Any other cold hearted nurses out there?

[sweet~revenge]

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?

[nursecat64]

I once worked in a facility for "brain injured" patients. Many patients were there for a long time so we got to know them well. I worked with a nurse that I considered "cold". She was very efficient, objective, and by her own words "do not get personally involved with these people" She did her job well though I didn't agree with her methods. We had a contest, with only the patients voting -for "best dressed" "nicest smile" etc.. Well, the nurse whom I considered "cold" won "most compassionate nurse"! -I learned an important lesson that day! You don't have to "take on" the emotional burdens of the patient in order to be a good nurse, and most of the time, it's best if you don't!

[0402]

We had a 105 yr old patient die on our floor recently (comfort care only; I work m/s). One of the nurses said something about it being sad that she died. I commented that I really didn't think her passing was sad (the fact that her family couldn't be bothered to be there was sad but not her actually dying). I was glad that she was kept comfortable and her nurse, the charge nurse and I checked on her constantly (we had her by the nurses station), so she really wasn't alone too much. I thought it would have been sad if her family didn't agree to comfort care- letting her pass on was the best thing for her at that point.

I have a friend who is in nursing school and doing some sort of externship in an ICU, and she commented how sad it was that her pt died during her latest shift. This was a 90-something, WWII vet who was very ill. I don't look at it that way- I look at it as he is at peace now, and I'm glad that she was there to hold an old vet's hand while he passed. Everyone else commented that it was sad that he died. I was the outlier.

I think that sometimes we cannot advocate appropriately if we look everything as "sad" (I'm sorry, I know that isn't quite the right word, but my I'm in the middle of transitioning from my night shifts back to my day shift family life). What are the means to the best "end?" Yes, it sucks for the pt to have to put in an NGT, but when they aren't even cognizant enough to realize that it's a means to a necessary end, I look at it similarly to you. It's a means to an end- not an emotional event, per se. And that end is what's best for the pt.

(And I don't work with babies or kids, so I'm sure that's a different ballgame.)

[UTVOL3]

I'd include myself in your heartless bunch. Like a pp mentioned, there often just isn't time for sentimentality. I feel for anyone who is struggling, but I can do my job much more effectively if I stay task focused and don't think about the emotional part of it.

I think some people are just better at compartmentalizing like that.

[ANurseDivided]

I really feel that it is all about balance. While I do agree that you can probably get more accomplished by being calm, cool and collected (soothing talk, constant applause when the patient does what you want them to do, holding the hand, etc), sometimes it does not work and you need to resort to more drastic measures. There is nothing worse than dealing with a confused / combative patient. It just gets under your skin (or at least does for me and I consider myself pretty patient with patients although I am not patient in everyday life). I feel that you should at least start down the path of least resistance and then alter your plan as needed.

I think that with experience, we all become pretty jaded at some point. Think about all the crude and unprofessional "jokes" that we say at the most inappropriate times. When I talk to my husband about some of the things that happen at work and how we "joked" about it gets him so incensed. But I feel that we do it because it is a coping mechanism for us...it helps us get through it. If we sat around and cried about every little thing that we did we would all be basket cases and nothing would ever get accomplished.

So with all of that being said, I understand your struggle and I do not find that you were wrong.

It was also at this point that I knew that I needed to remove myself from the bedside, because I was becoming less and less sympathetic to my patients (not to say that you are). I still cared for them with compassion and respect, but I was definitely becoming less sympathetic. It would irritate me when my patients would start to cry because I told them they could not have something to drink 5 minutes after being extubated for the 3rd time among other things. So I made my exit and never been happier.

[badmamajama]

I don't think you're heartless or cold at all, just realistic. It sucks having to hold a confused person down to perform a scary, painful procedure but when all else fails and it's their health or life on the line sometimes it's all you can do. It sounds to me like you still had the patient's interest at heart, that you had your eye on the prize; improving their health. You said that when you got the tube in you saw how badly he needed it. I shudder to think what must have gotten sucked up into the suction canister(s)!!! The first time I had to give a baby a Vitamin K shot and hesitated because I didn't want to hurt the poor baby an experienced nurse told me "hurt 'em for a minute, help 'em for a lifetime." I remember that every time I have had to do an uncomfortable proceedure and it's been part of my mantra since.

As for the asystolic babies, one of those babies was mine. I couldn't read anyone else's posts after I read the one about not crying over babies. Sorry, maybe because I have buried a child myself I will probably always have a very hard time with peds codes. I think I am finally to the point where I won't be a train wreck and can offer comfort to families in a bad situation and I'm thinking of going into L&D. We'll see.

T

[Trekfan]

Sometimes it better just to be the "bad one " and get it over with case in point when I have to get my s/p tube changed it is the most painfull thing I have every done in my life 20/10 pain . When it is done at the doctors office 2 nurses come in one holds me down and the other rips it out and yes I am screaming for them to stop and crying buts its over pretty fast .My doctor now has home health do it and the last 2 people that came out to do did not want to cause me pain and stoped pulling when I began screaming all this did was drag the hole thing out for 20 mins because they had to keep trying . I allmost think fast is better .

