Too attached

  1. So I've reached a point with a patient that I think most of us get to at one point. This is the first time in my short career as a PICU nurse that I've really 'taken work home' and can recognize that I'm spending too much time thinking about this case.

    Without sharing details, I've reached the point where I don't think another nurse can care for this family as well as I can. Not medically, because I know all my co-workers are incredible nurses, but emotionally and socially. I've been taking care of this patient for the past several weeks, and more recently the past two days. I have spent significant amounts of time talking to this child's mom, and I've been able to advocate for her and really connect with her. I'm not working today, and it's honestly tearing me up because I'm concerned that there isn't anyone with her who knows will be able to listen and care for her like I could.

    So that's my dilemma. I'm at the point where I understand that I am too close to this case, but not at the point where I would begin to know how to distance myself, or even if I could.

    Thoughts?
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    About Double-Helix, BSN, RN

    Joined: Apr '11; Posts: 3,484; Likes: 6,955

    16 Comments

  3. by   1JerseyCCRN
    My neice suffered a bleed after falling from large slide at a playground when she was 5, she was in PICU for 4 weeks recovering, there was one PICU nurse who my brother and I grew close to and she would call us everyday that she was off just to make sure we were ok and that things were running smoothly with her care. I just wanted to let you know from the other side of things we appreciated her more then words would describe. My hats off to you and your collegues for the work and love you share day to day. Dont have much advise to you but from a patients perspective You are an angel.
  4. by   AJPV
    Ashley, I really admire your courage to acknowledge your emotions. I'm a new grad, so I'm not sure I have a lot of advice to offer, but I'm looking forward to hearing what others think. I think the PICU must be one of the more difficult places to not become too attached. I'm confident you'll find the right answer!
  5. by   just keep swimming
    I have had this problem with my patients before and have realized that this way of thinking is a bit egotistical. Please don't be offended by this. The way that I look at it now is that I have had the opportunity to really make a difference for this patient and their family. Is the patient taken care of while I'm not there? Of course they are. Is any harm going to come to this patient with another nurse just because it's not me? Probably not.
    I know we are not supposed to get attached, but we are human. You probably cannot change these feelings, especially as a new nurse, but you can make sure your feelings do not drive your actions. Good luck!
  6. by   Been there,done that
    You know it is not in YOUR best interest to get to this point. You're not even able to enjoy a much needed day off.
    It is NOT really possible to give the best nursing care when you become involved on an emotional level.

    You need to work through this. I wouldn't do it with ANYONE at work. It will be viewed as a "problem" and come back to bite you.
    Go through Employee Assistance, get connected with the right counselor. If it's happening already... it will happen again and will wring you out emotionally.

    Good luck.
    Last edit by Been there,done that on Dec 9, '11
  7. by   Jan Thompson
    This is going to sound cold and unfeeling and I hope you don't take it the wrong way, but, you are too attached and need to distance yourself emotionally.

    It is really nice that you are such a caring person and that you or so engaged with the situation.

    However, the industry you are in and the type of nursing care that your have been trained in will eat you alive if you don't learn to not get so attached.

    What happens in future assignments that are much more difficult?

    What happens when you must care for a terminally ill patient?

    Is there a chance you will ever become a hospice caretaker?

    It is best for you and your patient in the long run if you lighten up and not take yourself quite so seriously.

    Other nurses are quite capable of filling in.

    I agree with the previous commenter, you are an angel...

    but you have been hired to be a nurse.

    Jan
  8. by   Tofayelbd
    It is good, but time will passing and you will more professional.
  9. by   Esme12
    Quote from Ashley, PICU RN
    So I've reached a point with a patient that I think most of us get to at one point. This is the first time in my short career as a PICU nurse that I've really 'taken work home' and can recognize that I'm spending too much time thinking about this case.

    Without sharing details, I've reached the point where I don't think another nurse can care for this family as well as I can. Not medically, because I know all my co-workers are incredible nurses, but emotionally and socially. I've been taking care of this patient for the past several weeks, and more recently the past two days. I have spent significant amounts of time talking to this child's mom, and I've been able to advocate for her and really connect with her. I'm not working today, and it's honestly tearing me up because I'm concerned that there isn't anyone with her who knows will be able to listen and care for her like I could.

    So that's my dilemma. I'm at the point where I understand that I am too close to this case, but not at the point where I would begin to know how to distance myself, or even if I could.

    Thoughts?

    Ashley....I like you. I read your posts and you are bright, articulate, and professional. But we are human. I see in your posts that you REALLY LOVE....being a nurse. I too, have become too attached, to a couple of patients in my career. Patients that have deeply affected me emotionally.

