Feeling like I'm not making a difference

[Wrestler133]

I've been an RN for about three years now and worked as an aide prior to that for a year during nursing school in the surgery department at a local county hospital.

After passing the boards I was hired directly onto the PACU floor at my workplace and would float to the preop area occasionally when needed. I worked here for about 9 months because I felt I was not learning much as far as the disease process and most patients were stable after surgery and any complications that occurred the more experienced nurses would jump in and didn't get much experience there either. I liked the job for the most part but felt I needed more exposure to sicker patients to really 'learn'.

I left that job for a float position at a nearby hospital and eventually cross trained in the ICUs. I would float to every tele, ICU and do ICU/Tele holds in the ER as well. Eventually took a permanent position in the Surgical ICU and learned a ton! It was very interesting work but slowly I just felt nothing I do really makes a difference in people's lives ..

Recently I took a job on tele floor at a hospital 5 minutes from my house and love having extra time to sleep and come home before it's dark. I left my previous ICU job because of the hostile work environment and management that seemed to micromanaged everything you could think of. My current manager said if I ever want to leave to the ICU at my current place I'd be welcome to do so after 6 months if any positions open, but I'm not so sure I want to do that anymore either. Each day seems like it's the same problems with patients; chronic conditions that aren't taken care of properly, drug seekers, people with multi organ failure from poor choices etc and family members that treat you as a servant, the endless charting that seems to have more and more 'assessments' added each month and management that puts staff last on a priority list for anything but blames then for any mishap. I don't feel like I'm making a difference at all in anyone's life, basically feel like a glorified waiter that helps prolong death.

I'm sure this isn't the only thread like this here and feel like I need to vent a bit. I try to enjoy my time off but often think if I did everything correctly at work or missed charting something and get a dreaded call into the management office. I'm thinking maybe a change of specialty but I don't know where I could go with my experience and have only been at my current hospital since March so trying to leave so soon would look bad. I've even thought about changing careers altogether but it would be difficult with a wife and child now in my life and the need to help provide.

Has anyone else felt like this? Any tips on things I can work on to maybe ease the stress? Any specialties that truly feel rewarding? I feel like I'm in a hole and can't get out.

[ruby_jane, BSN, RN]

7 hours ago, Kooky Korky said:

You do make a difference just by showing up to give care every day.

My cynical heart grew three sizes right now, Korky.

["nursy", RN]

On ‎5‎/‎19‎/‎2019 at 2:50 PM, caliotter3 said:

. When a person has unrealistic expectations, and looking to make a difference really is unrealistic, they are bound to be disappointed.

I do not think that looking to make a difference is unrealistic. When I worked in ICU, I get very frustrated and burned out. However, I have worked other nursing jobs where I truly felt valued and appreciated. When I worked home health, I got to work with patients one on one, do patient teaching, etc. Many patients were extremely grateful that a nurse would actually come to their house to take care of them. For about 15 years, I put in PICC lines. Just that...putting in PICC lines. Some nurses may think, ugh, doing the same thing over and over.....but I was VERY VERY good at it, and my patients were VERY VERY grateful that I was sparing them from multiple future painful sticks. I worked in a prison for 4 years. That may not be everybody's cup of tea, but I loved it. I never heard so many "Thank you ma'm" and "appreciate you ma'm" in my life. Sometimes the medical staff were the only staff that treated the inmates like human beings and they appreciated it and showed it. And now I'm a school nurse and I know I'm making a difference. The beauty of nursing is that you do have many, many choices.

[strength4unityRN]

Nursing overall is a tough field! The problems you describe our everywhere, everyplace has its problems.

I was an aide too before I was a nurse, overall I have worked in the hospital for 15 years I also traveled for a few years and have worked in over 20 different hospitals.

I think when you feel this way you have to find things outside of the job that fulfill you, it’s easy to become jaded and call yourself a glorified servant, but you are a health care professional, not to mention you are in the beginning stages of your career your not stuck, but stick with something and give yourself time to grow.

