grandparent. Id like to think I could have been a better caregiver if I'd known then what I know now about dementia.

    Who I am as a professional nurse does not really affect the way I deal with people in my personal life.

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    Is it healthy to act like a nurse in family interactions? Should one adopt a professional role in purely personal interactions? How many discussions have been held on this board about how family members don't have the right to expect a nurse to always be a nurse and that the nurse has a right to just be a person in their off time?

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    • Author

    Ahh. In this case, I am going to have to admit to not doing my homework. Jeepers, I know better! I guess I just thought that no one would come here and admit that they loathe a mentally fragile individual who happened to be in their sphere. And, as a nurse, I guess I thought I should have a better grip on this. Please forgive the any assertion that nurses aren't human too. Not what I meant to do.

    How do you handle this though? So far, I am trying to keep my mouth shut, because nothing I have to say is helpful. There's no way to cut this person off, the only thing I can think of is to try to facilitate an escape pod for their immediate family. I think this person has had wayyyyyyyy too many chances, and sometimes if people do not get to rock bottom can they finally heal?

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    • Expert

    This is why all the helping professions have rules about professional boundaries and the inappropriateness of working with (treating) friends and family. It's extremely difficult, if not impossible, to be therapeutic and professional with people with whom you have a personal relationship.

    If this person is going to continue to be a presence in your and your husband's life, you (and your husband) might find Al-Anon meetings helpful -- that is the "sister" organization of AA, which helps family members and other people involved with alcoholics/addicts maintain as healthy a relationship as possible with the loved one while minimizing the damage you allow that person to cause in your own life. Most areas have at least one group, and your area AA contact people can provide you with info about times and locations of meetings.

    Best wishes!

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    I guess I just thought that no one would come here and admit that they loathe a mentally fragile individual who happened to be in their sphere.

    Au contraire mon frere. I have one, and I'm not proud to say that we haven't spoken in almost two years, but I won't deny that it's increased the peace around these parts either. Mine doesn't involve substance abuse, though. I think Al-Anon is an outstanding idea for your situation.

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    • Expert
    I guess I just thought that no one would come here and admit that they loathe a mentally fragile individual who happened to be in their sphere.

    Nope, been there, done that! My position is that I get paid to spend time and empathize with unpleasantly mentally ill individuals :); for my own health and well-being (as part of leading a healthy lifestyle and taking good care of myself in order to be able to continue to function professionally), I choose not to do it in my personal life. And I don't feel at all guilty about that -- I see it as healthy boundaries and good self-care.

    (As a friend of mine always says, "Clear, healthy boundaries are the key to a happy life.")

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    • Author

    I thank you all very much. I feel a bit better about my struggles with this mess. I guess my "keep your mouth shut" policy is really the best one, amazing how that one always works. I will explore the Al-anon meetings, I think it would help my spouse and the rest of us.

    Many thanks!

    Happy Thanksgiving!

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    The way I see it.....at work I need to apply nursing care unconditionally. Even if a cluster B is driving me to wanna strangle them....I still gotta do my job as a nurse....

    However when it comes to my personal life I am allowed to dislike and ignore who I choose. I have no obligation to anyone outside my family. I have enough stress dealing with such pts. I don't need added drama that I'm not getting paid to deal with. I don't need that extra histrionic friend in my life. I've avoided a few of my now ex husbands friends cuz they got on my nerves. But we managed. He dealt with them and I stayed away.

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    I second Al Anon, of not for you, for your spouse. The behavior this "friend" of your spouse is exhibiting is classic addict behavior and I am sure if this person is causing your spouse such grief, your spouse is filling the enabler role right now. Al Anon helps with that and if nothing else, your spouse needs to just step aside and let this person hit his/her bottom.

    Dealing with addicts and mental illnesses in personal life vs professional life is a totally different animal. If I am going to he able to perform the best job I can, I have to be mentally healthy and I just can't do that if I have a lot of people that want me to enable them in my life.

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