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?

[RNOTODAY, BSN, RN]

I am totally the nurse you are......

[phill_rn, MSN, APRN]

I havent been a nurse for long and I denfinitely feel cold hearted. During my last shift, we had a 26yr old come in. He'd been drinking and yes, driving and was very intoxicated and ended up killing 3 others. He was banged up pretty badly and complaining of excrutiating pain and I felt nothing. Now thank goodness he wasnt my patient because as horrible as it is to say this, I dont even know if I could find it in my psyche to give him anything that would make him feel better ugh!

Or how bout the seekers? The drug seekers? I have no idea why this particular patient is still a patient. Almost 70, looks as sweet as can be and all she wants is more, more, more pain meds. So much so her BP dropped to 80/50. All she does is walk about-inside and out, make coffee, eat all she wants, plus there are no physical signs or anything to suggest she's in pain especially not with that low BP. For all you out there who'd like to say "pain is subjective"-yada yada, I know, please save it. She asked for dilaudid, I gave motrin, you shouldve seen the look on her face! I have absolutely no tolerance for patients like this and Im not there to be your drug supplier/pusher. So yes Im becoming colder and colder and having less tolerance for BS. And all you doctors/prescribers out there who enable patients like this just so you dont have to deal, STOP IT already!

Peace and Blessings

[J.R.theR.N2b]

sorry this so late but just had to comment. before you put your freshly polished halo to bed for the night i think you should consider another side of this issue. i suffer from very severe claustrophobia and cannot tolerate restraint of any kind, not even the seat belts in my personal automobile. if i were the confused, combative, disoriented patient in that bed needing a nasogastric tube and physically resisted, the four nurses restraining me would have come face to face with a completely unexpected problem. forced restraint upon my person causes very severe anxiety attacks, elevated blood pressure, rapidly elevated heart rate, and i become obsessed with only one thought-----------getting rid of the restraint in any way possible and with any means at my disposal. i know this as a result of a session with a phychologist for treatment of my claustrophobia he referred as flooding. this session was immeadiately terminated by a very surprised therapist, who afterward stated this was the worst case he had come in contact with in his practice. there was no doubt in his mind, nor mine, that any forced restraint would cause me to have a heart attack or stroke brought on by extreme fear and my superhuman struggling to avoid being restrained. i just wanted to show what may result from a simple exercise of "it's for their own good" and "we know best" how would you feel if the haphazard act of simply following protocol resulted in a patient's death? i think, in cases like mine, you CAN AND MUST sedate a combative, confused patient when he must have a procedure he would be expected to physically resist. thank you very much.

[Penelope_Pitstop, BSN, RN]

I think we all have different strengths, and for a reason.

I do have a heart. I've cried with patients and families, and I've held hands and hugged, but those are the exception.

I am not the most compassionate, "caring" nurse, but I have other strengths. If you code, you want me there. If you want an NG tube or a cath, I'm your woman. I will advocate for you until I am out of breath.

But, if you want a backrub, ask my friend "Kim." She loves nothing more than doing things like that. Her bed baths are a spa experience. Mine? They're thorough but take no time at all. I'm the queen of "I can't promise it will be pleasant but I can promise it will be quick" in regards to all kinds of things.

You wouldn't want Kim if your heart stopped...but if you needed someone to listen to you vent, or wipe away your tears, she is there. She could do hospice, or psych. I could not.

If we all had the same strengths...think of how much that would stink!

[Rexie]

I agreee, if we all had the same strengths, it would be a terrible thing.

I have had to pass ng tubes and have left the room feeling bad about it, but not too bad. It really doesn't do anyone any good. The pt needed it and we got it done. I have been on the receiving end of a failed ng tube insertion and it was pretty unpleasant. It would have been so much better if somebody who knew what they were doing had just come in and got it done. Less trauma and possibly a quicker recovery for me.

I think a lot of it has to do with comfort level. Hopefully, the nurses you were with, having seen how much the patient benefitted, will be less squemish next time.

[monkeybug]

I havent been a nurse for long and I denfinitely feel cold hearted. During my last shift, we had a 26yr old come in. He'd been drinking and yes, driving and was very intoxicated and ended up killing 3 others. He was banged up pretty badly and complaining of excrutiating pain and I felt nothing. Now thank goodness he wasnt my patient because as horrible as it is to say this, I dont even know if I could find it in my psyche to give him anything that would make him feel better ugh!

