Vent

[coolpeach]

Ok...I really need to vent a bit.

I am a somewhat new nurse who got into nursing to help people. I love people, have always been a people person, and have always reached out to those in need. I feel terrible saying this, but I am getting to where I don't like people at all. I do have some patients who are really great, but I don't have time for them do to the obnoxious ones who hit the call bell every 15 minutes. And of course even though you know who it is, and what it is because you have dealt with it 12 hours a night for the last two nights you have to drop what your doing (even helping the quiet ones in need). If you don't then you will get in trouble from management for not answer your call lights within a timely manner. You get the folks who call for their narcs every 15 minutes even though you just gave them 20 minutes before, and aren't due them again for 3 1/2 hours, but you have to go in each time they call (right skippy now) because if you don't the light will escalate to a manger who feels pain is an emergency right after ABC, and you didn't respond. It doesn't matter that you haven't been able to care for the other 6 patients they have entrusted to your care, and there is absoultly nothing you can do but say its still not time which is would remember, but he is on Metodone, PCA Dilaudid, Lyrica, Norco 10's and screaming for more.

And woe is me they might complain. I am feel like I am a waitress, but instead of drinks I bring narcotics. The only difference is people would be arrested for treating a waitress for the way its acceptable to treat a nurse. Then you have the snooty horrible awful patients who feel they have checked into the Ritz for the weekend. They want their pillow fluffed, their apple sauce warmed, their feetsies tucked in. One women wanted to send me out to the whole foods store for her specialty brand of peanut butter. The fact that you have a post op who really is in need of care pales in comparison to the fact that they want lemon in their water.

And then their are the drama queens (usually young women, but occasionally women in their 30's 40's). They generally are surrounded by family 24/7. They call you in every 10 minutes because their head hurts, their tummy hurts, their feet are tingly, they feel constipated etc etc etc. Each call their is panic in their voice, and when you get to the room the family is gathered around the death bed, the tone is emergent, and Scarlet requires immediate assistance for whatever ails her. I can't believe it when someone has elective surgery (they chose to do it) and then they call me in and act amazed that whatever they had surgery on hurts. Even if common sense fails you I would think that would have been part of the Drs pre surgical education...it will hurt, and even with the best pain meds there will still be come pain.

And then you have the folks who call you in stating their pain is a 10 while laughing with family, eating ice cream, and complaining that the blankets are too thin. Really if your pain was a 10 you wouldn't give a rats behind about the blankets, would not be eating ice cream, and you certainly would be sincerely laughing and smiling like the day is long.

And management what is wrong with management. Really???? How can they be so far removed from reality? They have to know all of this is going on. Didn't they used to be nurses or at least work in some clinical capacity?

I really am starting to dislike people. This X-mas I didn't volunteer, didn't donate, didn't do anything. When I used to walk by a homeless man on the street I would give him a $ and want to do more. I would reach out, volunteer, and had a soft heart. Now it doesn't bother me at all. Is nursing making me a horrible person?

[HiHoCherry-O]

Some of the responses I like to use are:

For those who tend to monopolize your time: "I need to check on my other patients, their needs are just as important as yours. I will return to check on you in xx minutes/time."

"Help me help you."

For the chronic 10/10 pain: "What is an acceptable number to be at if zero is not realistic?" "On an average day, where would you rank your pain level?" Some people say they live at a 8. This gives you an idea as to how to go about finding a comparable plan of managing pain. In my experience, I have found it helpful to have frank discussions with individuals about coming up with adequate pain management plans. I explain that I am willing to provide the necessary level of medication so long as it remains within the realm of their safety (not getting overdosed and needing interventions etc). I explain to them what the doctor has ordered, what his plan is (you'll know if you work with the same doctors frequently what their usual course of care is), how I intend to carry out that plan and what the patient's responsibilities are within that plan.

For family members who hover: I typically let them know that I appreciate their diligence in being at the bedside, however, there are times when the patient simply needs to rest and not be engaged in interaction after interaction.

With regard to management: make sure you cross your "t's" dot your "i's". Document objectively your interactions and education provided.

