Compassion....Why is it lacking?

[RedhairedNurse]

I've been working as a student nurse for the past couple of months and will soon graduate. I've seen nurses that lack compassion and it's really disturbing. Some nurses want to hold back pain meds until there dammm good and ready to give them. I've seen pts throwing up in pain...and still, the nurse takes her sweet little time or wants to take her break first. This makes me sick! Is this some kind of control issue that nurses have??? I'll say one thing....it's going to be very hard for me to keep my job because of this. I'm one who can't and won't stay quiet!

[GYPSY1349]

I think the nurses that burn out quickly are the ones who care too much. They'll put their patients needs before their own and take home all of their patient's burdens.

A good nurse is able to say "before this, I have to pee" or "before this I have to eat" or they can ask for help too.

That only works if you are not the one in PAIN.

Remember...Pain is subjective. It is not our job to decide who or who is not a "drug seeker." Our job is to DO our job, with compassion and professionalism.

:redbeathe

[correctlywrong]

It is true that there are nurses who become overinvolved.

It is true that there are often priorities that get in the way of giving everyone the exact care that they want right when they want it.

Not giving pain meds quickly may not be due to a lack of compassion. There are many reasons not to administer that PRN exactly when it becomes available again, and I think any rational person could agree with all of the above. But none of that absolves those, thankfully few, nurses who genuinely do not care about other people.

Compassion doesn't require ignoring one's own needs in order to address those of the patient. It doesn't require abandoning priorities. It requires making a mental habit of trying to see the situation from the other person's perspective. That part can be taught. If someone still doesn't care, well, I don't know that you can teach someone to do that.

I met a young woman last night who told me that she dropped out of nursing school when she realized that she truly doesn't care about other people. Instead, she is going into business, because she mostly sees other people in terms of what she can get out of them. I never thought that I would feel so much respect for someone with an attitude like that, but I am so grateful to her for having the courage to admit that about herself and make a better choice for her future. I wish that some of those rare nurses who persevered in the career despite similar feelings had such insight.

[UM Review RN, ASN, RN]

I also see nurses who will gossip about pts and and how they hate the "needy" ones. I just can't believe what I've seen and heard. To me, it's very sad. I hope and pray that these nurses are never in a situation to have to rely on some one such as themselves.

Not thrilled with "needy" patients *or needy family members* in this corner, either. The reason is that the needy patient will spend the entire shift on the light complaining about the food, the TV station, the weather, the nurses, the CNAs, the tests, the labs, the bed....and keep you running hither and yon for the most trivial things... you get my drift.

In the meantime, the confused LOL in the room next door is not able to complain because she really cannot breathe well enough to push her call light or is desatting so rapidly that she's losing consciousness. The result is that due to catering to the needy patient/family, critical interventions for the crashing patient may be delayed and could literally cost someone her life.

To me, needy patients steal care time from others who may need it more, and on those patients' behalf, you bet I resent it.

[bagladyrn, RN]

These patients Angie mentioned are the ones where I feel it necessary to not be the "kind, compassionate nurse". I practice limit setting with them: "I need to check now to see if you need anything else as I am going to be tied up for a while caring for another patient who is not doing well. If you ring, the CNA will answer, but it may be some time before I can get back in here. If it's a true emergency she will get me or one of the other nurses."

A prime example of how being the kind compassionate nurse is not always in the patient's best interest: A patient postop c/section who refused to get out of bed, refused to turn or move, just lay there and demanded pain meds. The "nice nurse" gave her meds, let her decide not to move, didn't push her because she was in pain. After 2 days of this she developed a DVT, threw a PE and ended up on the unit.

One year later she came in for a repeat c/section. The OP would probably consider me one of those heartless nurses because when I admitted her I told her that when I came back that night I was going to be the mean nurse who made her get out of bed and walk, even if I had to go out and get the jack from my truck and jack her out of that bed - there would be no discussion of the matter. I medicated her, she walked, she recovered and went home with no complications that time. Now who was really taking good care of this patient? I'm strong enough to handle the patient (and other staff) thinking I'm heartless if it means the patient has the optimum recovery. (And no, the patient did not want to listen to education as to why being OOB was better for her)

[casi, ASN, RN]

That only works if you are not the one in PAIN.

