Any other cold hearted nurses out there?

brownbook · Jan 18, 2012

I agree in a way. Many medical/nursing interventions are painful. I don't think your feelings are wrong or bad.

All I wonder in the retrospectroscope if for this specific case more IV sedation wouldn't have been a better idea. But I understand how hindsight is 20 20 vision. It was "just an NG tube." you could hardly (or safely) "knock him out" just to insert an NG tube.

LaterAlligator · Jan 18, 2012

I'm with you. I'm coming to acute care from a background in a dementia facility, so I'm accustomed to patients fighting me on every single thing - oral care, brief changes, transferring from wheelchair to bed, etc. With that population, you have to just do it, because if you let them refuse care every time, they'd be sitting in the same spot, filthy and covered with pressure ulcers within a week.

Now when I have confused/combative patients at the hospital,I don't think twice about having someone hold their hands so they can't hit me while I do hygeine or whatever on them. It just has to be done, and that's all there is to it.

sweet~revenge · Jan 18, 2012

Thanks, I feel a little more normal now. I agree with you, I would have liked a little more medication, but this patient's doc is notorious for being stingy with the sedatives (I can't say that I blame him.) We were lucky to get what we had :). You're right though, can't really sedate someone to place an ng. Even thought he didn't want to, we did need the patient's help with swallowing while putting it in. Ice chips, gotta love 'em...

anotherone, BSN, RN · Jan 18, 2012

Anybody else feel like you're just not as caring and compassionate as other nurses? I think of myself as a caring nurse and I try to do the best I can by my patients. I love it when I leave at the end of a shift and I feel like everything was done well and my patients were well taken care of. However, I've been in some situations where I don't seem to be as sensitive as some of my coworkers when dealing with patients.
For example, one day another nurse needed to place an ng tube on a very confused patient with a bowel obstruction who was not very cooperative. Knowing he was going to be resistant, she asked for help from me and the charge nurse. She premedicated him with iv valium, we went in and his nurse tried to do it the nice way with the patient's cooperation but of course he fought us. Then we finally did it the way I would have done it from the start, which of course involved 4 of us restraining this very strong combative confused man while one of us inserted the ng tube. By the time we hooked him up to suction, it was really obvious how much he needed it.
Afterwards, the charge nurse and the other nurses were all saying how much they hated having to do that and just basically talked about how bad they felt for doing that to him. A new nurse who was there and just wanted to observe was horrified and is probably traumatized for life. Meanwhile I didn't get it. We did what had to be done and the patient was better off for it. If anything, I felt a sense of satisfaction and accomplishment. Am I some sort of unfeeling freak of nature or what? This is just one example of this where I feel like the odd woman out. Does anybody else have this problem?

The question is, is that pt really better? sometimes that is something i struggle with but that is a WHOLE other lengthy issue. How long have you been a nurse? I think overtime I just have to care less to protect myself. I get the job done but compartementalize over it. Have you ever heard of compassion fatigue?

xoemmylouox, ASN, RN · Jan 18, 2012

I can be tough when it comes to certain things, however I can be very compassionate. It just depends on the situation. I have grown attached to some patients and when they pass it is very hard, but I am forever grateful for the time/experience I had with them.

VICEDRN, BSN, RN · Jan 19, 2012

I think it comes with experience and I don't think its cold hearted. I think its realistic. You have been there done that before and you want it over quick as possible for everyone. You already know that avoiding providing the care that the patient probably needs just makes it worse for everyone.

I have been stared at in horror by a new grad who was shocked when I didn't cry when we coded a baby in the er who arrived asystolic. I had other patients to work with, it wasn't my first asystolic baby and I didn't expect a positive outcome and we didn't get one. She actually called me heartless to my face because of it but whatever, like I said, other patient needed care and it wasn't going to go well.

Other times I know we have shocked med students and new grad Rns by how readily we "ignore" pain in the trauma room. Well, I can't medicate with vitals and I refuse to kill a patient with fentanyl or morphine so it has to wait till the primary survey is over. Further, missing injuries can result in life long harm and death but you know this, which is why it doesn't bother you to do the care as needed. ;-)

Perpetual Student · Jan 19, 2012

In the case you mention above I wouldn't have thought twice about dopin' him up, holding him down, and doing what needs to be done. If I heard most of those comments I would laugh. I must work with a bunch of bitter old nurses, because they'd all look at someone saying that like they were dumber than a sack of hammers. You were doing the guy a favor by dropping the NGT--it made him feel better! So what if you had to wrestle with him a little bit. It's not like you punched him in the face and choked him out to gain compliance!

Having wrangled many patients as they emerge from anesthesia, I find most patients get a chuckle from it after they're alert & oriented again. They understand. Even if they don't understand, it's your job. Just do it. Same goes for the story above about the initial management of a trauma patient--you've got to do what's necessary.

I am bothered when someone loses something unexpectedly (life, function, a family member, whatever), but honestly it's someone else's loss, not mine. I can usually feel bad for someone then a little later go eat a cheeseburger and joke about farts.

I don't think I'm a sociopath, just a realist. We're all going to die sooner or later. Life's hard and bad things happen. All we can do is deal with it.

sapphire18 · Jan 19, 2012

I don't see why you would go straight to pinning the pt down and shoving the tube up there on the first try. Giving compassionate care and even talking to the pt in a soothing voice goes a long way for them, especially when they are confused and having painful procedures performed on them without understanding why- they don't need to be pinned down and yelled at straight off the bat. Which happens. Nursing is not just about physical care but emotional care as well.

wooh, BSN, RN · Jan 19, 2012

I don't call it cold hearted, I call it compassionately realistic. Doing it slow and "compassionately" in most cases just draws out the trauma of having whatever done. It's like taking off a band aid. There's the compassionate way of, "Oh you poor dear, let's just pull this corner a bit, oh I'm so sorry, let's pull a little bit more, oh I know you don't want to take it off, let's take a break, and now a little bit more." Then there's the TRULY compassionate way of just ripping the band aid off. I'll take #2 anyday.

Esme12, ASN, BSN, RN · Jan 19, 2012

We do what we have to do.....when it is said and done and when you hook up the NG to suction and get a liter.....it's ok to feel an accomplishment. I mean, jeeze, talk about adversarial circumstances. I have often felt that if we were viewed by the public almost everything we do is crass and heartless at times. Sometimes if you don't laugh or make and unusual "off color" comment you'll just go crazy......the fresher to the profession just don't, and can't, see it that way....yet.

Babies still get to me and when it's all done I give myself that one tear and the sadness of it all even though it is for the better when we don't get them back......but just one and move on. Someday the fresh and new nurses will understand, If you feel it all the time it will suck you dry and burn you out. Moderation is key here.

DixieRedHead, ASN, RN · Jan 19, 2012

coded many a baby, not a tear for anyone to see. maybe not even a tear. but they don't see you when you go the bathroom stall, stand in the corner, and just stare at the wall. coding a baby is no time for tears. neither is the aftermath. there is work to be done, skills to be exercised, parents tears to be dealt with, yours are not important.

there is a great deal to be said for being skilled. there is a great deal to be said for knowledge. you want a crying, cutesy, bubbling little nurse, they are a dime a dozen. give me a crusty old bat that knows what she's doing every time.