Cm is a thankless job!

[lisa41rn]

I don't know what it is, but for the last few weeks I have busted my butt for a very financial needy patient or two and have had that very patient be completely unappreciative for what I've done. I guess I should be happy it tends to be only a patient or two a week and the majority don't seem to care about what what I've done or if I'm lucky I do get some appreciation from a family or two.

I had a patient needing IV antibiotics and didn't have much money to cover the deductible amount. I begged the hospital to help him with the bill and they ended up paying $300.00 or 1/2 of his bill. The thanks I got? He told me "no one does xxx anything around here!" I couldn't believe how he dropped the f-bomb when I worked so hard for him. I felt like telling him I don't get paid enough to be spoken like that. Instead I brushed it off that his anxiety was getting the best of him, but know one has the right to be rude to us!

Today I had a lady dc'ed who needed a SNF. I called her sister-in-law yesterday to let her know the pt was offered a bed and that she would be leaving the today. Well her brother stopped by the hospital at d/c and is clearly angry that she is leaving in a johnny (fully covered in blankets) by the ambulance company and he was to bring clothes to the SNF and meet her over there. He had no bags in his hands when he stopped by the hospital with clothes had he wanted her to change before leaving. I guess what I wouldn't give this a second thought but this brother is deaf. The pt was at her baseline and lives alone. Although the brother was the DPOA it was never activated. I guess I feel bad as had he come in earlier I would have gotten an interpreter even though the pt was capable of communicating with him and it wasn't medically necessary to do so. By the time I realized the brother was upset she was already in a w/c van being transported to the SNF. We didn't even expect the brother to be at the hospital at the time of transfer.

Ugh! I find healthcare so exhausting. It really is a thankless job. I hate worrying about things (ie this deaf brother - should I have gotten an interpreter although I know he came in as the pt was being transferred and his wife was told the previous day about it?!) My husband says I don't get paid enough to worry as he knows I'm very detailed and thorough, but healthcare is tough and we're all overbusy at times. How do some of you shut off your jobs when you walk out the door at work?! Does everyone worry about this sue-happy society we live in?

[Rntr]

Personally, I have thought this about "healthcare" for a long time...

[SummerGarden, BSN, MSN, RN]

op: the only way i avoid feeling this way about patients and or family members is to accept the fact that i cannot change anyone. i also cannot make someone's life significantly better with one act of kindness. not to mention i have accepted the fact that many may not care or appreciate my help. also, i have accepted the fact that the patients got really bad over a long period of time (made bad life choices and/or had bad events happen to him/her over time). thus, a short time with me will not change his/her life overnight. so, how do i shut it off at the end of the day? i just do! as soon as i walk out the door of my unit, i am done.

of course, it took me a bit of time to be this way. i used to work in case management prior to nursing and was a lot like you describe yourself for years. however, a very well respected and wise msw pulled me aside and told me that if i did not change my approach to working with clients/patients (i.e. if i did not stop taking everything i did and the outcomes and reactions of patients/clients to heart and if i did not stop worry about people i cannot fix), i would easily burn out. she still works today with well over 30 years of experience. so i am again taking her advice as i embark on expanding my nursing career into case management. good luck and keep us posted.

[rnrainy]

There will always be that one client who will make it worthwhile. You are only responsible for yourself and can't help what others portray...that being said, you don't know the dynamics behind each family and client. I once worked on a floor where no one was grateful for all the extras I did, until MANY years later, I met three previous patients I had cared for. Not only did they remember me, they thanked me profusely for my loving kindness, calmness, and consideration. So you may not get a pat on the back today, but remember it all adds up in the end!

[Tenacious Me]

I too feel the same. You bust your hump day in and day out, and often get no thanks at all and it's off to the next train wreck. I have to constantly remind myself that I cannot change anyone but myself, but if I can affect the winds of change in someone else's life, then I have done what was needed. Some of my most difficult patients end up being the success stories and they often acknowledge how I helped them.

As someone else said, it takes some time to understand this, but eventually you will, even if it's just to save your own sanity.

[jeffsher]

It's called "entitlement attitude", and it's becoming more and more pervasive.

[mtngrl, ASN, RN]

I have some members who say how much they appreciate me and then those that just want want want and act like they DESERVE everything for free just because they are a senior. (Um arent we taught to save save save for retirement...because life isnt free???). (I do CM for elderly and disabled, for long term care services). One actually said to me "I thought this was the land of the free". OMG!

I work all hours, I vent to my bf who says "aren't you OFF work right now?", I even DREAM about my job!!! I have to sometimes make calls or visits on my weekends when Im actually OFF, because I have to meet timelines and have so much work.

Butttt.....it's SOOOOOOOOOOOO much better than a hospital!!!!!!!!!!!!