Does anyone else feel this way?

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I'm currently a nursing student and while my passion is to help people feel better I find myself going in with mixed feeling towards certain patients. The patients I am referring to have sicknesses caused by smoking and drinking. While I will do everything in my power to help them get better or be as comfortable as possible I find myself not feeling sorry for them. I feel like they got what was coming to them and that they knew the risks involved in using these substances and so only have themselves to blame. Does anyone else feel this way?

I know some may answer that the same should apply to obese and diabetic patients and I believe it doesn't. You need to eat to live, yes moderation is the key but many things can contribute to obesity and you can't not eat; however, you don't have to smoke and you don't have to drink and so it is solely the choice of the person using these substances.

Specializes in Peds/outpatient FP,derm,allergy/private duty.

I think some of these responses are incredibly harsh. To the OP - when you say "they had what's coming to them" it sounds like "serves you right". Is that what you intended to convey? If so, you will probably have difficulties because the underlying issues are unique with every person. My mom died of cancer in July. She smoked for decades, and then suddenly shocked us all by quitting for the last 5 years of her life. Did she still "get what's coming to her?". I doubt many people would agree. I hope not anyway.

We should not be in the business of telling people how they must think or feel. And you absolutely can take care of these patients respectfully and professionally. We shouldn't think judgemental thoughts? Sorry, that's nuts. They usually come unbidden anyway. It's what you do after that -that matters. There are many threads here that hash this out in depth.

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Specializes in Med/Surg, Ortho, ASC.
Try to remember that you have no idea what has gone on in a persons life before you met them. There are all sorts of reasons people end up addicts, drunks, obese, depressed . . . Believe it or not there are horrors in life that make addiction preferable. Of course this isn't the case for everyone but you just can't credit it all to bad choices. I'd venture there is almost always a root cause that goes so much deeper than thrill seeking or lack of control.

Excellent point, NomadMomma. While a patient's circumstances may seem obvious at first, we often don't know the half of it. Another solid reason to treat all patients as just another one of God's children.

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Specializes in Assisted Living Nurse Manager.

I do not usually chime in on posts such as this, but saying "they got whats coming to them" is an awful thing to say!!!! I cannot even express the hurt these words can provoke. I am sorry you feel that way!

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Specializes in Peds/outpatient FP,derm,allergy/private duty.
I've heard it all before. Still think it's BS. I have 2 family members who are addicts that feed me these excuses daily. I still wouldn't call it a disease. Does it suck? Yes. Do I hope all addicts can be "cured" and never look back? Of course. My heart goes out to them. But it's not a disease.

I do however agree with you that there may be a genetic predisposition to addiction, but it's insulting to people who have a real disease to call it that.

Is anorexia a disease? Is schizophrenia a disease? Is autism a disease? If you approach current thought and research (the study of addiction is a bona-fide specialty just as oncology or cardiology)as a nurse with the idea that your opinion is the final say on the matter, I guess anything you can't see is fair game.

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Specializes in Substance abuse, hospice.

You can be a nonsmoker and still get lung cancer.

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Specializes in Ambulatory Care, Case Manager.

You are talking about smokers, obese patients, etc...The same goes for women with no insurance who have unprotected sex and end up pregnant. Yes, it bothers me that they are bringing a baby into the world, before thinking about their own financial situation. I had several patients with possible miscarriages and told them that they needed to go straight to the emergency room because we didn't have the appropriate equipment. They were concerned because they didn't have money or insurance to pay the bills. Well, they should've thought about that before they had unprotected sex. I had another patient who was diabetic, had insurance, was put on medications and was supposed to follow up with his provider. One year later he shows up around lunch time with his blood sugar over 400 and symptoms of hyperglycemia. There were no providers available and again mentioned to him that he needed to go straight to the ER. This time he didn't have insurance and saw in his chart that he never followed up with his provider. I was worried about this patient and decided to follow up with a phone call one week later. Because he didn't have insurance, he ended up going across the border to get his care. He accused me about not wanting to help him and that he almost went into a coma, etc... All this time I was shocked. I told him off by saying that he also needed to be accountable for his own health and not blame me when I tried to help him. That is when he apologized for his angry outbursts.

One of the rules in nursing is to be nonjudmental. Yes, for some of us is difficult but that doesn't mean that those types of patients don't deserve the same care as everybody else. As a matter of fact, I noticed that I am more compassionate with HIV and homeless patients. I don't think about what they did to get that way. I just focus on taking care of them. What if they were a family member? What bothers me is when patients are noncompliant and blame me for their outcome. Sometimes you have to tell those patients like it is in order for them to be held accountable for their own health.

That's my :twocents:

BJ

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i just find it odd that you feel this way toward supposed smokers or drinkers (although you seem to make quick judgements which may or may not be rational) about whether or not they were even smokers or drinkers based on their diagnosis. yet you think obese patients have an excuse.

just remember that someone who has lung or liver cancer doesn't mean they smoked or abused alcohol. at least consider the fact that they didn't. EVEN if they did - i know there are great people (even nurses) along with firefighters, teachers, etc. who did many great things and helped boat loads of people throughout their lives but also smoked or drank - and that choice doesn't diminish them as a person or all the good they did. even if they did no good for "society" they are still someone's mother, spouse, and child. the last thing they need when lying in their deathbed (or just seeking treatment) is to FEEL the disapproval of some nurse who thinks "they had it coming" and if you think by SAYING you care for them the same makes your feelings undetectable, you're wrong. one of my first teachers (an almost elderly nurse) said something that is so true and i'll never forget - "patients KNOW when you don't want to take care of them. they can sense it. you can't fake it."

