Anyone have difficulty dealing with a specific type of patient?

[BrooklynRN11201]

I'm wondering if anyone else has experienced this. I have type 1 diabetes, and I take very good care of myself with an A1c of 6.8% - on an insulin pump and continuous glucose monitor, eat very well and exercise daily, etc.

Clinicals started last semester with basic MedSurg, and while I'm thankful I'm going into OB and Psych this semester, I can't shake what happened to me when dealing with a DMT2 patient last semester. He had end stage renal disease, on dialysis 3x weekly, was completely blind, had several toes amputated due to gangrene and was in the unit for some type of gastric hemorrhage, so he had a PEG put in.

When I was administering his meds through the tube, my heart rate suddenly sped up and I got light headed and dizzy. I had to apologize to my clinical professor and step out of the room. I went to the bathroom and cried. Now I know I'm not the only one to cry necessarily, but this freaked me out as I would like to become a CDE and will no doubt run into poorly controlled diabetics in the future.

I'm just wondering if anyone has experienced anything similar and how do you overcome this?

[nurseprnRN, BSN, RN]

in your psych rotation you'll hear about transference and all that stuff. it's always hard to care for someone that touches you personally, like an old lady who resembles your beloved grandma, or your child, or...yourself. with time and practice you get used to it. in this case, as i am sure you've thought of by now, this patient has clearly not taken the good care of himself you take with your self-management. i couldn't take care of children within weeks of becoming pregnant, and it's worse now that i'm a grandma.:heartbeat i also can't stand burn units-- i do try, and i can take care of all sorts of trauma and other gore, but whatever else, my patients just gotta have skin, ya know? so i deal with these by staying the heck away from suffering children and acute burn patients, although, oddly, somehow i seem to have acquired several burn survivors in my (nonhospital) practice.

we see this a lot in nursing school-- so many students are sure they know what they want to do before they really have any clue at all as to what this marvelous profession offers. many want to be pediatric or mother-baby nurses because, ta-da, they have had contact with kids all their lives via babysitting or having them. you have been a diabetic for years, and you want to be... a cde! imagine that!

i think one of two things will happen. either you'll get used to it, or at least learn how to cope with it (perhaps with a little session or two with the friendly counselors whose business it is to help people like you with problems like yours) and you'll go on to the point where as a hotshot cde you'll pick up dead toes off the mattress with nary a qualm. or ... you'll discover something else in nursing that just jumps up and grabs you, and five years from now you'll wonder why the heck you ever wanted to do anything else.

meanwhile. remember: breathe. people get dizzy with hypercarbia, and they also stimulate the vagus nerve when they hold their breaths in an unconscious valsalva which drops their heart rate. either way, it's not a good way to work . time passes.