Remember...Pain is subjective. It is not our job to decide who or who is not a "drug seeker." Our job is to DO our job, with compassion and professionalism.

:redbeathe

Yes pain is subjective. As I'm a nursing student I recently went through that lecture in class. Here's the thing, in the circumstances the OP described, she could have easily asked another nurse to pass the meds. Or at least in a job setting where there is team work she should have been able to. Part of me thinks something still maybe missing from this story.

While pain is objective there are still the patients who are on the call light ever 15 minutes between cell phone calls and trips to the nursing station to beg to go outside and smoke asking for their pain meds with a slur in their speech and a distant glazed look in their eye. And did I forget to mention a drug test with positive results? I'm sorry, but I can't help but be suspicious when I have several patients who are a few days post open heart surgery who aren't on nearly as many medications. The patients who are really sick are on the call light less than these people.

I'm sure everyone now thinks that I'm a horribly jaded CNA who should drop out of nursing school now, but I promise you that I treated all of the above patients with respect. I may have complained when I came out of their rooms, or thew down some foor or took a pee break before I answered the call-light king/queens light, but I still greeted them with a smile.

Yes, I recently had a nasty weekend with where the healthiest patients were the neediest, and yes I'm kind of venting.

[geekgolightly, BSN, RN]

re: venting about "needy" patients.

We are nurses not saints. There will always be patients that hit us the wrong way and we vent about them. It doesn;t mean that we don;t give them proper, compassionate nursing care, but are we not allowed to vent about them with coworkers or others who feel our pain?

re: prioritizing their needs vs our needs.

if there is a patient who has stable vital signs, received pain medication recently, has no physiologic reason for needing more than 2mg dilaudid IV in less than one hour, and has a history of polysubstance abuse and I have not been able to get off the floor to pee in the last five hours and I feel like my bladder is about to burst, and I know if I go in there and give this patient pain medication I will be forced to sit and listen to them vent about how gross the food is for the next fifteen minutes, I will take the time to care for my bladder before their pain medication is given. If that makes me evil, just call me Nurse Ratched.

[Natkat, BSN, MSN, RN]

I will say the same thing I say to all nursing students.

"Wait until you're a nurse."

I got so tired of listening to my classmates judge the nurses they worked with in clinicals. What you learn in the textbook almost never applies to real life. It's completely different. And remember, in school you are learning at "Utopia General". You only have one patient and you have all the time in the world to give them all the care they need.

In real life you are pulled in a thousand different directions. All patients believe that their particular complaint is worse than anyone else's. You have to set boundaries. As a nurse, you have to take care of yourself. A patient can wait if the nurse wants to go on break. Our working conditions would be so much better if every nurse would be assertive about taking the breaks they deserve. Maybe management would pay attention.

I had a horrible patient today. I do acute dialysis so I am one-on-one with a patient for four hours or more. The whole time I was with him he kept telling me how I wasn't taking care of him right, how he was going to sue me because the room was too cold. And oh by the way, I'm not all that attractive and I'm too fat, according to him. He was threatening me and being verbally abusive the entire time I was with him. Eventually I said "you know this it the first time I've heard that a nurse's weight can have an affect on dialysis. Tell me how my weight is impacting your treatment and maybe we can find a solution." He suddenly became very interested in watching Animal Planet and said nothing....or least momentarily until he thought of new ways to try and abuse me.

I still want to give the best care I can, but a person's compassion wears a little thin after a day like that.

[RedhairedNurse, BSN, RN]

Natkat...

I'm sorry you had to listen to that. That was absolutely awful. I agree that there are going to be pts that cause us to have bitterness. I'll just have to wait and see how it goes for me.

[RedhairedNurse, BSN, RN]

That only works if you are not the one in PAIN.

