Are we doing good for our patients?

idodialysis · Dec 8, 2015

I saw this frequently when I did acute dialysis...get that line in the patient, hook up to crrt only to die 12 hours later. No sense on a 90 something year old.

Anna Flaxis, BSN, RN · Dec 8, 2015

Moral distress is the reason I do not work in the ICU.

GeologistRN · Dec 9, 2015

Anna -

That is reassuring and distressing to hear. Have you stayed in nursing/found a field that makes more fundamental sense to you than ICU nursing? I do not want to be a quitter, do not want to leave a thing before I have really given it a chance, but I am really struggling with where I have found myself, and not sure the fundamental struggle with what ICU nursing is is likely to change any time soon.

Lev, MSN, RN, NP · Dec 9, 2015

Miracles happen rarely. Hold onto those moments when they come your way. I dont think I would last long in the ICU. ER is my niche for many reasons.

Anna Flaxis, BSN, RN · Dec 9, 2015

What worked for me was trying different settings. I've worked in long term, outpatient, and acute settings, and I've found that ER is the most tolerable. Your mileage may vary.

KatieMI, BSN, MSN, RN · Dec 9, 2015

That was one thing I was distressed deeply about in ICU. I love LTACH because I sometimes see sense in what I'm doing there. Not always, far from it in fact. Maybe 50%, counting all good outcomes (which I accounted for successful weans as well as comfortable and dignified deaths). But it is still better than to constantly lie (or, pardon me, "provide great customer service") that the Mother is doin' great, labs are great, she had her BM today and her blood pressure is fine.... on max Levophed and something else, that is.

I miss ICU with acuity and speed and technical things I just love to deal with, but to get really close to the patients and families and never have to say these d***ed sugar-coated lies to them means a lot for me. I really value these moments of trust. When someone tells you that you are the first one in weeks and months who told him or her the truth, hard as it might be, it means you did the elusive thing of "making the difference", and you did it right.

OP, after you become mentally comfortable, you may want to try different settings or different ICUs. Finding your niche in nursing takes time but can really make difference in how you see yourself as a professional. You might try to do PRN jobs to get a taste of different settings. But start it only after you become comfortable at your current place.

Hoosier_RN, MSN · Dec 9, 2015

Moral distress is the reason I do not work in the ICU.

Reason I left the hospital. It seemed like save at all costs

annabanana2 · Dec 9, 2015

Moral distress is the reason I do not work in the ICU.

Same here. I briefly considered something like NICU while I was in nursing school because I loved working with babies but I couldn't cope with what I perceived as torturing these little beings for no real benefit to them or to their family.

And now I work in palliative care! OP, consider hospice when you're ready to let go of ICU.

HopefulRN7 · Dec 9, 2015

I thoroughly enjoying private duty with pediatrics. We get patients when they've already been prodded and poked and we do our fair share of those things plus more but our mission is to enhance quality of life and assist patients in progressing developmentally (among other things). I'm currently working with a 1 y/o high grade glioma pt and find it incredibly fulfilling. I could be making a lot more money in the acute care setting but IMHO the experience of caring for patients in the home setting is INVALUABLE.

Good luck to you, I'm sure you will find your niche- it already sounds like you have a great sense of self-awareness early on and know what may not be working for you- you're way ahead of the game already.

PMFB-RN, RN · Dec 9, 2015

Hi everyone,
I am a brand new nurse, went straight into a MICU. I am about 2.5 months in (of a 3 month preceptorship) and struggling on a fundamental level with what this job is: It seems that all we are doing for 90%, perhaps 95% of our patients is prolonging suffering. We add tubes, we poke, we paralyze, we shock them, we wake them at all hours of the night...and for what? So they can die a couple of weeks later than they would have otherwise? A couple of months later? After having endured minimal, if any quality of life? In an unfamiliar environment, no windows, no plants, no sky? The last three shifts were the ones that put me over the edge: pouring blood products and pressors into a guy in DIC, and watching ever more blood pour out of ever more parts of him. And Nimbex, (along with Fentanyl, Versed, and Propofol) into a patient in ARDS with an ever-dropping pH and her daughter there hanging on every word, hoping for a miracle. Right now I am wishing I could give many of my patients and their families a priest's care, not the technologically advanced "care" I give. I would rather sing to them than stick them with needles and paralytics. How do I keep doing a job which, at least at the moment, feels like I do more harm than good? Watching people die in front of you all day (or night) and trying to keep them from dying is really, really difficult. It is excruciatingly painful, it is sad, it is terrifying, it is confusing, and I don't know if I can continue to do it.
Any thoughts?

Yep, you nailed it. Its why I always preferred SICU vs MICU. What you have observed is standard across the country in my experience.

Its caused by our awful culture that won't accept death and cowardly physicians who wont be honest

mc3, ASN, RN · Dec 9, 2015

And this is why I'm a firm believer in Hospice. What is done to these people is nothing short of cruel.

mc3:no: