Compassion Fatigue!!!!

Altra, BSN, RN · Jan 19, 2012

"Compassion" includes using assessment skills to prevent getting a patient so snowed on pain meds that they stop breathing, at least in my book ...

NoviceRN10 · Jan 19, 2012

"Compassion" includes using assessment skills to prevent getting a patient so snowed on pain meds that they stop breathing, at least in my book ...

Tell that to the physicians who order the narcotic doses that keep the pts in la la land instead of just comfortable.

Altra, BSN, RN · Jan 19, 2012

Tell that to the physicians who order the narcotic doses that keep the pts in la la land instead of just comfortable.

Not a problem -- good documentation (patient's VS and what they look like) is your friend.

OhioCCRN, MSN, NP · Jan 19, 2012

who said anything about being snowed i cant recall anyone being able to whimper and holler if they are "snowed" and yes. Physicians are complete enablers.

fiveofpeep · Jan 19, 2012

I get it. I just give them whatever they want, though, because really, the hospital is not the place to cure an addiction. I don't even let it get to me. I just smile and give it as much as they can take it without apnea.

I work in ICU though with an itty bitty ratio. I don't know if you work medsurg or tele, but if that were the case, I would be super annoyed because of how much time that would take up. If I was super busy with my other patient within an inch of life I would also be really annoyed. Luckily, they usually staff so that doesn't happen, though.

I'm sorry you had a ****** night. Next time you can always just give her just enough to require intubation

Altra, BSN, RN · Jan 19, 2012

I may have misunderstood your post, OP. I interpreted it to mean that you observed behavior/assessment data that did not match up with a patient in pain ... and you felt bad about it.

Wishing you a better shift next time you work ...

Esme12, ASN, BSN, RN · Jan 19, 2012

:hug: Oh honey....that's not compassion fatugue you were sick of caring for a manipulative PITA that is looking for a high or to be snowed and not relief. Unfortunately using duct tape isn't legal.....(just kidding) It's ok to be annoyed sometimes, we are, after all........human!

Aurora77 · Jan 20, 2012

Oh my goodness, I could have written your post. I had a very similar patient recently. Pt and family talked to physician, doc ordered pain meds he was comfortable with (cause, you know, there's that pesky thing called breathing to worry about). Pt still carried on like we were torturing him. What really hacked me off is that the pt had a roommate and still had to act like the center of the universe. Very rude and disrespectful. I have never been so grateful to have a couple of days off. I'm just praying said pt isn't there when I get back to work.

allnurses Guide · Jan 20, 2012

It's ok to be annoyed sometimes, we are, after all........human![/quote
Ohhh my,,,, we are? Dang, I keep forgetting not to be a robot. (jk :rotfl:)
Esme is right, compassion is when you feel bad along with the patient for the situation they are enduring; this is the kind that just sucks you dry if you try to offer what they don't want. Such as, compassion, understanding, and the knowledge they need to change.

LobotRN, BSN, RN · Jan 20, 2012

So agree that acute care is not the place to address a "tolerance" or "addiction" issue, but I find that I by and large don't have the total Hx to say what's what baseline. Sooooooo.....I go by orders, keep them safe, keep them breathing first, doped second.

But then I have to wonder when little Suzie (wanna be) Snowed Shooooz says to me, "I only want you to take care of me, or wake me up." She'll be back and back an back and back. And, yes dear, I have noticed that all these abcesses on your body for which you get continual I&Ds are only on the portions of your body that you can reach (because your plump posterior prevents your curiously short arms from injecting anything past the lateral hip). OOOOOH! And that could I please push it IV sideline. NOPE! Sorry, I administer IV medications with the utmost consideration to safety and use the pump secondary to ensure you receive your medication at a safe rate that reduces the risk of, oh, NOT BREATHING! (OR providing any positive reinforcement for your narcotics needs). Nope, no rushes or quick highs for you on my watch, dear.

AND THEN! There was the pt who's family was saying "he's in pain, he just won't say anything." But when I ask specific questions beyond the stoooooopid number scale we (and so many others) are required to use, along the lines of, "OK if we were to get you out of bed right now to use the bathroom, would you be able to make it to a bedside commode or to the bathroom." or...."How does how you feel right now affect your ability to shift around in bed?" or any other number of Qs to try and decipher what the pain affects and their tolerance for it. And this pt really wanted to just work through the pain. I educated him about the benefit of "staying ahead of the curve," the limited potential for addiction in the short term when narcotics are used for specific purpose and effect with the goal of tapering, and at least medicating before physical therapy (to which he agreed).....the family was so in his and my face about giving him drugs that I wanted to just smack the lot of them.

Oooooooh, OP. I'm sorry I hijacked, but thanks for opening this can of worms for me. I feel so much better! I had these two plus a bunch more similar ones over my last six shifts. I don't think I have compassion fatigue, I think that based on my (limited) experience, I don't want to foster the flyers and I want to advocate for my patient, not only to MDs and other providers, but to the family as well.

speedyG · Jan 20, 2012

When i have shifts like this i swear i sometimes think " come on let the world end already i'll be the first to say jesus here i come".