Compassion Fatigue: I finally figured out what's wrong with me

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Specializes in LTC.

I have been distressed the last few months trying to figure out why it seems that my care/concern for my residents has dwindled to the point of near non-existence. Here is a link to what I found: http://www.buzzle.com/articles/compassion-fatigue.html

Don't get me wrong, I still do my duty, address issues as they arise, obtain orders when changes in condition are noted, etc. I still do my job. I even manage to smile once in awhile. But the compassion I used to feel is nearly gone. It takes an extraordinary set of circumstances for me to feel compassionate anymore. I feel angry, resentful, tired, stressed, over-worked/under-appreciated. I cry nearly every day before I go in. My residents just take and take and take until I have nothing left to give, then they want more of me. I am emotionally tapped. Of course, my employer piles more and more on me, expects more than I am capable of doing in an 8 hr shift and then scoffs when I tell them enough! There is no more I can take on in a day! They keep adding census without adding staff. I now have 37 residents with 9 tubes (4 of which are bolus feedings) and 8 BS's. (Could be worse, I know). I leave for the day with my tail hanging low, head down, feeling defeated at yet another shift that I was not able to really take care of my residents. I don't feel like a nurse anymore. I feel like an old mule that's broke down, used up, but still expected to perform like a champ. I'm tired. I have put in apps for different positions outside of LTC, but fear that until I recover from "compassion fatigue" I'll end up feeling more of the same. I can not afford to take a vacation (we do not have PTO and I do not have vacation time avail yet), and can not afford to quit. Any of you been there before? What did you do to make yourself better? Thank you for any and all suggestions. And thank you for allowing me space to whine. :)

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Specializes in New Critical care NP, Critical care, Med-surg, LTC.

I wish I had an answer for you, just want to offer you support. Working in LTC is hard in so many ways. I look at the nurses that do it full time and I know that I couldn't handle that. I'm lucky that it's a part time thing for me, 16 hours a week (I have a non-nursing full-time job). I try to always remember that some day my entire world might be reduced to four walls of 1 room, and then I will also ring my call bell to have my tissue box moved 4 inches across the bedside table, or to have my shade lowered (but not all the way!), and waiting more than 30 seconds when I have to to go to the bathroom will be "unacceptable!". But you're right, in the end people are centered on themselves, everywhere, and nursing isn't often a two way street. Some of my residents will ask me questions about me, but most don't see the nurses as a person, just the delivery system for their meds, food, etc. Now that my ramble did nothing to make you feel any better, I hope that you can find something in your work to keep your spirits up. You clearly do care about the residents, and I have the feeling that you're a great nurse. Everything in life is a phase, good or bad, and I hope this one passes quickly for you.

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I'm only a nac but can relate to some of what your going through. In my case it doesn't seem like what I do is good enough. Maybe you need to take a mental relief day off of work.

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I could have written this entry. I completely understand your feelings toward your residents, I deal with the same type of scenarios on a daily basis.

To those of you who have not experienced these feelings, I'll give you a few examples of a typical day's experiences that bring about my feelings.

I have residents who yell, complain, growl about EVERYTHING, from the number of pills they take to what is being served for breakfast. They seem to feel that it's perfectly acceptable to launch a verbal assault against the nurse because they have an "issue". Sadly, we have to stand there and take it, or risk losing our jobs if we voice our displeasure of being their sounding board.

I also have to deal with the "I'm ENTITLED" behavior. These are the drug and/or alcohol abusers who have lived on public assistance their entire life, the ones who have NEVER worked a day in their lives. The ones who haven't been to any type of doctor in 30 years, but as soon as they come into LTC on Medicaid, of course, they demand appointments with the eye and foot dr as well as the dentist. These types can VERY QUICKLY help you lose all compassion for these residents.

Does anyone else have to deal with these types on a regular basis, and if so, how do you handle it?

For the original poster, I wish I had a solution for you, but I am, unfortunately, dealing with the same issues.

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Specializes in LTC.

KRSLPN,

Oh my yes, I deal with those very same types daily. Our facility will literally take anyone with a pulse, regardless of payer source. (We accept Medicaid pending residents, even.) I have residents that yell at me because we are "stealing my check!" backed up by the family that lived off of "Momma's" check who are suddenly very concerned about "when Momma can come home." (read: when can we get her check back?) The residents who are, by far, the MOST sick and have the MOST pain that NO ONE CAN UNDERSTAND MY MISERY-types who are nowhere NEAR as sick as they seem to wish they were. They want the MD called at least daily, and will hijack his time when he's silly enough to venture near their proximity. Never mind that there are residents who really need to see the MD, so long as the "dainty (400lb) princess" gets her special time with the MD. That one is the one who is daily going on about all of the "poor little old people" that "nobody EVER helps." We can't! We're too busy in here catering to you! We have tons of psych people who really need to be somewhere else, but hey! They have a pulse and Medicaid so horray census. This is just a guesstimate, but the average age of my population is around 65. The older folks are no problem. They are mostly grateful for your time and efforts, and will only use their light or ask for assistance if they can't handle something themselves. They try to maintain a level of independence. I thoroughly enjoy taking care of them. It's the younger than 60 group that wears me out. They tend to be the whiny, entitled, needy, demanding, ungrateful group. I have a 51 y/o woman who literally cries at me every time I'm "late" with her meds. "It's not you. It just seems no one cares about the residents here! (sobs/sniffles)." GAAAAAAAAAAAHHHHHHHHH!!!!!!!!!!! I can't hardly take it anymore. And, oh joy of joys, I get to go do it again today. (sobs).

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Specializes in LTC.

Just thinking, but it seems I've stumbled upon the source of my problem: The younger group of residents. At least now I can maybe focus on how to more effectively deal with them. I'll try to pay attention to my interactions with them over the next few days and see what patterns emerge that I can make changes to. I'll let you all know how it goes. :)

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Specializes in Psych, Skilled Nursing.

It is extremely frustrating!!! I have been in LTC only 4 months and I have days where I feel like this myself. I am sorry it seems to be a constant burden for you though. Try your best to focus your efforts on all the positive things you do for these residents and the gratitude that the APPRECIATIVE ones feel. And the ones who appear non-appreciative may show it in less obvious ways! :)

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