[hppygr8ful, ASN, RN, EMT-I]

I'm not sure why so many nurses feel such a strong desire to "Make a difference." by this I mean that I seen countless young nurses who become so disillusioned because they feel they are making a difference. If you really stop and look at what you do, you make a difference every day. You are not going to cure cancer and you aren't going to change a non-compliant diabetic, but when you offer a kind word, a gentle touch, a warm blanket or an understanding ear. You are making a difference in fact you make a difference several times a shift. Be happy that you are able to do that much and each day will be a success.

Hppy

[RLoya]

I hear what some of you are saying about having a Messiah complex. I think OP has a point too though.

I'm glad that you guys have learned how to be at peace with some of the frustrating parts of the hospital. The hospital would be a much worse place without you.

There truly are problems with the hospital system, however, and probably have been for decades. While we shouldn't pity ourselves or hype ourselves up as saints, it is important for patients' sakes at the very least to acknowledge these problems and to acknowledge that they are not ok. By justifying or minimizing them, we enable those at the top (i.e. hospital administration) to continue to turn a blind eye or to even worsen the plight of patients and health care workers. I'm glad, OP, that you are paying attention to the fact that we health care professionals are not providing the best care to our patients through the current health care infrastructure. There is definitely room for improvement.

I felt exactly like you. I worked in ortho for 2 years, med-tele for 1 year, and now work at the county health department in an STD clinic. I got fed up with the fact that we focused on saving lives but not improving them. The goal of health care should be that patients rarely need to be admitted to the hospital. Especially patients with chronic conditions. While each patient has free choice and is ultimately responsible for his actions, constant hospitalization for complications of chronic diseases reflects on our health care community as well. These patients tend to need more than medicine for their health issues. Nursing is supposedly a holistic field. It doesn't seem that way in the hospital where we are very reactive, barely able to put out fires let alone prevent them in the first place. It's great that you in the hospital are taking the time to turn patients, clean them, help with bathroom care, etc. But patients do need more than that. They need help coping with and accepting that they have chronic conditions. They need to have realistic, practical ways of managing their conditions so that hospital visits are few and far between. They need support systems and accurate, relevant education about their diseases and the importance of managing them.

OP, I think the public health field might be a good fit for you. You might lose a few hospital nursing skills but you gain an immense array of other nursing skills. You truly have more autonomy and therefore more opportunity for critical thinking. You learn what to do in real life when someone passes out. In the hospital I felt tethered to all the gadgets to care for patients. Plus you get to use more therapeutic communication, history-taking interview skills, etc.

As an STD nurse, I have my own exam room. I draw blood, take patient history, and do a full exam on each patient I care for. I encourage them, I support them, and I challenge them to make better choices. I learn why they make certain choices and I empathize. It has been such a breath of fresh air. Those who think that there is no life after the hospital, not true.

If you are getting burned out, don't put on a brave face. Move on to a field that truly recognizes and utilizes your invaluable skills appropriately (especially your empathy and focus on the well being of others). If not for yourself, for the patients who need you. And for your family, who probably are most happy when you yourself are happy and at peace.

["nursy", RN]

1 hour ago, hppygr8ful said:

I'm not sure why so many nurses feel such a strong desire to "Make a difference." by this I mean that I seen countless young nurses who become so disillusioned because they feel they are making a difference.

Nursing is getting harder and harder with less and less support for nurses. Human nature is such that something good stays with us for a flicker, something bad has us obsessing and losing sleep forever. So, we say a kind word, and fluff a pillow, somehow that just doesn't make up for the times we are elbow deep in the poop of an end stage cirrhotic alcoholic, or pulling up and turning q2 the patient who weighs 450 pounds, or dodging the kicks and punches of someone crazed on bath salts. Even then, maybe one could make the case that you are doing something valuable, because every patient deserves the best we can give. And then comes the patient family who complains about everything and admin takes their side because....well, patient satisfaction scores. So I think wanting to "make a difference" is a very reasonable and realistic thing. There aren't too many professionals with degrees out in the world who's daily routines include cleaning poop and pee and vomit, suctioning mucous, dressing pus filled wounds, inserting various pieces of equipment into various orifices, and, oh yeah, at my last ICU job admin instructed the nursing staff that we had to empty all the garbage at the end of the shift, because HOUSEKEEPING IS TOO BUSY!!!!