i HONESTLY don't have these feelings towards patients whether they be smokers, drinkers, drug addicts, or over eaters - but just this week i did care for a lady who was about 500 lbs. and was still mobile (from the bed to the bc at least) and although i can say now, "how can someone get THAT bad to the point their legs are oozing" i never thought that when i was caring for her. i was a little nervous helping her actually bc she had to use the potty and it was very akward trying to help clean her up when i literally couldn't see/reach the area that needed cleaning. she wasn't a pleasant patient either - i assume due to her embarrassment that i could sense. this was the first patient of this size i've encountered, and when helping to lift her legs up to the bed - there was skin flakes from her scabbed legs flying everywhere which i wasn't prepared for. i'll admit i was a little grossed out. who wouldn't be grossed out about skin flakes from someone's oozing legs unexpectedly flying around their body/face? still, i felt nothing but empathy for the woman. she even tried to trick me into getting her a drink when she KNEW she was NPO. i didn't KNOW, but considering i knew she obviously had an addiction and was asking for a drink in the middle of the night/early morning - i checked to see if she could have something and the response was, "NO! she knows that." obese people (even when they cant wipe themselves and their legs are oozing) will still ask for food/drink bc they're ADDICTS just like someone with lung cancer will continue to smoke. i was having trouble getting her bed rail up because her body was hanging over, and she was saying "i'm sorry" and i felt HORRIBLE because (even though i knew her choices brought her to this point) i was making her feel bad by taking too long to get the rail up. i said, "don't be sorry - i haven't worked here long. i still have trouble with some of the beds." that wasn't really true, but by saying NOTHING do you not think this patient would've sensed some disapproval?

i dunno - i just find it ironic that someone who gets to that state passes your internal radar because "people need food." i'm NOT a saint, and we do all judge people, but i truly can't wrap my head around having the "they had it coming" attitude as a nurse. nurses just aren't the type of people i'd expect to feel that way toward patients - regardless of what brought them to where they are. i know of a guy who is comatose because he overdosed on steroids and while he made the CHOICE to take steroids and mostly for superficial reasons - none of that mattered when i was taking care of him. it just broke my heart.

i only hope that as a student you haven't had much interaction with patients so these feelings you're having are just that - feelings. hopefully when you're working with the patients you'll forget about why they're there and see them as people who deserve respect which more often than not they'll provide to you. i'm not a nurse yet - i'm working on my BSN as a second degree and chose to be a CNA to get some experience in the field. honestly, even though i get a quick run-down during report, i don't know why most of my patients are even there. sometimes if i connect with a patient, i'll go back and look out of curiosity to see what the reason was - but for the most part it doesn't even matter. i have heard people gossip about patient in "room 10" being an IV drug user or patient in "room 20" not recovering because they aren't following the doctor's orders. that means absolutely nothing to me. i'm not religious, but maybe in some way i'm "blessed" to be able to look past those things which seem so very unimportant when caring for a patient who needs me.

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Specializes in Cardiac Nursing.

Who I feel sorry for is that lung cancer patient that his nurse assumes smoked and the patient with cirrohsis who never drank. I have heard of non-smoking lung cancer patients get told they had it coming and people not believing them when they said they never smoked. They live with the "stigma" of "only smokers get lung cancer".

Just my :twocents:

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Specializes in Med/surg, Quality & Risk.
Try to remember that you have no idea what has gone on in a persons life before you met them. There are all sorts of reasons people end up addicts, drunks, obese, depressed . . . Believe it or not there are horrors in life that make addiction preferable. Of course this isn't the case for everyone but you just can't credit it all to bad choices. I'd venture there is almost always a root cause that goes so much deeper than thrill seeking or lack of control.

Yep like the alcoholic with panc I took care of last week who drinks a pint a day, and is an advanced practice nurse so she obviously knows better. Turns out a few years ago her husband took their two children and their dog, put them in the car, unhooked the garage door opener, turned the car on and killed them all, while she was out of the country on a church trip. I'd drink too, folks.

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roser13

I guess I feel this way because of the notoriety of these substances and the fact that people abuse them anyway. While you make a valid point with the speeder and the STD I cannot know if this person always speeds or always has unprotected sex it can be a mistake and so I'd give them the benefit of the doubt. However you do not get lung cancer from one cigarette nor do you get cirrhosis of the liver from one drink so I know this person abused these substances. Again I would never let my feelings get in the way of treating these patients and I would give them the same respect I would anyone else. I am just referring to my personal internal view of the matter.

Be Gentle. While sometimes, we may want to feel that way. Remember to be gentle in your judgement of them. A few short stays in hospital does not give us their life's history. We only know of their medical history.

Sometimes we need to see people, through their eyes and not just the physical being there. There's a story to it all, we just don't always know it.Be gentle:)

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Sorry I also meant to say some people with addictive behaviours - in any shape or form - will NEVER change or consider modifying their behaviour unless they really want to, even if you have the best nurses, best doctors, drugs, clinics, best counsellors - it does not matter. They will not change anything until they are ready too. Perhaps one way to look at it, as in psych, is to see yourself as a facilitator in this process - you are not responsible for their behaviour - THEY are responsible in the end, and we have to keep enabling them to help themselves.

But in the end, you have to realise some people will not change no matter what therapy is instituted, because they are immature and not ready to take responsibility for their actions. They may never take responsibility for anything again in their lives.

Ouch. Is this the only reason?I take it you're a psych nurse.

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I'm w/ orange tree.

Do I judge people's choices? Of course, I'm human. Does it impact the way I feel about them? Absolutely, I'm human. Does it detract from the care I provide them? No, I'm a professional.

I don't think it is necessary to empathize with every person who crosses your path to be good nurse, but trying will make your nursing hours less unpleasant.

I'm thiking someone else will have to decide that:)Your actions may not be as fluid or professional as you believe.Just saying:smokin:

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