Remember...Pain is subjective. It is not our job to decide who or who is not a "drug seeker." Our job is to DO our job, with compassion and professionalism.

:redbeathe

You said exactly what I wanted to say but couldn't think of the good words you used. How can we say that a person is a seeker??? How can we as nurses know the truth behind someone's pain? I think we should treat everybody the way we would want to be treated if we were in that situation.

[RedhairedNurse, BSN, RN]

I worked this weekend with a 20+year exp nurse who was gripping about my pts yelling out. My pt had an abdomen distended 3x normal size, had major cirrhosis and various open wounds in multiple stages of healing. This sr nurse said " I just have a hard time taking care of people who did this to themselves". r/t pts alcohol hx.

At one point sr nurse said "we may need to play bad nurse-good nurse, but this yelling has got to stop, I am not going to listen to this all night". FYI my pt was partially sedated, his yelling was more of a chanting, he was not yelling on purpose he was hurting. I told him the yelling was not the problem the fact that he was in pain was the problem, deal with the pain and we will solve the yelling.

I had to remind sr nurse we are paid to do a job, that job is to take care of people and it doesnt matter why they are in the hospital.

FYI after a call to the Dr, and some position changes pt quited down.

Also might want to note, this nurse is the exception to what I normally work with. As a whole I do not see nurses lacking in compassion, I may see them get stressed and we as a team need to jump in and help when that happens.

I've seen nurses like this too. I'm glad to hear your story. As for the nurse from He!!.....she doesn't like taking care of people that "do this to themselves". She shouldn't be so judgemental. Alcholism is a disease in itself. Maybe this person that was sick didn't have such a good upbringing....can he/she help it???? Nurses like this make me SICK!! They need to change careers!!! I'm glad you reminded this nurse what we are here for. Good thing there are students and new nurses coming into the profession.....without them, who knows what it would be like.

[RedhairedNurse, BSN, RN]

Not thrilled with "needy" patients *or needy family members* in this corner, either. The reason is that the needy patient will spend the entire shift on the light complaining about the food, the TV station, the weather, the nurses, the CNAs, the tests, the labs, the bed....and keep you running hither and yon for the most trivial things... you get my drift.

In the meantime, the confused LOL in the room next door is not able to complain because she really cannot breathe well enough to push her call light or is desatting so rapidly that she's losing consciousness. The result is that due to catering to the needy patient/family, critical interventions for the crashing patient may be delayed and could literally cost someone her life.

To me, needy patients steal care time from others who may need it more, and on those patients' behalf, you bet I resent it.

This isn't the "needy" kind of pt I'm talking about. The needy pt I'm talking about was very sick. She was total care, trach, etc....she had to press the nurses call button for most everything.....she had no family, she had NO ONE to help her. She was dieing. There is a difference to me in "Needy" and demanding.

[TheCommuter, BSN, RN]

My following statements might be construed as heartless and negative, but this is how I feel.

Many of our patients and visitors don't give a rat's crap about us. Violence against nursing staff is a relatively common phenomenon. A nurse can be assaulted and beaten to a bloody pulp by an angry patient or family member, and it is the norm for hospital administrators to do nothing about it. What's their reason? "Oh...sickness brings out the worst in people."

Nurses injure themselves in the direct presence of patients and family members on a daily basis. I know of a nurse who sustained a debilitating back injury while caring for a patient, because the overzealous family member got in the way during routine repositioning of the patient. Neither the patient nor the visitor helped the nurse when she fell. They did not bother to ask if she was okay. They did not care about their fellow human being.

If a visitor walks into McDonald's and beats up the fry cook because he/she was displeased with the food, the visitor definitely will be escorted out of the building. Charges might be filed. However, the visitor who starts throwing punches at the nurse at the hospital often gets away with it.

Compassion and caring for your fellow human being are of the utmost importance. I totally agree and can appreciate that. Unfortunately, society is lacking in compassion and basic regard for each other. It's truly sad.