Did I miss my calling?

Trauma Columnist · Feb 18, 2004

I've been in the ER for almost 8 years and recently changed jobs to become the case manager. Sometimes you need a break...not necessarily out of the ER, just something different. Take care...

petiteflower · Feb 18, 2004

First off---please remember that we are only human.

We work in a high stress area that gets to see the bowels of humanity. Really. It's tough dealing with people who on a daily basis don't think about things like tylenol and come in with headaches wanting drugs. It takes special people to work in ER. Not every one can do it. Sometimes we all have to take a step back and look at the big picture, and sometimes we see that what we perceive as shortcomings in ourselves are really not. Not everyone can save a life--not every one can make that sweet old person comfortable while waiting for a bed.

Please, don't think of ER nursing as a thankless job---we may not hear the thankyous, but look at the faces of the families of the people you save, or the smile of the little old lady you took care of during the shift, or the smile of the patient who feels more confident because you are there to take care of them.

I don't think you have lost your compassion--re read your post--there's lots of compassion there.

Take a step back and look at it--and focus on the good things---and don't be so hard on yourself.

:) :kiss

huggietoes · Feb 18, 2004

So know where you are coming from, I have even had nurse friends of mine lately tell me, "you weren't this bitter when you worked med/surg". As much as I hate to admit it they're right. When someone comes in with menstrual cramps via ambulance, when they bring in their children with temp and never think to give tylenol/motrin, when the person with 10/10 abd pain who is screaming for Demerol, yet sitting on the stretcher eating chips, candy bars and drinking soda then begin their oscar worthy performance when I enter the room call me many explitives when I request that they not eat until further evaluation is completed, or how about the family members who see you running to an EMERGENT situation and they go to the desk requesting you to come in and adjust grammy's blankets, when a drunk pees all over the floor and laughs about it, when the person on government assistance tells me "you will do it because that is what you get paid for", I feel a little burned out and used. I too am considering a change, was offered a position in another unit, but do not know if it will be a good fit. I too like running like my tail is on fire but I am afraid if I stay in the ER I may lose every ounce of humanity I have left in me. Some patients are just needy soul suckers and they are bleeding me dry. Keep us posted on your decision, good luck in whatever you choose.

kc ccurn · Feb 19, 2004

I am beginning to think I went in to the wrong profession.
I have wanted to be a nurse since I was knee-high. And I'm a fairly new one, only for a couple of years. But I feel like I have lost my compassion. I've seen the same people with the same complaints over and over so many times that now I hardly believe anything I'm told.
I hate that I look forward to the "bad" patients just so I may be able to use nursing skills other than IM injections of Demerol/Phenergan. I hate that I am so quick to dismiss someone c/o of pain as "drug seeking behavior." I hate that I am so quick to get angry with parents not giving Tylenol. Isn't part of my job to educate? Basically, I do not like what the ER has made me. Don't get me wrong, when I started, right out of nursing school, I loved the ER. And when I think about where else I would like to work, I don't want ICU, m/s, pcu, ob, or anywhere else. I do have nights where I go home and know that I was part of a team that saved a life. And that is what keeps me coming back for more. Adrenaline junkie I guess!
So here's my question. Does this mean that nursing isn't for me? I went in to nursing thinking I was gonna change the world, (naive I know, but one's gotta dream). And I LOVE the feeling after resuscitating somebody, or even taking care of an sweet elderly pt for an entire shift until we have a room to admit them to. It's just nice to feel like you made somewhat of a difference or just to be appreciated every now and then. I knew in school that nursing was a thankless job, but I NEVER knew it to be this bad. I thought this is what God called me to do, but maybe I was wrong.
Please don't think I'm am some mean person. I have (or did have) one of the biggest hearts of anybody. I cry over anything. I like that about myself, and don't want it to change. Is this just something that goes along with the job? Any advice on how to change it? Does it get better as the years go on? Is this just the "honeymoon is over phase" they teach in school? Thanks for listening.

