How do you come to terms.....

TheCommuter, BSN, RN · Jan 24, 2007

I think it is wonderful that you possess a compassionate heart and want to assist your patients with even the smallest of things. Never, ever lose your love for people. No amount of paperwork is more important than the patients who make your work day possible.

However, you will need to learn how to delegate tasks to other staff members if their scope of practice allows. I have seen super nurses become burned out and resign on the spot because they did everything for their patients and did not know how to delegate.

I know you are probably not open to this suggestion, but long-term care will provide you with the opportunity to have rewarding relationships with your patients. I work in long-term care because I get to see the same faces day after day, learn about the patients' families, have long conversations with them, and spend more time with them than their own relatives. The most fulfilling, loving nurse-patient relationships can be found in LTC. Take care and good luck!

jjjoy, LPN · Jan 24, 2007

My experience with LTC was that nurses had around 30 patients, 2 med passes, and charting meaning an average of 10 minutes/day of direct patient contact, a good part of that cajoling disoriented patients to swallow their pills or pushing meds through a g-tube to a totally out-of-it patient. No time to get to really get to know patients. If one were a unit manager, they were responsible for 60-90 patients, checking on status changes, getting new orders, and documenting, documenting, documenting.

In regard to wanting to spend more time with patients and give more holistic care, that's a very good question. My experience in most hospitals is that kind of idealistic care is considered "extra." The main focus is on clinical care and monitoring. With limited time and resources, that takes priority. It's understandable but I'd have rather had more instruction in dealing with that reality in school. It feels a bit like bait-and-switch. I digress so back to topic.

Maybe hospice nursing? Some kinds of psych nursing (eg eating disorders)? Long-term rehab (eg spinal cord injuries)? Keep seeking out options! Good luck!

Elvish, BSN, DNP, RN, NP · Jan 24, 2007

Hospice nursing sounds like a good option. Also, I worked for a while at a community health center (not a health dept., that is different) and found that it was a great way to get to know people over a period of time. We had some people that came once & we never saw them again but a great many had been patients there for many years. We got to know their stories, their families, their particular struggles. It was busy, as is any other nursing job, but I loved it.

Curious1alwys, BSN, RN · Jan 24, 2007

Thank you for the feedback. And thanks for the compliment. I was starting to think something was wrong with me!

I like the idea of hospice. But I can't do that as a new grad. Psych is a maybe, but I think I give too much advice to work there.:roll

Something to ponder! Thanks!

fleur-de-lis, BSN, RN · Jan 25, 2007

Ok, maybe I am just a naive student also, but I think there are things you can do even with patient loads, charting, etc. to connect with your patients. You are already doing assessments (hopefully), so while you are doing them, ask the patient "what is one thing I can do today that would help you". They may not have an answer, but they might have something simple that you can do or delegate to be done. (And on the subject of delegating, part of delegating is making sure it gets done. I know you don't have that power as a student, but as a nurse you will be able to make sure the patient gets fed.) And if their request is something that you cannot do, be honest and tell them you will do everything else in your power to make them comfortable. Just knowing that you care enought to ask means alot - I've had patients tear up and tell me no one has even asked them that. And yes, I do ask this question to my patients in clinicals and plan on doing it throughout my career. Call me a Pollyanna but I just think there are things nurses can do to make a difference, even with terrible staffing, patient loads, etc. We can't do it all, but we can do something.

Hoozdo, ADN · Jan 25, 2007

......
How much involvement will I be able to have with the patients when I graduate? Is there any area I can go into where I will have more involvement. So far, most all I have seen is Med Surg. Would it be different in ICU? I guess then they are too sick to talk, lol:roll
What do you all think about this?

When the patient is to sick to talk in ICU, then you get to talk to their families! :monkeydance: And that is FAR MORE talking than you would do with the patient. Somehow though, it is easier to walk away from an intubated and sedated patient, than a lively talking patient.

