How do you disconnect?

rn/writer, RN · Nov 28, 2010

You don't have to harden your heart to work with vulnerable patients. You do have to learn how to discipline your emotions, or you won't be able to help the very people you care so much about.

I would encourage you to take some time to think about what it is that trips your trigger? Did you watch someone in your family go through this? Do you see these people as tragic or defeated? Are you worried about growing old yourself?

Don't be too quick to run away from these feelings. They will tell you a lot about yourself and about how to find the balance that will allow you to keep doing your job.

Once you identify the source(s) of your emotions, you can begin to develop strategies for dealing with them.

Here are some thoughts that might make a difference:

You can't save the world. You can only make it a little better for a handful of people a few minutes at a time. This is not failure! It's success taking baby steps.

Hold a hand. Do a good job with physical cares. Ask the residents about things they did when they were younger. Connect in small ways and show a genuine interest.

Learn what it feels like to have good boundaries. Give people what they need, even if it's not always what they want.

Don't take things personally.

Care for your residents, but don't get sucked into feeling sorry for them. You can certainly wish things were different for them--that they were physically stronger or had more visitors--but pity is a poison that helps no one.

Get them talking about what they did when they were younger. In a facility that one of my daughters worked at, the residents had pictures above their beds of them in their prime. It helped the staff to see them as vital, dynamic individuals whose spirits were still lively, even if their bodies had grown frail. It made such a difference to the way folks related to them. They became real.

Temper your idealism with the understanding that you have a job to do and it isn't making everyone happy. There will be days when you will walk away feeling like all is right with the world, but there will probably be more days where you wish you could have done better. Welcome to life.

Don't stop caring--never stop caring!--just do it in a way that keeps the river in its banks and the fire in the hearth. Passion is a wonderful thing if it's channeled.

Take care of your own heart. It isn't the job of the residents to keep from making you feel bad. It's your responsibility to see that your own needs are met away from the job (so you won't inadvertently look to your residents to build your self esteem).

You also need to learn how to balance your emotions with truth. Yes, there are going to be some genuinely needy folks out there whose circumstances make you sad. You can't fix everything. But you can be a cheerful presence who connects in a healthy way and encourages them to make the most of what they have.

The daughter I mentioned before has a very good understanding of this kind of maturing. She started in LTC when she was still in her teens. At first, her heart went out to everyone and she keenly felt the unfairness of the world. She wanted to quit. But gradually, out of necessity, she reigned in her emotions and put her training and good sense to work.

She learned how to nurture her residents without being manipulated. She got so she could meet each person where they were, but then challenge them just enough to take them someplace better.

She worked at three places over a period of nine years, almost always on PMs. She refused to engage in power struggles but seemed to know how to get the "difficult" ones to stop making trouble. Other CNAs would ask for help with people who were refusing to do something and she worked her share of miracles.

When getting the residents ready for bed, (usually 12-15 people) she offered a kiss on the cheek and a hug. Almost everyone took her up on it. But she could do this only after she had establish good internal limits. Even the stinkers got a kind word and the hope that tomorrow would be a better day.

Whenever she left a job, she and the residents would have a good cry. She'd go back to visit for a little while, weaning herself and them off their connection. I am so proud of her for being able to give of herself but still exercise good self-control. She is now in school again and the years that she spent in LTC are giving her much to draw on.

You can do this. You can. You are stronger than you think, and you will learn how to find the path between too much and not enough.

Don't disconnect. Just do it in a healthier way. We need you.

fuzzywuzzy, CNA · Nov 28, 2010

I don't get this. How are you emotionally attached after only 2 days? I usually look forward to seeing my residents again rather than dread going back.

volcomcna · Nov 29, 2010

I don't get this. How are you emotionally attached after only 2 days? I usually look forward to seeing my residents again rather than dread going back.

During my clinical at a 99 bed facility, I hated going back too. It smelled every morning terribly, residents were treated poorly, and it was an overall bad facility. Now that I am working for a company that only takes residents with private insurance and hospice, and I love it, so I could see why she would dread going back, it depends on the facility really.

On the other hand, I agree that how could you feel so attached after 2 days? I barely knew my residents by the 2nd day. I also look forward to my next shift knowing that you are doing what you can for these residents, and crying won't save their lives or help their pain. A lot of them are suffering everyday until they die, and some go faster than others. there is nothing to cry about. People get old, sick, and then they die. If you can't handle that then maybe it isn't for you? :confused:

Jen{NAR} · Nov 30, 2010

Over time your body and emotions become slightly numb. Now just because I say that my emotions are numb does not mean that I don't care about my residents 100%. It just means that I don't cry my eye balls every time that they say something saddening, rather I smile and laugh with them giving their hands light squeezes or pats on the back. The happier you act the easier it is to get through the day without breaking down. Doesn't mean I don't drive home thinking about the little old lady that just won't eat and complains of everything and have tears come to my eyes. T.T

I love my job

That helps too...the fact that I love my job...going to work and seeing my people well cared for and not too aggitated. And WE all are helping them.

