Every now and then I'm reminded...

indigo girl · Nov 28, 2010

Thanks for posting this, Mike. I can so relate to what you have been feeling. I work in psych, and see much of the same sort of cases you have described. It is so easy to get discouraged. It is good that you at least recognize it for what it is. Your post really hit me in the heart.

I can't always make a difference for many of my patients. I just try to remind myself that I am there to help stabilize them, and sometimes that is all that I can do for them. It is really wonderful though when one of them tells me that what I said or did changed something for them.

I don't interact with families often since I work nights but, I know how much they suffer when their loved ones are so sick, and how helpless they feel (I have worked hospice, home care, and LTC in the past). You really helped that family hear what they needed to hear because you were straight with them, and supported them through it even though you didn't realize how effective you were being.

Kudos to you, and don't forget to take care of yourself.

dudette10, MSN, RN · Nov 28, 2010

As I left the unit to go home I ran into my patient's daughter in the hallway. She stopped me, and started tearing up as she told me how much they'd appreciated what I'd done. I was a little taken aback, and stammered something about being sorry I hadn't had more time to speak with them. She cut me off and said, "You didn't need to. We were watching, and what we saw was that you went above and beyond for our mom. Thank you."

Do you believe in signs? I'm beginning to, and God help me, maybe I'm beginning to believe in Him again too. (Oh, how it hurt for this self-proclaimed Catholic-to-atheist to just type those words! )

You got what you needed right when you needed it.

And they got what they needed right when they needed it. They needed you. :redpinkhe

sunnycalifRN · Nov 28, 2010

You are so right that those few words of thanks from the family or patient, can make a horrible shift, more bearable. I've had many shifts similar to what you described . . . just running the entire time; and often, not always, the family or the patient will comment on how busy I was but thank me for the care delivered, nonetheless.

carolmaccas66, BSN, RN · Nov 28, 2010

What a fantastic post!

When I watch all the medical dramas on TV, there are always the special 'moments' happening b/ween patients & families & staff, which we don't always have in real life.

I find nursing to be a bit boring at the mo, quite humdrum and routine. But there r moments of sunshine, when people really appreciate what u do.

However, if I was young again, I would not choose nursing as a career & I would still actively discourage younger people from going down this path. I find it too hard to keep up with shiftwork & ++ stressors now I'm older, and will be getting out soon after my study debts are paid.

Marie13 · Nov 28, 2010

...why I got into this line of work.
I've had a rough few months at work, and if I'm really honest... I guess I've experienced my first brush with burnout. I've had a string of frustrating, and/or futile patient assignments. It seems like ETOH withdrawal, psych/self-inflicted trauma, futile care, and combative post-TBIs have been my bread and butter lately. I only recently started to recognize the vicious circle I was caught up in. Feel dissatisfied with work, begin investing less of myself into it, become more dissatisfied, and repeat.
So, I went in to work last night determined to put forth my best effort and break the cycle. It ended up being a grueling double shift during which I admitted a pt. with a catastrophic hemorrhagic stroke who was well on her way to herniating. It was a very difficult and long morning for her family, and due to the intensity of my assignment I really didn't have time to offer them much support (or verbal communication of any kind... really). My only significant interaction with them was when I gently reinforced what the neurosurgeon had told them by describing her neuro assessment and explaining what things like fixed pupils and absent reflexes mean. They'd been told there was no hope already, but I saw their fragile bubble of hope finally pop as they heard it a second time.
I left work feeling pretty well overall about my night, but regretful that I hadn't (in my opinion) been able to support that family in the way I should have. As I left the unit to go home I ran into my patient's daughter in the hallway. She stopped me, and started tearing up as she told me how much they'd appreciated what I'd done. I was a little taken aback, and stammered something about being sorry I hadn't had more time to speak with them. She cut me off and said, "You didn't need to. We were watching, and what we saw was that you went above and beyond for our mom. Thank you."
It's funny how much impact a few words like that can have. It reminded me of something really important that I'd lost sight of... that my work may often be futile and/or unappreciated, but every now and then I get to make a very special kind of a difference for someone.