For yourself: You are still learning. Give yourself a break. Ask those you trust and whose opinions/insight you value what they would suggest in handling the situation. Learn how to establish boundaries with your patients (a fine art that comes with time, experience and patience).

[misschiatia]

Welcome to nursing. One of the most challenging aspects of our work is maintaining our compassion and caring of others in the face of situations like you described above. Sometimes it helps me to remember that we see people at their very worst. And the ones that act out the most often have personal and personality issues that will continue to make them miserable long after they leave your care. We only have them for 8 hours(or 12, however you work your shift.) But they have to live with themselves forever. I feel sorry for some of the family members who have to go home and deal with these people indefinitely. Also, the same people that need attention so bad that they are not happy unless someone is in their room fawning all over them, must really have something missing from their lives. When you finish your shift, shake it off and be glad you have more personal peace and are less needy than they are.

[canesdukegirl, BSN, RN]

OK-vent accomplished. Take a deep breath. Welcome to the reality of nursing.

Cool, you mentioned that you are somewhat of a new nurse. How long have you been working in med/surg? This is a very typical day...or at least it was when I worked med/surg. You are actually going to get used to the pace, used to the pain in the a$$ patients, used to the Scarlets...eventually you will get back to the way you were-soft hearted and giving. It just takes time to adjust. It took me about a year before I started liking people again :)

How long has it been since you have had a fun vacation? Not a staycation, not a working vacation, not a long weekend, but a REAL kick-up-your-feet-play-all-day kind of vacation? If it has been a while, go ahead and plan a vacation for yourself. I used to be of the mind that I could never afford a nice vacation and would rather just take long weekends at the beach as a substitute for a real vacation. I had my first real vacation in 7 years back in July when I got married. I took 2 weeks off. Girl, lemme tell ya, when I came back to work, I was ZEN calm. Co-workers goofing off and not helping out? So? Management in a tizzy because they didn't schedule enough people to work that day? So? Docs yelling because their cases are backed up? So? I realized that NONE of the above scenarios were the result of anything I had done. Before my vacation, I used to get angry when I saw my co-workers slacking, would volunteer to stay late or to work an extra shift because I felt bad that the unit was in a pickle, I would knock myself out trying to get cases started for the docs so they wouldn't have to stay so late. "To what end?", I asked myself. Nobody was going to give me a gold medal for doing anything above and beyond, and most of the time my actions were forgotten the next day. But I was sure feeling the stress.

Now I have learned to take on LITTLE favors for my workplace. I would agree to stay late 1 day a week instead of 4. I had to learn to only expect MYSELF to give 100% and not be angry when everyone else was not so willing. I learned not to let the job OWN me.

I understand that you were just ranting. That is always good for you. It is really nice to be able to come to a forum where people totally understand what you are going through. I wanted to share my experiences with you so that you know that you are not alone. What you described sounds exactly like a typical day for me when I worked med/surg. It was frustrating at best. I had to chuckle at some of your descriptions-you are spot on!

You will like people again. It just takes some time.

[canesdukegirl, BSN, RN]

Welcome to nursing. One of the most challenging aspects of our work is maintaining our compassion and caring of others in the face of situations like you described above. Sometimes it helps me to remember that we see people at their very worst. And the ones that act out the most often have personal and personality issues that will continue to make them miserable long after they leave your care. We only have them for 8 hours(or 12, however you work your shift.) But they have to live with themselves forever. I feel sorry for some of the family members who have to go home and deal with these people indefinitely. Also, the same people that need attention so bad that they are not happy unless someone is in their room fawning all over them, must really have something missing from their lives. When you finish your shift, shake it off and be glad you have more personal peace and are less needy than they are.

Beautifully stated. And VERY true. It does help to keep in perspective that we are seeing a snap shot of someone's life, and the fact that they are in the hospital is never a good photo.

