I’m struggling....

[Ally Fearnow]

I’ve been thinking a lot lately about choices. Mostly about the career choices I’ve made and how it has personally affected me. I have been a nurse since 2005, and I became a nurse because I have a genuine care for people. I have always tried to treat patients as if they were my family. In the beginning of my career I thought that there were clear lines between people that became nurses because they wanted to improve the lives of others and people that became nurses for financial gain. I’ve tried to treat everyone with compassion and respect and mostly to give them care I felt they deserve. As many of my fellow nurses know there is nothing more rewarding than to know that you have made a significant impact in a patient’s or family member’s life in a positive way. But I’ve been a nurse a long time and as time goes on I’ve learned the struggle of providing excellent care to my patient’s and at the same time maintaining my employers standards of timely documentation, struggling with patient ratio’s, and maintaining a balance of employer expectations and giving my patient’s the time and attention they deserve. I’ve never considered myself to be a “company” person or one to fall into the politics of an organization and many times it has caused me to have not so “positive” relationships with my employer. At the same time, the relationships and memories I have established with my patient’s over the years far out weighs any accolades or “attaboys” from my employers. I became a nurse to care for people, and lately I feel it is becoming more and more difficult due to quotas and productivity. I struggle with that on a regular basis, I work long hours, my paperwork isn’t always “on time”. I frequently am frustrated with higher ups talking about census and ways to increase revenue. All I want to do is help people, why is it becoming so difficult to be a compassionate nurse these days?

[dream'n, BSN, RN]

We all know the answer to why.  It's a broken health care system that is profit driven. Now the real question is what we are going to do about it on an individual and collective basis.

 

[Davey Do]

It's always easy to blame the system for our woes: "If only they would get their act together, then everything would be fine".

Reality check: In my 40+ years of being in the field, it's always been this way to some some degree or another. As Charles Dickens wrote over 150 years ago, "It was the best of times, it was the worst of times".

We need to struggle to adapt to situations are they are unless we have the power to change them. "God grant me the serenity..."

Your situation, Ally Fearnow, reminded me one one which I experienced nearly 20 years ago. I had just been terminated from an NS position, planned on giving up on nursing and making money from my art when a high paying nursing job found me.

During my orientation, I was discussing the concept of burnout with a paramedic/instructor who had been in the field nearly as long as I had. This wise man allowed me to experience a sort of self-revelatory illumination. Those who survive in this field- swim where others sink- do so partially as the result of professionally learned coping mechanisms.

One of these coping mechanisms he termed "short cuts". Once we know our priorities, we realize that we don't have to dot every I or cross every t in order to do our jobs- give good patient care.

I institutionalized this wise man's concept and it helped get me through the next 17 final years of my career. I focused on priorities- providing quality patient care along with adequate documentation- and expending the remainder of my energies where need be in certain varying degrees.

I sense you are a quality care provider, Ally Fearnow who is endeavoring to continue being a person of integrity. Verily I say unto thee: Use these and your own professionally learned coping mechanisms.

The best to you.

 

 

[Guest 1152923]

     You sound like an incredible and conscientious nurse first of all!  Sadly, as dream'n BSN RN above noted, our country has a badly broken health care system and as long as it continues to be monetized, I honestly don't see the trend reversing.  It's like any big business endeavor such as mass production; increase productivity with as few resources (human capital, supplies, durable goods) as possible to maximize profit for fatcat CEOs and shareholders.  For this reason, I don't recommend Nursing to anyone as a career path anymore.  In your particular case, is it possible for you to reduce hours, go per diem, transfer to a less demanding specialty area?   Above all else though, you have to take care of yourself above all and worry less about your employer's demands and expectations.  When your body and your soul are properly cared for, your patients will naturally reap the benefit also.  

[Emergent, RN]

9 hours ago, dream'n said:

We all know the answer to why.  It's a broken health care system that is profit driven. Now the real question is what we are going to do about it on an individual and collective basis.

 

Not only that, but the regulatory demands from the government have become increasingly unrealistic. New,  impracticable protocols, charting demands, multple, time consuming screening questions, are sucking the lifeblood out of nursing. Many seem to have been cooked up in a vacuum by academia, far away from the clinical setting. 

[Davey Do]

With all due love and respect for both MLTF & Emergent, Ally Fearnot's premise is supported as to why it is so difficult to be a compassionate nurse these days, but no remedy is approached.

Support on a perception is therapeutic, but there the therapeutic intervention ends. It's like the old adage of singing to the choir or an intervention by Captain Obvious. Yes, we all know the healthcare system is broken, but want can we as individuals do about it?

You may say, "Yes Davey Do- you can sit in your retirement and be an armchair quarterback, but what about those of us who are currently short order cooks in the heat of the lunch hour rush?"

To this I respond, take the concepts that have worked in the past and apply them to the present.

The proof, as they say, is in the pudding.

[Guest 1152923]

2 minutes ago, Davey Do said:

With all due love and respect for both MLTF & Emergent, Ally Fearnot's premise is supported as to why it is so difficult to be a compassionate nurse these days, but no remedy is approached.

     Davy, the old saying, "If you do what you've always done, you'll get what you've always gotten" comes to mind.  The obvious, albeit not so easy remedies then, are to change or be changed.  This is either through acceptance/acquiescence, or actively taking steps to improve the workplace or find alternative employment.  It seems Fearnot though enjoys some aspects of her current position as well as the patient interactions, so a possible solution may be for him/her to just stay put and reduce hours or go per diem to recharge their proverbial batteries and better care for themself. 

[JBMmom, MSN, NP]

I think that your ability to be compassionate is not really the problem. Clearly, you are compassionate and care deeply about patient care, the problem is that there are so many other constraints on your time and efforts that your ability to provide the level of care you think is appropriate is limited. Unfortunately, it is unlikely that the things that you describe are going to change any time soon. 

On my way out of work every morning, I try to think of at least one way in which my patients are better off than when I got there the night before. Sometimes lately I'm really grasping at straws, especially with the COVID pandemic. It may be as little as, I got all of my turns in for that patient so I know he or she won't have any skin breakdown because of my efforts. Or when I walk out of a room in the morning and know that the oncoming nurse has a totally clean and organized work environment to start their shift, I did what I could. As long as I leave focusing on something positive, all of the ridiculous charting, and policies, and death even, fades away a little as I head out. And when I'm not at work I try to make sure that I'm filling my time with the things that bring me joy. Time with friends and family, even just walking my dogs. When I can't be the nurse that I WANT to be, I try to accept that I was the best nurse I could be in the time I had that night.

Be kind to yourself, you're doing your best.