BeezRN · Dec 1, 2010

I agree with jen, you do get slightly numb after a little time. I was like you and got attached to 2 residents during my orientation and would come home and cry because some cnas were a little mean and rough wit them. I've been told the same thing by residents, that I'm the nicest and if ill work tomorrow or that they love me. I think, especially after you get a job, you might get attached to some residents but after reality sets in about the job and how busy you'll be you will notice you won't have to much time to think about your emotions. Not only that but you will feel better that your taking care of them at least for that one shift and not those mean cnas. Plus the residents like happy faces not sad because they can confuse it with anger and will become hostile.

yousoldtheworld · Dec 2, 2010

It's hard, but I don't disconnect. I used to try, and I felt like you at my first job in geriatrics, but at my current job it's just impossible.

I absolutely LOVE the kids I take care of. Since it's a Children's Home for the developmentally disabled, many of them are there because of tragic circumstances - abuse, accidents. We have shaken babies, drowning and house fire victims, fetal alcohol/drugs, etc. It's not uncommon for me to go home and cry my eyes out, sometimes. I've just learned to control these emotions while I'm at work.

We recently got a new boy who is able to talk and very bright, and wouldn't really need to be in the facility if he had family who weren't awful deadbeats. He has cerebral palsy and is in a wheelchair, is incontinent, and has limited use of his hands. The circumstances that led to him being in our care involved him being left home alone with no food or water for a week. (His family has a lot of drug problems). He was found on the floor eating dog food by a family friend.

A few days ago, his roommate was talking on the phone to his mom as he does every night. The other boy said something to the effect of "I bet it's nice to have family to talk to every night and tell you they love you." He's completely aware of his circumstances, and it just breaks my heart. I wanted to cry when he said that, he has the saddest eyes and is truly the sweetest kid you could ever ask for. Instead, I just sat with him for a few minutes and let him tell me about his day. He thanked me for "hanging out" with him. The residents genuinely can tell who cares about them and appreciate it.

I channel how much I care about them into how I care FOR them - I treat them as I'd want my own children or family members to be treated, both physically and emotionally. Most of our residents cannot talk (but many communicate in other ways - eye gestures, smiles, etc), but I still talk to them just as I'd talk to anyone else. I give plenty of affection - hugs, kisses on the cheek, hair strokes, pats, whatever that particular resident enjoys.

Showing compassion and affection for them is a GOOD thing. WIth time, it'll be easier to hold yourself together and control your emotions, but we need more people in this field who genuinely care.

blessedinscrubs · Dec 7, 2010

I can relate to this. I was the same way during my clinicals. Never in my life had I felt that I was somewhere I really, truly belonged, as I did when I walked through the doors of that nursing home. When I took my test, the state examiner said to me, "Which nursing home have you worked at?", and I said, "I haven't. Just this one for my clinicals." She said to me, "Are you sure?" with a strange look. And I said, "Yes." And then she said, "Oh...well....You have a very nice way with the residents." I have never doubted since I began that geriatric nursing is my calling in life.

In the very beginning, the whole experience was extremely emotionally charged for me. I'm not saying it isn't emotional now. It is. But the beginning was like an epic surge of this nurturing/maternal/caregiving emotion.

The thing is, the practical side of this work does not allow me to behave in perfect harmony with these emotions. Think of your favorite resident whom you felt most attached to. Imagine they are dying today. The nurse tells you that it won't be long now. Three, four hours maybe. Emotionally, what you would naturally do is sit by their bed, hold their hand, stroke their head, maybe sing to them, etc, right? Well imagine that you have 16 other people to take care of. One of them is about to fall, climbing out of bed. Another is screaming at the top of their lungs because a confused resident wandered into their room. Your supervisor comes up to you and lets you know that you'll need to do an extra two showers on your shift, and as if you didn't already know, reminds you that Ms. Smith and Mr. Johnson's call lights are on again, and that your paralyzed stroke victim needs to be clean, dressed, up and ready to leave for an appointment in fifteen minutes. Then that wierd pain in your knee/ankle/neck/back/wrist reminds you that you really do need to try to stop for at least ten minutes for some sort of break before you run out of time to take any break at all.......

fuzzywuzzy, CNA · Dec 7, 2010

The thing is, the practical side of this work does not allow me to behave in perfect harmony with these emotions. Think of your favorite resident whom you felt most attached to. Imagine they are dying today. The nurse tells you that it won't be long now. Three, four hours maybe. Emotionally, what you would naturally do is sit by their bed, hold their hand, stroke their head, maybe sing to them, etc, right? Well imagine that you have 16 other people to take care of. One of them is about to fall, climbing out of bed. Another is screaming at the top of their lungs because a confused resident wandered into their room. Your supervisor comes up to you and lets you know that you'll need to do an extra two showers on your shift, and as if you didn't already know, reminds you that Ms. Smith and Mr. Johnson's call lights are on again, and that your paralyzed stroke victim needs to be clean, dressed, up and ready to leave for an appointment in fifteen minutes. Then that wierd pain in your knee/ankle/neck/back/wrist reminds you that you really do need to try to stop for at least ten minutes for some sort of break before you run out of time to take any break at all.......

You said it!