[leslie :-D]

And then their are the drama queens (usually young women, but occasionally women in their 30's 40's).

i DID read your entire post, but am still chuckling over the above statement.

i almost fell over my walker then tripped over my orthopedic shoes, reading it.

you've gotten some excellent advice.

communication is everything in nsg.

explaining to pt WHEN their next dose is due, is sometimes helpful (if they have watch/clock in their room).

explaining the poc in detail, as to what is wrong, what is ordered, what to expect, etc...is sometimes helpful.

polite limit-setting, is sometimes helpful (but it is an art).

having the doc giving them a talking-to, is sometimes helpful. (including doc threatening to dc some narcs if their antics continue)

this is an intervention that you cannot rubberstamp.

your approach will be different from one pt to another.

give time a chance.

sometimes it's your best friend.

leslie

[canesdukegirl, BSN, RN]

Leslie-I didn't even compute the sentence you quoted. THAT is funny stuff! I can hardly read this, though. BRB after I get my bifocals!

Just ribbin' ya, OP:)

[coolpeach]

i DID read your entire post, but am still chuckling over the above statement.

i almost fell over my walker then tripped over my orthopedic shoes, reading it.

OMG...I just reread my post. I am in my 40's and didn't mean it that way. LOL. What I meant was that you kind of expect the whole drama queen thing from a teenage girl, but not from a grown up. And once you hit the 30's and 40's you should been way over it.

[Mulan]

Didn't they used to be nurses or at least work in some clinical capacity?

:rotfl:

[martymoose, BSN, RN]

Coolpeach- boy do i hear you. It can be so hard to deal with those types. And i have walked away hating people too.I feel so bad when I have someone who really needs my time, and you got some other inconsiderate jerk who feels you are there for them only. I agree whats up with mgmt? Its not like we are allowed to say- " oh , I was with another pt" ughhhh .I had a lady that threw me a curve ball the other day- I thought I was helping her, coming in every two hours to peek in on her( i work nites) she would be sleeping. seemed pleasant in the beginning of the shift. Then I walk in to se her at 4 am- she tells sme she wants to see the mgr immediately. Im like " is there something wrong- what can I do to fix things for you- how can I help you?. she went on saying that this was the worst care she had ever had in her life. I was flabbergasted. she never put her call light on.never said anything when I would peek in on her. I was doing q2 vitals on her. I have no idea what set her off. Part of me thinks maybe cause she was elderly and maybe confused,but she had seemed very AOx3 prior.

Any how, sorry to have gone on like that but that was an example of that lady complaining that the light hadn't been answered( which i would say was answered probably with in a couple minutes- we had no tech.I hadn't been able to zip right in there because I was dealing with a man who was running around naked, continually ripping off his tele, while being on cardizem for rapid afibl.Oh nooo we cant explain that. Id say some pts are such inconsiderate jerks that the could care less if you were performing cpr on someone.

what does help is the very rare once in a while pt who is appreciative, thankful, non- demanding, one who you give your all- if you could. These people remind you there are decent people out there.

I guess theres no way to change the current me me me society.Hang in there- maybe you will grow immune to it. I always remind myself that why i make the salary I do. Not too many jobs out there that pay like this right now.

[SlightlyMental_RN]

Yep, I hear ya. I had a patient demand to discharge ASA the other week. I'd been checking on them q2 hrs, and vitals were being done q2h, too. Every time I checked on them, (walked over said their name and even very gently shook their arm)--they were asleep (or pretending.) All of a sudden towards the end of the shift, they stormed out of their room and demanded to know why they were receiving such "sh*tty care" and that they had been continuously vomiting for hours on end. Yeah, right, that's why you were sleeping every time I checked (including the 30 minutes ago before you stormed out your room)?? And, when I offered them their PRN anti-emetic, they initially refused it. I actually had to sweet-talk them into taking it. :icon_roll

[barbyann]

I was at Home Depot a while back and the cashier looked up at me and started crying, she said "you probably don't remember me but you were my nurse and I will never forget you" ...... She then told everyone in line behind me to "just wait a minute while I give this great nurse a hug" and she did. Everyone clapped. Just one thank you like that and you forget all the crap. Hang in and know you make a difference.