Monster, RN

We are constantly exposed to the heights of human emotion every day. Sadness, tragedy, extreme joy, fear-every emotion finds its way in to patient care. But after so much exposure, many of us become numb to it all. At what point does ‘burn out’ make you a monster? Nurses Announcements Archive Article

Monster, RN

I grew up on a steady diet of Coke, pasta, and medical dramas. Shows like House, Grey's Anatomy, and Nurse Jackie were a weekly binge treat that fueled fantasies of working in a well-lit hospital, looking adorable in my scrubs, and making lifelong bonds with my coworkers (while also finding true love, rapidly climbing the professional ladder, and performing a cricothyroidotomy with a pen, yada yada yada). Cut to the here and now, and I'm a frizzy, greasy, stressed out ER nurse who sweats through a 13 hour shift long enough to eventually crawl home and stress eat my weight in carbs.

Even though I know how ridiculously untrue most medical TV shows are (sure, let's shock the asystole, and why yes, it's quite common for 3 doctors to ambulate one patient after placing the IV themselves, and hell yeah! I've had sex in an on-call room several hundred times), one thing always resonated with me, episode to episode: how the patients struck a chord within their providers. Obviously it makes for better TV when a patient gifts a nurse/doctor with pearls of wisdom prior to passing away dramatically. Poignant music pairs much better with a scene of a nurse sinking to his/her knees in the hallway, weeping while thinking about how that patient that changed their life. But regardless of the drama of it all, there was something to be said about the connections formed with the patients, and the way the patients inspired the providers, be it positive or negative. They FELT something. And in reality we all know that not every patient is like that, not every shift is like that, and hell, not every month is like that.

But it still inspired the type of nurse I wanted to be.

When I started my career, I hoped to be the nurse who was affected by all her patients. The nurse that felt the visceral pain of a grieving family member in her stomach, the nurse who felt true joy with the birth of a baby, the nurse who held her patient's hand and really meant it. And I'm not saying that I don't have my moments, but the more I work and the more I endure the common use and abuse nurses face all day, all around the world (from patients, from patient's families, and from other staff alike), the more I find myself feeling nothing in the face of tragedy, or even joy.

I'm scared that becoming a more experienced nurse is also turning me into a monster.

I recently had a patient with a miscarriage, who sat in the overcrowded ER, wailing at the top of her lungs as the OB/GYN at the bedside explained to her what was happening to her baby. All I did was pull the curtain closed. I cleaned up the body of a young man who was my age, who had jumped off a building and killed himself. I closed his eyes myself, and while his mother wailed over him, hugging his face to her chest, I filled out paperwork. And during a code where we pounded into a guy's chest over and over and over again until at least three of his ribs were broken, and his family cried audibly outside, I felt nothing at all.

When I voice my concerns that I am becoming burned out, and/or a bad person, the majority of people say: "but you have to separate yourself like that, otherwise you couldn't do your job". But does that make it okay? What does it say about me, that I feel detached even about burning out? Have so many violent or emotionally abusive or demanding or truly needy patients broken something within me, within other nurses like me?

To be in healthcare implicitly means that we are exposed to death each day, because it is always there. It is the enemy, but it is also lurking in the corner of every patient room, its long fingers waiting to reach out. Death is the person no one invited to the party, yet he found his way in. And with that constant exposure, there becomes a familiarity, and possibly even more, an acceptance.

So, I ask you, at what point should my work badge say 'Monster, RN'?

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molly.hershman

About molly.hershman

RN, BSN ER Nurse

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Specializes in ICU.

Would you prefer to absorb all the sadness and cry with each of them? You can't physically do that. That's way worse mentally and physically.

Our patients and families need us to be strong for them. They don't need a nurse who sits there and sobs with them. They need us to empathize but not sympathize.

Not everybody is cut out for it. I don't see myself as a monster. I see myself as the strong and level headed one when the families are not. I see myself as the rock that helps these families get through in a small way. Sometimes with certain cases, I take a few minutes to mourn. I may shed a few tears, but my next patient rolling in as the last one leaves to go to the morgue needs my strength more. They need me to not be a mess from the last patient so I can give them top notch care.

I don't feel that makes me a monster. I feel it makes me a good nurse.

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Specializes in Emergency Nursing.
Would you prefer to absorb all the sadness and cry with each of them? You can't physically do that. That's way worse mentally and physically.

Our patients and families need us to be strong for them. They don't need a nurse who sits there and sobs with them. They need us to empathize but not sympathize.

Not everybody is cut out for it. I don't see myself as a monster. I see myself as the strong and level headed one when the families are not. I see myself as the rock that helps these families get through in a small way. Sometimes with certain cases, I take a few minutes to mourn. I may shed a few tears, but my next patient rolling in as the last one leaves to go to the morgue needs my strength more. They need me to not be a mess from the last patient so I can give them top notch care.

I don't feel that makes me a monster. I feel it makes me a good nurse.

NurseGirl525, I can't agree with you more on this issue.