Sounds a bit like the stressed/burned out syndrome that every nurse gets at least once in their career. I was talking to my mom about how unappreciated I've felt and how frustrating it is to care for pt's that don't care for themselves. She reminded me of a book that I just read called 'The 5 people you meet in heaven'. It is an awesome book. It is basically about how every life "touches" another life in some way, we sometimes don't know how positive of an impact we've made on another's life until we get to heaven.

This really had an impact on me and has, in a sense, renewed how I want to approach my nursing. It is sad that I used to have that sense of accomplishment and satisfaction in my nursing but over the years of seeing the bad in people, it has tainted me as well.

Be good to yourself, take care of yourself so that you are more able to emotionally take care of others.

veetach · Feb 20, 2004

I dont think you have developed burnout, not at this time. I think you have just realized the reality check of emergency medicine. It may be sad to most people, but to us it is life. Life sucks, getting old sucks, people suck. But once in a while something will happen to give you just a little more faith in the human race.

After seeing a lot of trauma, abuse, neglect and just plain stupidity, I think we need to do one of two things to survive:

1. either realize that life isnt a bowl of cherries and bad things DO happen, but we are the ones that victims turn to for help and we have to have a clear head to be able to do that. And we are what stands between life and death sometimes,

or

2. realize that dealing with the horrible stuff is not for us, and seek out employment in a more stable environment, or a unit with less chaos.

either way, it is no reflection on your ability as a nurse. I know former ER nurses who are now working in occupational health, school nursing and same day surgery who are ecstatically happy. I think it is a very personal thing.

Good luck with your choices, just remember that you are not uncaring, and please dont lose your confidence in yourself, ease up and smile...

Dr. Kate, BSN, RN · Feb 20, 2004

It strikes me that perhaps you could do with some time taking care of people in a setting where you have a bit longer contact with them than you do in the ER. I become concerned when I hear relatively new nurses sound like old veterans. Truth is you haven't seen enough on your own to be that jaded. More likely you have picked up on the reactions of your more experienced coworkers.

Reconsider another area, some aspect of critical care can give you the excitement you enjoy and the contact with patients you need to be the nurse you want to be.

Just a thought.

susswood · Feb 20, 2004

I think what you have written rings true for many of us. I have recently realized (after 4 years in an urban ER) that it is no longer for me, but I am so grateful for the experience I have earned. I think that knowing just how much you can take is important and equally, when to quit as well.

Try something new, and if you miss the ER you can go back with renewed passion. Write a list of all the things you love and hate about the ER (I'm working on one now)....you can refer to it later and use it to justify a decision to stay away or go back!

Good luck!

teeituptom, BSN, RN · Feb 20, 2004

ER is the only way.

mary_claire25 · Feb 21, 2004

i know how it feels like…i’ve been in that situation couple of years ago. you just need a break! some time to relax and realize those things that you accomplished…there’s a lot of it may be you’re just unaware…we’re just human and even though a lot of nurses are so smart in the area they still have their own weaknesses. i can tell that being a nurse is still the best profession i ever had! if i will have a privilege to live this life again and if i will have another privilege to choose the profession i want>>>>still i will choose nursing profession and become a nurse forever!!! and to work in er is the best area for me…

“i am so proud to all my co-nurses coz i know they really work hard and willing to take the risk for the sake of the pts.” just don’t forget to pause and take a break when the time is tough…then move on…go on …and save live as many as you can…we can make it nurses!

iiwdn · Feb 21, 2004

You've gotten alot of great advice!! It's tough-- but you sound like compassion is still part of your fabric. It just takes getting back in touch every once in a while. Here are 4 of the most simple and most profound reminders.

Be impeccable with your word.

Don't take anything personally.

Don't make assumptions.

Always do your best.-- Don Miguel Ruiz

mary_claire25 · Feb 21, 2004

You've gotten alot of great advice!! It's tough-- but you sound like compassion is still part of your fabric. It just takes getting back in touch every once in a while. Here are 4 of the most simple and most profound reminders.
Be impeccable with your word.
Don't take anything personally.
Don't make assumptions.
Always do your best.-- Don Miguel Ruiz

well...you can't render your care to your pts without compassion. it doesn't mean i am perfect coz i do have my own weaknesses ..hope that you don't get me wrong... :) :) :)