What you are learning is time management, and it isn't easy and not for sissies! :lol2:

MALE*RN*777 · Jan 25, 2007

As a student you will have issues with delegation and then also with being a new nurse with older co-workers who will want to take advantage of you. I felt the same way you did and you did nothing wrong. We are here to treat the body, mind and spirit. You do however have to set your priorities. For example if you need to hang an IV antibiotic do at that time, someone will not starve for a couple of minutes while you do that. You will learn if not already what is a priority and what can wait a couple of mins. You will also be able to learn how to word things to your staff to have them do what you want when you want. You will be able to reason things out with them that make them want to do as you ask without being authoritative. But then again you will get those who think you are the young new nurse and have no clue and then you have to show your teeth. I rather go home bone tired and know I (myself) cared well for my patients instead of doing a half (you know what) just because my staff didn't have the go to attitude. Lastly and what may should have been first, I was you. I loved talking to my patients instead of just being a med pusher so I changed to Psych which has its ups and downs and you may not be talking to someone all there mentally but you could comfort then and make them feel safe as you would a dementia pt. in a LTC. Good Luck and hang in there. Oh yea, once you graduate and pass your boards, everything you do in nursing, like the 546 step process to changing a trach and other things will change to short cuts you will learn from other nurses. As long as you don't compromise the health and safety of your patient or yourself you will cut the process way down.

Calgon-take.me.away · Jan 25, 2007

My goodness,,,as if I am seeing myself just a short time ago. My husband always tells me that I can't save the world. I recently quit agency to work at a small 66 bed nursing home just 7 miles from my home. It is where I first started out 12 years ago as a nurse. It was boring, slow paced at times and if someone got a nosebleed,,,well you get my drift. I went to the big city, got some real education. Not just on the professional side, but with inter personal relationships, how to handle the tough demanding patients/CNA/family. Care in these LTC facilities in the city is so far removed. Attitudes abound, staff arguments in the halls, racial tension, residents being ignored by staff. So, after much deliberation and a huge pay cut,,,I went back to my roots. And wish I would have done it sooner. I feel so bad for the patients that I left in the city. I feels as if I left them to the wolves. Alot of guilt,,,,but knew I had to get out to save my self. I'm much happier,,,can concentrate on quality patient care. Can sit and talk with them, get to know them better, a wonderful family atmosphere

Blee O'Myacin, BSN, RN · Jan 25, 2007

More so than learning to start IVs or hang piggybacks or put on sterile gloves - that's follow "step A, step B, step C" - here's where you deal with human emotions and more often than not, the exception is the rule!

With experience, you learn that you can be nice, polite and respectful to a patient while telling them that they are not going to get what they want immediately. Be direct and honest. When the patient takes a breath in between sentences - "I hate to interrupt since we are having such a lovely visit together, but I have to finish making my rounds. I can come back when I am finished (if you can come back). Is there anything that I can bring for you when I return?" When I was new, or if I am really busy, I write it down. Now that I work in an ICU, I have 2 patients and they are usually sedated, but during the times that I am pulled to tele, I am writing stuff down all the time!

Good luck with this - your heart is in the right place, but you are there to be the nurse and part of that is to set limits. You will learn to do it in a way that is not off putting to the patient. Remember that there are some people that are not going to be happy unless you are at their mercy, and even then there is no pleasing them - so just don't take it personally!

Good luck!

Blee

Roy Fokker, BSN, RN · Jan 25, 2007

Heh!

Now you know why patients like student nurses?

I tend to lose track of time because I end up helping my CNAs too much and the following shift RNs/LPNs.

Then, every time I start feeling over whelmed - the words of my platoon sergeant would ring in my mind - "Don't try to be no hero!" I pause, reassess situation and then priorotize.

It's an on going process - one that will only get easier with experience. I'm sure each and every nurse has gone through it. Successful time and resource management are keys to simplifying work load.

"Work smart - not hard"

cheers,

AliRae · Jan 25, 2007

I'm one of the chatters. I work in PICU, so if my kids aren't up to talk, I'll talk to the family. Granted, there are days when I don't have time to say "boo" to a goose (I don't really know what that means ... my granny used to say it all the time), but those days tend to be the exception. Yesterday it was all I could do to pop my head into my one kid's room to make sure his pain was okay every hour, what with the other one in SVT and transferring and admitting a fresh post-op scoli. But generally I find time to talk to my patients and their families. I find it to be one of my favourite things about nursing. I love the first 10 minutes of my day, when I set the tone of my interactions with the families. I think that taking a couple extra minutes, obviously as long as it's not endangering my other kiddo, has saved me tons of aggravation and gained me much cooperation with families.

And does singing to babies count as talking to them? Because sometimes I even schedule that on my to-do list. =)