    I had a little girl I cared for many years ago that was struck by a car (I'm thinking of you angel) that I can cry about to this very day. I cared for her relentlessly, expertly, effectively, and caringly. If I was off for a few days... I would call and check on her and I thought of her constantly. there were a few time that I would not be able to care for her when I came in as someone else would have her and it drove me nuts (and I drove them nuts). My co-workers knew me trusted me and let me love this little girl. When the day came that we had to determine brain death......I HAD to be the one to go to the tests. I needed to know MYSELF, without a doubt....that she was gone.....so I could look at her mother and KNOW she's gone. Most of all I NEEDED the closure. I needed to know as I removed her form life support to place her in her mothers arms for the first time in weeks....to die. I cried as she sang her a lullaby and I cried when her mother so distraught that she would still be cut up for the autopsy (despite all my efforts, she refused donation ) Because I loved that little girl I was able to give her mother peace in her heart before she left that day. Right up to zipping up the coroners bag, at which I became unglued, I loved that little girl and her Mom. So, yes I have cried at work and I'm proud. That was now.....almost 20 years ago, how time flies.

    Here's my advice. Keep perspective. Keep your judgement. Make sure you are still able to act on emergencies and perform your job. Acknowledge your feelings but don't be afraid to care. Keep yourself busy on your days off and chastise yourself if you think you are getting carried away......but ALLOW YOURSLF TO CARE!!!!

    Hey little angel I thought of you today!!!
  10. by   AnonRNC
    I disagree with the one who said you are egotistical. You are not; you are just having inappropriate thoughts. I applaud your self-awareness and ability to recognize your inappropriate thoughts. We ALL have inappropriate thoughts at times. Usually we can control them, but sometimes not. It's okay; the important thing is to recognize when they are out of control and do something about it.

    As for what to do about it...I see two choices: work through it yourself or get counseling. I think the recommendation to use your facilities Employee Assistance is a good one. I believe most programs offer a small number of counseling sessions at no cost. I agree with the poster who said NOT to discuss with anyone at work.

    You might consider calling of 'sick' for a few days, to give yourself time for emotional healing - this is NOT cheating; mental health is part of health. You also might consider asking to be assigned to another patient when you next work - you can still go check in with the family in question, but some distance seems wise.

    There was a post above about a primary nurse who phoned the family on her days off...while the family appreciated it, I think that practice crosses professional boundaries and seems as unhealthy as what you are currently experiencing.

    Courage and peace to you Ashley!
  11. by   leslie :-D
    this is why i just can't work with kids.
    i did peds hospice for around 6 months, and it nearly destroyed me.

    even during my peds rotation in nsg school, i was assigned a 2.5yo for 6 wks.
    she had been badly abused by parents, and was now product of the system.
    anyways, i fell in love with her...
    and even got to the point of looking into fostering her, then adopting her.
    when it got to that point, my instructor immediately reassigned me.
    i was devastated.
    yep, you really can get too attached.

    how you choose to handle it, is on you.
    it's to the point you're becoming a tad territorial.
    that's not good for you or your pt.
    either be reassigned, or give yourself a good dopeslap.
    but you need to do something.

    good luck, honey.

    leslie
  12. by   just keep swimming
    I apologize for using the word egotistical. Leslie said it better when she said territorial. Bad choice of words on my part
  13. by   doomsayer
    It helps me a lot to read this. My soft spot is for geriatrics. My first orientation at the LTC facility, I teared up just looking at the lonely little old ladies waving at me. Then I get assigned to a demented, fantastic firecracker...

    I became very attached to the PT, and she to me. It is killing me not to find a way to see her. She loves me, I make progress with her. She touches my face and tells me that I am her friend. I know she is cared for, but I know that I am able to reach through her dementia and contact the person inside of it all- not being delusional, you can feel it when it's real. But I have to sever ties or I will impale myself on this, and I know it. It's hard. I know she has no family or friends- and other students the get assigned to her mention that all she talks about is me. It hurts my heart, but such is life.
  14. by   PsychNurseWannaBe
    The first part of this is that you are assessing your feelings. That great. What my red flag is the statement that you feel your fellow nurses can not provide the same care. As a nurse you have to be concerned with transference and counter transference. You also need to keep in mind that you are engaged in a therapeutic relationship, it is goal driven. It is part of the nurse - patient relationship.

    Even with all that in mind, we do at times get too close to people. We are human after all. But you need to step back. You do not want to be a crutch for this person. What you may want to do is empower them to be their own advocate.

    But the first step you did... you realized you are too attached.

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