I am probably tired, but I am sad

beth66335, BSN, RN · May 4, 2009

Hi all,
I am probably just tired from school and working fulltime and everything else that goes along with life, but I had a pt in clinicals last week (of course, I chose this pt for my careplan). I am just sad. It's not that I dont feel empathy for all of my pts but this one truly has me shook.
If you met this pt, you would NEVER guess that the the pt was sick. Late 30s, married with childern, healthy active lifestyle, non-smoker, no family history but stage IV cancer with mets to the brain. Mets discovered approximately one month after initial dx.
The positive attitude and personal strength of the pt and the spouse are inspiring and yet, it seems to make me sadder. If they were raging against the horrible hand they have been dealt I think it would have been easier for me.
I need to understand how professionals deal with this kind of situation everyday and don't run screaming for their jobs.
I have waited a long time to be a nurse, I am ready to graduate and love everything about it, but this has truly thrown me.
Any advice would be greatly appreciated.
Thank you

I'm sorry you are sad...but I'm glad the patient isn't. Anger on his part would be wasted energy and he has chosen the better path; to make what time he has left full of joy and love. His family will have good memories of him and know how much he loved them all. You will have patients like this all your career, that kinda get inside you...you can't change yourself and how it affects you, but you will adjust to dealing with it. You will, with time and experience, learn how to keep it from taking you over emotionally w/o becoming hardened. It is just one of those things you don't learn in school...:heartbeat

psalm, RN · May 4, 2009

Sounds like the pt. and her family have moved from the denial and anger stages, as well as the bargaining. I hope you can "hide" your sadness from them. Like Beth alluded to, you'll be learning lots of ways of dealing with stuff not covered in class. Hugs to you.

Long Term Care Columnist / Guide · May 4, 2009

Hi all,
I am probably just tired from school and working fulltime and everything else that goes along with life, but I had a pt in clinicals last week (of course, I chose this pt for my careplan). I am just sad. It's not that I dont feel empathy for all of my pts but this one truly has me shook.
If you met this pt, you would NEVER guess that the the pt was sick. Late 30s, married with childern, healthy active lifestyle, non-smoker, no family history but stage IV cancer with mets to the brain. Mets discovered approximately one month after initial dx.
The positive attitude and personal strength of the pt and the spouse are inspiring and yet, it seems to make me sadder. If they were raging against the horrible hand they have been dealt I think it would have been easier for me.
I need to understand how professionals deal with this kind of situation everyday and don't run screaming for their jobs.
I have waited a long time to be a nurse, I am ready to graduate and love everything about it, but this has truly thrown me.
Any advice would be greatly appreciated.
Thank you

Yes, you probably are tired. Yes, you have a lot on your plate. But you also have empathy and compassion, two qualities which are essential for the life's work you have chosen; and you need not feel bad that this patient has gotten "under your skin".

Every nurse goes through many experiences like this throughout the course of her/his career. No matter how many years you do this job, you are going to have patients who, for one reason or another, hit you right in the solar plexus. Sometimes it's someone like your patient, who seems to have everything going for him and then finds his life shattered into a million pieces with the utterance of the word "cancer". Sometimes it's a little old person whom nobody seems to love---someone who has been forgotten, or merely outlived all his or her family members. And sometimes it's a child who never had a chance to fully live, or who suffers terribly at the hands of those who are supposed to love him/her.

If there's a cure for this sort of hurt---outside of leaving nursing altogether---I've yet to discover it. I keep going because this is my life's work, it's what I was put here on Earth to do, and I can't turn my back on it just because it sometimes causes me great pain. Yes, it does become less frightening over time, because when you've been through this a few times you realize that you CAN endure, and that you CAN go on to the next patient, and the next, and the next. But you don't want to become case-hardened, nor do you ever really "get used to it".........because a nurse who can't feel isn't really a nurse, only someone who performs a job and takes home a paycheck.

It's OK to be sad, and to hurt for your patient. Be there for him now, but know that there will be others who will touch your heart, and their pain will be yours as well..........for a time.

Best wishes to you, you will make a wonderful nurse!

Daytonite, BSN, RN · May 4, 2009

Find things in your life to be happy about. Start to appreciate what you have around you. Begin to realize that people and what we can learn from them are more important than the physical "things" in your life. Unfortunately, many people don't learn this until they are facing their mortality. As a nurse you get to see this and learn to apply this your own life. When I was diagnosed with my 3rd cancer 2 years ago I was asked by a lot of people how I felt about it because the likelihood of metastasis was high, and I may not be out of the woods yet. I am OK with it. I saw lots of death as a nurse and I am not afraid of dying. I am more concerned for my pets and their care since they are elderly and one cat is an insulin dependent diabetic.

VickyRN, MSN, DNP, RN · May 4, 2009

I had a patient like this who made a profound impact on my life. I wrote about her in this thread: https://allnurses.com/general-nursing-discussion/mary-passed-away-22975.html

elthia · May 4, 2009

The Kubler Ross model of grief states there are 5 stages of grief.

Denial

Anger

Bargaining

Depression

Acceptance.

It's more of a cycle...and pt's can move up and down the list.

I've learned that part of nursing is to try to accept pt's and families no matter where they are on the list, but if they make it to acceptance be happy for them. They are making memories that will bring the surviving spouse through the times to come.

You probably are tired, and in part grieving for the pt also...I think most nurses do grieve some for the pt's we get close to. It's important that you recognize it and learn to give yourself time to take care of yourself. I would rather be an empathetic nurse who sometimes cries a little, than an objective nurse. If I became objective and it didn't bother me, it would be time for me to quit.

pinkiepie_RN · May 5, 2009

Just a topic to think about or maybe look up, that I just learned about in my nursing issues class is "compassion fatigue". It's possible you're feeling some of that. *hugs* It can be hard to care day in and day out but I think if you make sure to take care of yourself as well as your patients it helps tremendously.