To the OP, we need to empathize with our patients but when we begin sympathizing with them to the extent that we try to absorb all of the pain and suffering of our patients we will be rendered unable to do our jobs. As someone who works in both critical care (ED) and psychiatric/mental health settings, I have learned that taking on all of the patient's pain and suffering is not healthy for us and in some ways it makes the issue more about us and not about the patient/their family. I am a big proponent of support groups and individual therapy for nurses, I think that we see and deal with so much that it never hurts to talk about it sometimes in a safe and protected setting.

OP, I don't think that you're a monster at all. I think you're a nurse who is trying to figure out how to not lose their humanity and the fact that you are talking about it and trying to work through this means that you are on the right track.

!Chris :specs:

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Specializes in Critical Care, Education.

Compartmentalization is an essential requirement for professionalism. It is our obligation to care for our patients AS IF they were our family... but to keep in mind that they are not. We go home at the end of the shift to our real lives. IMO, inability to compartmentalize is a fast train to bahooty-ville. This means that we maintain . We're the calm in the midst of the storm. We can block out the emotional storm and focus on the resuscitation. We step out to contact the patient's loved ones when death is imminent so they will not feel guilty forever because they were not there.

We can't effectively care for patients if we are overcome with emotion. It's about them - not us.

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Specializes in Med-Tele; ED; ICU.

It doesn't make you a monster... it doesn't even make you broken.

Brokenness would be if you lost the ability to feel pleasure or sadness *outside* of your professional role. Can you still be moved by tragic events that occur in the lives of your friends or family?

I think you had unrealistic expectations when you started out and that you have evolved to a place of professional detachment, which is exactly where you should be as a nurse.

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Specializes in Trauma Med Surg, Telemetry, Education.

It definitely does not make you a monster. I've had situations where I've cried and others I was like eh, gotta get back to work. Through it all I questioned burnout, if there was something wrong with my sympathy chip. I decided it was a good thing, if I couldn't separate work and my feelings then I would probably need some serious medication to deal with all the crap I've seen and dealt with.

If you do feel burnt out switching departments sometimes helps give you a feel of rejuvenation.

Just remember not a monster, just good a separating things for your own health!

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Specializes in Strictly school experience.

You need to change to a different discipline, or area in which to work. Being that numb to another person's emotional agony is a BIG RED FLAG. Good luck to you...

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Specializes in I/DD.

It is important to see and respond to someone's pain (compassion) but I like to think that it is not my pain to bear. No family member wants to see their nurse falling apart while they care for their loved one. When dealing with death and dying the family is an extension of the patient. But I'm not a grief counselor. Stick with what you are comfortable with: I'm sorry for your loss. Would you like the chaplain to come? Social work? I find myself matter of fact in these situations, and I spend most of my time reading the family to see what they need. If they are asking questions I answer them. But leave the grieving mother alone with her son, there is nothing you can do to ease her pain right now. At most I would set a glass of water and a box of tissues next to her and move on. During a code? I work the ACLS protocol, for good outcome or bad.

I dont think it is cold, I think it is realistic. It is possible to be professional and realistic and do your job without "feeling all the feels" all the time. It is not your job to grieve for your patient or their family, it is your job to give them what they need. I can still get emotionally invested. Right now I really want my 30 year old ARDS pt on max vent settings to get better and be ok. When I have the time I talk with the family and find out what kind of person he is. But if he doesn't make it I'm not the one that has to grieve for him.

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It's probably your own mind protecting you. Imagine, if during a 20-30-40 year career, you felt each sadness deeply? The mind is not built for that. Now THAT would burn you out. Try re-framing the situation: who stayed calm, provided care and documented the details while those things happened? Yes, that was you. It's a dedication and kindness that you provided during these times. Perhaps including these people in your prayers (if that's something you do) would help you reconcile a bit with the fact that you don't feel their pain as deeply as you think you should. Honestly though, you're doing much better than you think you areí ½í¸€

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I'm not a nurse at all yet, but I'm kinda fearing this

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Specializes in GENERAL.

Molly:

I would try script writing/advising for medical shows.

This way you and others could achieve the ultimate goal of many dedicated,

compassionate nurses which is to never really have to touch or interact with patients except maybe in a cursory or virtual way.

There is no harm done in coming to this conclusion.

This, I believe, is a decision many people come to that leads them to academia, case management and pharmaceutical sales among other things.

So to each his own.

If you think I'm being facetious or sarcastic, I'm not.

I prefer to call it truthful.

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I've also experienced this crusty numbness that you describe. I think everybody that does this for a little while feels that way. I think it's a survival mechanism brought on by years of vicarious trauma.

For me, the meaning is found in the constant struggle back towards humanity. It doesn't matter whether or not you feel something. What matters is that you care whether or not you feel something. IMHO, to be human is to constantly struggle towards being a better person. As a species I think humans are fallible, fearful, lazy, and self-serving. The nobility of humanity comes from struggling to overcome these base traits to be something better- to transcend.

The work we we do is intrinsically humane. It's ironic that we have to lose part of our humanity to do it. Just remember, if you're a spiritual person you can connect yourself to the source of infinite love. Our time, resources, and feelings may be finite, but we can love infinitely. Strive towards that...

Good luck. And know that we have been there and we are all here for you.

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