Does anyone else feel this way?

anotherone, BSN, RN · Mar 8, 2011

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.

Of course it should apply... YOU DO NOT need to eat that much to live. come on. using the same logic " they did it to themselves" JUST as much as a smoker with lung disease or alcoholic with a bad liver etc.... Many patients come in with problems that arose at least in part through their own decisions...

anotherone, BSN, RN · Mar 8, 2011

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.

Have not read the whole threat yet and am sure others have pointed it out. A person can get cirrhosis or lung disease without ever having smoked or drank alcohol........... You don't get obese from one donut either

rn/writer, RN · Mar 8, 2011

The solution to this long-standing nursing dilemma is simple--not in the sense of being easy, but in the sense of being understandable.

You separate the patients from what they do/have done/will do. Their actions can irritate, infuriate, and frustrate you to the max. You can call a spade a spade. You don't have to say that whatever they do is okay. BUT you keep all of this on one side of the room and recognize the patient as a person who needs care and support, whether they "deserve" it or not.

Actions have consequences, and try as we might (or might not) we can't spare people the results of their bad circumstances and crummy choices.

But we can try to find the human being inside the mess and connect with them. Sometimes there's only a flicker of humanity left, but even a spark can flare up.

Every person you take care of was once somebody's baby. That isn't just a cliche. You may want to shake your head and shudder when thinking about what could have changed them from that tiny little bundle to this sad and sorry excuse of a person in front of you, but the truth is that they still need to be treated with decency and regard.

Does this mean you condone their bad choices? Not at all. It only means that the fact that they--took drugs, smoked, overate, got pregnant when it wasn't wise, tried to commit suicide, cussed at you, tried to smack you, messed their bed, whatever--doesn't determine whether you see them as human or not.

Some of the above bad choices may affect treatment options and boundary setting, but that relates back to what they do.

Just about anyone who indulges in any kind of self-destructive behavior has been on the receiving end of someone else's contempt and disapproval. It's not like our disgust will suddenly enlighten them and make them want to do better.

The best rule I can think of to deal with patients who are difficult (for any reason) is, "Don't make it personal."

That goes both ways.

Don't take their behavior personally. Don't set yourself up to be harmed either, but realize that the conflict isn't about you.

And don't react to them in a personal way. You can respond to the signs and symptoms and give them real information about their poor prognosis, so long as it's done as an ally and not as an adversary.

Here's a secret--as long as you let the bad news be the problem and you don't become the enemy yourself, you allow the struggle to remain where it belongs--inside the patient. As soon as you pick up the tug-of-war rope, you short-circuit that internal battle and interrupt any progress that was being made.

The only way to win is not to play the game of "who deserves my kindness." And that means that everyone gets treated with decency. Their behavior may well be up for discussion but never their humanity.

If you can't get to this point, then treat them with respect, not because of who they are but because of who you are.

redhead_NURSE98!, ADN, BSN · Mar 8, 2011

Of course it should apply... YOU DO NOT need to eat that much to live. come on. using the same logic " they did it to themselves" JUST as much as a smoker with lung disease or alcoholic with a bad liver etc.... Many patients come in with problems that arose at least in part through their own decisions...

I think the point most people try to make about obesity and food "addiction" is that when you're an alcoholic or smoker, you can cut that completely off from your life eventually. A food addict is still ingesting the addictive substance every day because they have to have it to live. Much easier to relapse that way by eating too much of it.

RNJill · Mar 9, 2011

On crazy-busy days, or just times when I'm feeling Scrooge-like and tired, I have definitely found myself having similar thoughts toward patients. Sorry to disappoint anyone who feels like a nurse should NEVER have these thoughts, but just being honest!

However....I have realized several things about these thoughts, all of which can be summed up by saying they are simply not helpful for anyone. On days when I have let myself feel that resentful toward a patient for an illness that "is" (or I feel is) their fault, I sap a lot of my own energy with this anger. I also subconsciously do not approach the patient with the best attitude that I could, which I think often leads to them feeling mistrustful of me and we don't end up forming the best nurse-patient relationship that I know we could. Of course, this only leaves me feeling even more drained/resentful from the patient interaction.

I've come to realize that hospitals are FULL of people who are there largely (or at least moderately) due to their bad choices. Just because I treat someone with the same kindness I would treat another "easier"/kinder/"more compliant" patient doesn't make me a pushover or show that I support all of their choices. It just means that I will leave work knowing that I gave my best to all of my patients.

Poi Dog · Mar 9, 2011

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.

Wow, my heart stopped after reading that

Hell yeah, I'd be a drinker/user after that. People choose whatever means they have or can find to cope with whatever bs is going on in their lives as the above post demonstrates.

So no, OP, I do not feel the way that you do.