Attachment to patient and vice versa

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I have been working for a home health agency for several months and particularly with a client with whom I work with over a 16 hours shift, once a week. This is a bedridden client who needs total care and who has been a joy to work for. Over the months I've received such great feedback/compliments from himself and his family. An issue that's developed lately is that I recently began the first semester of my BSN program and due to my school's location, I have a long commute and these factors have made my total availability to work, more limited. I've noticed that once I told my client that I wouldn't be as available, he began to act a little differently with me, seemingly withdrawn. I can't help but feel that he is disappointed that I am not able to see him as frequently as well as when I am there, in between performing my duties, I tend to be engrossed in my studies. This doesn't make me that much less present or likely to engage in conversation with him, as we still have great report much of the time, I am just sensitive to the changing dynamic and am posting this here for any insight into how to best deal with this. Am I just too sensitive? Is this something that all newbies go through? Any help would be greatly appreciated.

Thanks!

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Specializes in Peds(PICU, NICU float), PDN, ICU.

Seems typical. You have to have thick skin for this job. They will look for reasons to have problems. Is all about trying for control that they don't have.

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Seems typical. You have to have thick skin for this job. They will look for reasons to have problems. Is all about trying for control that they don't have.

Just out of curiosity, who are you referring to when you say, "they will look for reasons to have problems" ? Are you referring to patients? If so, is this a generalization/attitude that I should anticipate adopting? Is it easier to approach these situations with an attitude that lends itself to making judgement about, "them," and their feelings, just as it keeps the caretaker from experiencing any feelings themselves? Could it not be interpreted as "they" simply experience feelings just as the caretaker does, or is this not sustainable in this job? I'm not trying to sound like a jerk, I'm genuinely interested in finding out what people think.

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You will have a better understanding about SDALPN's comment after you have more experience working in home health. Very, very few individuals do not encounter the phenomenon described, that is typically par for the course in hh.

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I do think I understand. It's good to hear consistent responses. It makes me think about it and begin to understand where others are coming from :)

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Specializes in Peds(PICU, NICU float), PDN, ICU.

They...as in parents and some patients. I hate to put it that way. I wish it were better. But you will see it's almost all the same, just different homes. I love the work I do. I love being a nurse and making a difference or making a kid smile even once. But, yeah, it really is like what you experienced everywhere. Eventually every nurse learns in this area of nursing that it's like this, either by experience or by being burned.

We (nurses) care. But for the parents and some patients, it's about control and a power trip. If you want reality from the other side, go look at a group on FB for parents with trach kids. You will see what we mean. Tracheostomy is one page. Moms with trachs is another, but hard to get accepted in to the group.

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Specializes in Pediatric Private Duty; Camp Nursing.

Even Mary Poppins made a clean break at the end. It was a job, nothing more.

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Specializes in Cardio-Pulmonary; Med-Surg; Private Duty.

The family I've been with for three 12s/week for over six months is going to find out soon that they're only going to have me for one 12/week starting in October.

Rather than being grateful for what coverage I am able to offer them, I expect the mom's attitude to get even worse, which will likely result in them having me for zero shifts/week in November, because I'd rather not work for them at all if it's going to be a crap-show of attitude every night.

Sometimes it's out of meanness/control freak issues, and sometimes it's just an internal preservation mode, OP -- maybe they realize that they got too dependent upon you, and they are pulling back a little just to protect their own emotions as the situation changes.

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Yes, I have had this happen. As others have said, it may be a protective mechanism, a control mechanism, or something of both. When it's the patient, I completely understand the behavior. It's a complete submission on their part in many ways, and when the person they have been that open with has to "leave" it must be challenging. I am not really understanding where the parents come from yet. LOL! I do my best to not take it personally and remain professional.

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Specializes in Cardio-Pulmonary; Med-Surg; Private Duty.
I am not really understanding where the parents come from yet. LOL!

If you do figure out the parents, please share... I think we'd all love to understand that! LOL

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Sometimes it's out of meanness/control freak issues, and sometimes it's just an internal preservation mode, OP -- maybe they realize that they got too dependent upon you, and they are pulling back a little just to protect their own emotions as the situation changes.

I neglected to share particulars about this client but due to his condition (which is steadily worsening), he is completely dependent on his caretakers, and has been for decades. Because of this I can definitely see how his behavior might be a protective mechanism. Thanks for reminding me of this.

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It definitely makes sense, they way you put it, and thank you for your insight. It makes me realize how "green" I am but also grateful to have learned this lesson.

The family I've been with for three 12s/week for over six months is going to find out soon that they're only going to have me for one 12/week starting in October.

Rather than being grateful for what coverage I am able to offer them, I expect the mom's attitude to get even worse, which will likely result in them having me for zero shifts/week in November, because I'd rather not work for them at all if it's going to be a crap-show of attitude every night.

Sometimes it's out of meanness/control freak issues, and sometimes it's just an internal preservation mode, OP -- maybe they realize that they got too dependent upon you, and they are pulling back a little just to protect their own emotions as the situation changes.

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