Or how bout the seekers? The drug seekers? I have no idea why this particular patient is still a patient. Almost 70, looks as sweet as can be and all she wants is more, more, more pain meds. So much so her BP dropped to 80/50. All she does is walk about-inside and out, make coffee, eat all she wants, plus there are no physical signs or anything to suggest she's in pain especially not with that low BP. For all you out there who'd like to say "pain is subjective"-yada yada, I know, please save it. She asked for dilaudid, I gave motrin, you shouldve seen the look on her face! I have absolutely no tolerance for patients like this and Im not there to be your drug supplier/pusher. So yes Im becoming colder and colder and having less tolerance for BS. And all you doctors/prescribers out there who enable patients like this just so you dont have to deal, STOP IT already!

Peace and Blessings

This is inexcusable. It is not within your realm of responsibility to "fix" her. Chronic pain patients often don't manifest outward, objective pain cues, like changes in BP. Would it make you feel better if she turned purple with green polka dots when in pain? Would you believe her then? And ask yourself, why in the name of all that is holy do you think your belief and judgment play any part in her care? She has a complaint, her physician has examined her and ordered accordingly, and you, being almighty and full of righteous indignation, decide that the both of them are wrong and YOU have the answer. Your "tolerance for patients like this" shouldn't even come into play. I should never wish ill on anyone, but I think it would be very helpful for all the nurses like you to spend a week or two with some invisible pain, and then have their pain medication withheld because you don't look sick enough to suit someone else's arbitrary criteria. You say she walks around, eats whatever she wants, etc. Well, that's the point of pain management! So she can live a life. You need to go back to your nursing textbooks and review the pain chapters. Your attitude makes me so angry and sick. How dare you? You are the reason patients delay seeking treatment. They know that, because they don't have a compound fracture or some other obvious reason for the pain, they will have to convince some unfeeling, sadistic individual that they really do deserve care.

[martymoose, BSN, RN]

Just a question Monkeybug,, just curious? Do you work in pain management, or have you had pt's who are like the one described above ,especially for 8 hours a day?

I have had some of the patients as described. One can't help but group them together, and I as a chronic pain person, get so angry because these types of people ruin for others who have pain.

I don't think it's coincidence that some pts who are chronic"drug seekers" are totally mismanaged to the point that they are addicted, and yes, the doc gives them what they want, and we have to deal with the aftermath- low b/p's ,falling, decreased respirations, etc. Funny how a lot of these people always want phenergan with their 4 mg of IV dilaudid( and these are not post op or CA pts), and spend their whole time in the hospital as a zombie. Oh, but any other antiemetics will not do- it has to be phenergan- .and we all know what phenergan does....

And of course there's the other side of the coin, the doc who will not prescribe the narcs that the pt wants. Again we deal with the after math, which I'm sure I don't have to explain here.

After a few experiences of the above described over the years, yeah, sometimes one can get cold.

[BrandonLPN, LPN]

I havent been a nurse for long and I denfinitely feel cold hearted. During my last shift, we had a 26yr old come in. He'd been drinking and yes, driving and was very intoxicated and ended up killing 3 others. He was banged up pretty badly and complaining of excrutiating pain and I felt nothing. Now thank goodness he wasnt my patient because as horrible as it is to say this, I dont even know if I could find it in my psyche to give him anything that would make him feel better ugh!Or how bout the seekers? The drug seekers? I have no idea why this particular patient is still a patient. Almost 70, looks as sweet as can be and all she wants is more, more, more pain meds. So much so her BP dropped to 80/50. All she does is walk about-inside and out, make coffee, eat all she wants, plus there are no physical signs or anything to suggest she's in pain especially notwith that low BP. For all you out there who'd like to say "pain is subjective"-yada yada, I know, please save it. She asked for dilaudid, I gave motrin, you shouldve seen the look on her face! I have absolutely no tolerance for patients like this and Im not there to be your drug supplier/pusher. So yes Im becoming colder and colder and having less tolerance for BS. And all you doctors/prescribers out there who enable patients like this just so you dont have to deal, STOP IT already!Peace and Blessings

Yikes. I understand being disgusted by a pt whose drunk driving caused the deaths of 3 people. I understand not feeling much compassion for his pain. What I *don't* understand is you saying your feelings would prevent you from medicating him. That pretty much violates every aspect of being a nurse. Sorry, but who *cares* how you feel about the whole drunk driving situation. It has nothing to do with anything when it comes to providing care. Judge him all you want in your head, we all do that. Anyone who says otherwise is lying. But you still have to do your job....

[martymoose, BSN, RN]

I also wanted to note, is it possible that we are "cool hearted" as a defense mechanism?Especially when it when it comes to repeated tragic events, codes, etc.

I find it torturous some of the things we have to do to the confused elderly. In their frame of mind, they see it as it is- someone shoving a ng tube in, putting in an iv feels like someone stabbing you with a giant needle, foleys? no description needed.

I've had a few pts recently that were in limbo for failed swallowing tests- some had ng tube placed in the meantime. They DO NOT understand that this means they will never eat or drink again!!! I will admit I feel bad for the elderly who keep crying out for something to drink The swabs just don't cut it.

It is like others have said though, we don't have time to let ourselves get upset. I will also say that I feel that being "stoic" is an acquired skill.

[BrandonLPN, LPN]

Just a question Monkeybug,, just curious? Do you work in pain management, or have you had pt's who are like the one described above ,especially for 8 hours a day? I have had some of the patients as described. One can't help but group them together, and I as a chronic pain person, get so angry because these types of people ruin for others who have pain.I don't think it's coincidence that some pts who are chronic"drug seekers" are totally mismanaged to the point that they are addicted, and yes, the doc gives them what they want, and we have to deal with the aftermath- low b/p's ,falling, decreased respirations, etc. Funny how a lot of these people always want phenergan with their 4 mg of IV dilaudid( and these are not post op or CA pts), and spendtheir whole time in the hospital as a zombie. Oh, but any other antiemetics will not do- it has to be phenergan- .and we all know what phenergan does....And of course there's the other side of the coin, the doc who will not prescribe the narcs that the pt wants. Again we deal with the after math, which I'm sure I don't have to explain here.After a few experiences of the above described over the years, yeah, sometimes one can get cold.

Well, if someone is hypotensive or respirations are too low, by all means hold the pain med. But it's not okay to hold an ordered PRN medication because you feel the pt "doesn't need it". That is not a nurse's call to make. If you're going to refuse to give an ordered PRN medication, you'd better have solid, objective data backing it up. If a medication is ordered and the pt can clearly tolerate it, why even waste your time and energy resisting it?

[Ruby Vee, BSN]

sorry this so late but just had to comment. before you put your freshly polished halo to bed for the night i think you should consider another side of this issue. i suffer from very severe claustrophobia and cannot tolerate restraint of any kind, not even the seat belts in my personal automobile. if i were the confused, combative, disoriented patient in that bed needing a nasogastric tube and physically resisted, the four nurses restraining me would have come face to face with a completely unexpected problem. forced restraint upon my person causes very severe anxiety attacks, elevated blood pressure, rapidly elevated heart rate, and i become obsessed with only one thought-----------getting rid of the restraint in any way possible and with any means at my disposal. i know this as a result of a session with a phychologist for treatment of my claustrophobia he referred as flooding. this session was immeadiately terminated by a very surprised therapist, who afterward stated this was the worst case he had come in contact with in his practice. there was no doubt in his mind, nor mine, that any forced restraint would cause me to have a heart attack or stroke brought on by extreme fear and my superhuman struggling to avoid being restrained. i just wanted to show what may result from a simple exercise of "it's for their own good" and "we know best" how would you feel if the haphazard act of simply following protocol resulted in a patient's death? i think, in cases like mine, you CAN AND MUST sedate a combative, confused patient when he must have a procedure he would be expected to physically resist. thank you very much.

I'm sorry for your issues. However, this is a vent thread for nurses, and you don't have perspective as a nurse. Your perspective is as a patient. I might have been inclined to cut you some slack, but when you started out your post with "before you put your freshly polished halo to bed for the night," you pretty much eliminated my sympathy for your perspective. I read your post as an attack on nursing. When you jump on a vent thread for nurses and immediately disrespect nurses, that sort of thing happens.

[CodeteamB]

I think part of the problem is that our profession has been traditionally thought of/portrayed as soft hearted angels of mercy or nasty cruel witches (Florence/Ratched). Is doing what is necessary for the pt seen negatively in other professions? Do we look down on the doctor who inserts a chest tube or does an LP? Not in my experience. When we give a baby vitamin K to prevent bleeding problems or insert an NG tube to rest the bowels/ alleviate pressure or (as in the case where I was called a heartless b-) flush a toddler's eyes post chemical exposure, we are doing our best for our patients. We should not be expected to bellyache over it in order to be seen as compassionate, I'm not doing it for my own health, I don't enjoy doing it, but I take pride in my ability to do it and in the thought that it did in fact help my pt, that is not unfeeling or cruel. Just my two cents.