:nurse: I think that nursing is so difficult, your patient came first and the family saw it. Kudos to you! I think the best part of nursing is when your patients, supervisors and families acknowledge your hard work and dedication with a simple "thanks".

Cessna172 · Nov 28, 2010

I'm new to this forum, but wanted to say thanks for sharing this story.

Testa Rosa, RN · Nov 28, 2010

Thanks for sharing your story! As a new RN It gave me insight. Sounds like you are a solid nurse to me--keep up the good work.

In a small way I can understand how you may have felt. I too had a run in with a combative TBI pt, a long term resident on our busy post surgical floor where he clearly didn't belong but no other unit would take him. One day he attempted to hit me, and when I backed away too fast he turned sideways and hit his sister instead, hard. As he went to hit again, I grabbed his hand and told him this was unacceptable, and he needed to apologize, which he did. Of course at that point the sleepy security guard that was parked outside his door finally came in (!). But by then he was calm and taking his meds, and his sister and mother thanked me later.

He was an exhausting pt, and I still have nightmares about his random moments of agitation and spontaneous walking of the halls. He had a tough life with a chronic disability before his TBI, and there were moments he could be quite kind and thoughtful, and we all wanted to give him the best care...but he was such a difficult pt for us to care for. The stress of even having him on the floor was so draining--sometimes while charting at a cart in the hallway he would walk up behind me and practically fall in my lap. Really, there must be a better place for this sort of pt than in an acute care setting -- add to that the other type of pts you were seeing I can totally see why you were skimming burn out territory.

All it takes are some kind words from an observant and vested soul. Sounds like you are a good nurse and someone reminded you of this. Glad to hear there are moments that bring you back to the essence of why you nurse, Mike.

Stay in a positive place and keep up the good work.

PostOpPrincess, BSN, RN · Nov 28, 2010

Just when you think you've hit that wall, someone pulls you back...

You are on your way to burnout still, my dear, because of the nature of your work.

Please make sure you take care of yourself....

cherrybreeze, ADN, RN · Nov 28, 2010

I know well this feeling you describe, Mike, and wholeheartedly agree. It's those little moments, those few words, that remind us why we do what we do, in spite of all the burnout and frustration.

I've taken care of some patients in the last week or so that I've had been assigned to despite being off a few days in between. A few of them really made me feel like I had such purpose, and made such a difference during their hospital stays. In one case, I had reported off for the evening, and the nurse that took over for me came back to find me (I was still there charting), and told me that the pt in X room wanted me to stop in before I left. She just wanted to say goodbye, and wish me a good couple days off, and thank me for my care that day. She was going to be there for awhile, so I knew she wouldn't be discharged before I came back. That made the whole crappy day, and the fact that I stayed over an hour and a half to chart, worth it. Some of these other patients this past week or so have given me *the look* when I came back after a day off.........."I missed you yesterday."

It warms the heart so much, to know how much you can mean to someone, just by doing what you do best (at least to the best of your ability, with the crazy workload we have nowadays).

Hang on to that one, Mike, and pull it out when you need it.

86toronado, BSN, RN · Nov 28, 2010

I too work in neuro, and have had those moments of "why are we doing this" along the way... why are we detoxing this man who is going to go home and drink a bottle of scotch as soon as he is released? Why are we putting performing brain surgery on an 81 year old with such severe dementia that she doesn't even recognize her own children? And also the sadder ones, like why are we keeping this person with a brain tumor here in the hospital when we know he would much rather die at home with his family? I can't think of a more physically and emotionally demanding specialty to be in. You just have to take solace in the little moments of joy that your patients and their families give you along the way. Try to hold onto those moments for the thousand other times when you feel helpless and at the end of your rope.

Ruby Vee, BSN · Nov 29, 2010

thanks for this post. it reminded me . . . sometimes we really do make a difference.