[fiveofpeep]

For some of my patients, death is the best thing that could happen to them. Now, I don't push them into the grave, but when a 98 yo LOL who has been comatose for three weeks and is in MODs and has coded over and over, finally goes to meet her maker, I'm relieved she isn't suffering anymore.

[NurseCard, ADN]

You have an understanding that sometimes measures such as restraint have to be taken in order to accomplish a goal. You feel good that you accomplished what needed to be done in order to help this man. You know in your heart that you didn't want to have to restrain the man, but you realize that it was something that was necessary for the best outcome.

I mean, I have the same problem as you. I just always remind myself that I don't ever want to HURT anyone, I want to help. I may not cry every single time a patient cries, or get attached to every resident... but in my heart, I do want to help everyone or I wouldn't be in this profession.

I hope you don't have pediatrics on your floor; I can't imagine the scene when these girls are working and a toddler needs an IV for an infusion of antibiotics.

[AZ_LPN_8_26_13]

I don't think that it's bad feeling the way you do IMO. I am a male nursing student who is just about done being a student and plus I work as an aide in a busy metro hospital, so I've seen and actually been in on a lot situations like the one you described. I think that I've been in on a lot of them because I am a big strong guy and I am one of the ones who is usually called upon to help do things like this.

I feel bad that we have to do things like restrain people etc., but remember that we only do it as a very last resort. Yes, we probably could have just as well done it that way right at the beginning because based on experience we're pretty sure that this is the way it would end up. But we always have to start out offering the voluntary compliant patient option first, even if we know that it will probably be fruitless.

I've done a lot of pondering and reflective thought on situations like this, plus I've always been interested in psychology and the workings of the human mind - based on my own personal observation it seems like people who were maybe Type A persons who like to consider themselves as "in charge" of things before they were in the hospital seem to be the ones who have the hardest time with things when they are hospitalized. They are put in a completely reversed universe and are deeply resistant to procedures etc. that are necessary, and many times refuse to see or accept the logic behind those procedures. All you can do is try of offer what little "options" you can to these patients, and try to explain logically why the procedure is necessary. Many times unfortunately that's not enough. Afterward you will be assured that you know you did all you could to try and help that patient. It's tough when you have to do things against a patient's will and they fight you on it.

Getting back to your original question though, no there's nothing wrong with feeling the way you do - I feel the same way after something like this is done - satisfaction knowing that we did what we needed to do even though the patient was being uncooperative and helping that patient in spite of themselves. And while I might feel a bit bad about the patient and having to do that to them I don't really feel too badly about it for too long because after all we did give them the option of voluntary cooperation first. Sometimes when they are way confused you don't have much choice.

[AZ_LPN_8_26_13]

"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'm a guy and this is just my take on it, but the er isn't the place to start crying. You need to be as cool, calm and professional as possible when you are dealing with this stuff. You can't fall apart. You did what you were supposed to do and reacted the way you should have. Those other folks have a lot yet to learn IMO.

[leslie :-D]

For some of my patients, death is the best thing that could happen to them. Now, I don't push them into the grave, but when a 98 yo LOL who has been comatose for three weeks and is in MODs and has coded over and over, finally goes to meet her maker, I'm relieved she isn't suffering anymore.

there ya go, five.

it's when these type of codes work, and the pt survives...

now that is sad.

you know that (nike?) saying, "just do it!!"

that.

often in nursing, we do things that we know aren't going to be pleasant.

so you take a deep breath, charge forward...and just do it.

another consideration, is one's personality.

i am a very no-nonsense person, whereas others are experiencing anticipatory grieving before they've even gathered their supplies to do the dirty deed.:icon_roll

seriously, i've seen nurses dread a task so much so, that their angst only prolongs the inevitable, and prolongs the pt's torment.

i certainly wouldn't expect a new grad to understand our 'cold-heartedness'.

but in the end, we do what we gotta do.you can have your meltdown on the way home from work.

i am always bemused when we are by nature, "angelic and merciful", because nurses are anything but.

this profession is not for sissies or the meek.

when we have to do something invasive, why then, do we consider ourselves cold-hearted?

it is not that...we are only doing our jobs, and doing it well.

we see the big picture, and know what we have to do in order to do the job proficiently.

so then...are we going to whine or procrastinate or start diaphoresing because what we're about to do, is difficult?

nope...i hope not anyway.

op, you were fine.

don't start second guessing yourself.

it is those situations that you know that we should be affected, but we're not...

that is when you can start wondering.

but if that's not the case with you, then you know what you have to do.

so just.do.it.

leslie:)

[CrunchRN, ADN, RN]

If you let yourself feel every emotion for every patient you would be burned to a crisp your 1st year. A reasonable distance allows you tp provide the best care.