I think it's finally getting to me

jnette, ASN, EMT-I · Jan 3, 2005

I'm so sorry.

It's a terrible thing to happen.. when one begins feeling this way.

Scary and frustrating for both you and your patients.

Time to regroup, pull the staff together and determine what can be done to improve morale, staffing, and preventing burnout.

I know, I know... not a whole lot, right? Because it's out of our control, and our managers' control.

Kinda know just how you're feeling.. (as I'm sure soooo many others do as well).... because it's getting to be that way where I work as well. I never thought I'd hear myself saying it, but the past year has been a real eye-opener. Always more patients added, and more expectations.. but never more help to accomplish what we must. It's getting more and more impersonal, and that is the one thing I loved most about my work.. patient contact. Now there's too little time.. and the patients notice it as well.. and I feel like I've abandonded them. I hate it. :stone

((((HUGS)))

wcu_nurse · Mar 20, 2005

my specialty, that is. i've been doing peds heme/onc/bmt for almost 4 yrs now. i used to love it. it was so exciting, challenging. i still enjoy that part of it (hanging the chemo, transfusions, racking my brain to figure out why the lab values are abnormal, or what's causing the side effects, etc.). the problem is, the emotional aspect of the job, coupled with the extremely poor morale and staffing. it's become dangerous, to say the least. and under these circumstances, it's very hard to be emotionally compassionate and apathetic to my patients and their families. there's no time to sit and talk, and to 'go the extra mile'. there's barely enough time to check orders!! and i feel like lately, every case is sadder than the next. i feel bad for these patients, and their families. this sounds dumb, but i would like my job a lot better if i knew all my patients would survive, but that's hardly the case. they suffer so much, as do their families.

i used to get so annoyed when people would say to me (with a painful look on their face), "i don't know how you can do that". it bothered me because i never thought of it as such a terrible experience. i knew i was making a difference in my patients' lives. it also made me realize what could be, and not take life for granted. but now, i can't answer that question the same way

how do you think you could have prevented this from happening? i'm going to be starting at duke in the end of june and i will be on the pediatric medical stepdown unit with hem/onc pts. i'm really looking forward to it and am getting tired of people asking me how i could take such a depressing job out of college. i'm going into it for the smiles and the difference i'm going to make. it's where my heart is.

let me know what you would have done differently k? meanwhile, keep your head up, today was harder than tomorrow will be. you make a difference. it's not about you or your co-workers, it's about the kids. they need you.

kimmie

BeenThereDoneThat74, MSN, RN · Mar 22, 2005

how do you think you could have prevented this from happening? i'm going to be starting at duke in the end of june and i will be on the pediatric medical stepdown unit with hem/onc pts. i'm really looking forward to it and am getting tired of people asking me how i could take such a depressing job out of college. i'm going into it for the smiles and the difference i'm going to make. it's where my heart is.
let me know what you would have done differently k? meanwhile, keep your head up, today was harder than tomorrow will be. you make a difference. it's not about you or your co-workers, it's about the kids. they need you.
kimmie

i assume you mean the emotional part of it (as the other things, staffing and morale, are kind of out of my control). i'm not quite sure, to be honest. maybe it's just me. there are some nurses (actually quite a few) that have been there for many years, and full time at that. i was never fulltime at this place, and now i'm per-diem (doing it in small doses definitely helps- i would have been burnt to a crisp if i was ft!!) i ask the 'senior' nurses how they've handled it for so many years. they basically say they try not to think about it (which is what i used to do) and just 'do their job'. for the first 2-3 yrs, i saw a number of children die, and hardly cried. sure, i was upset, but i kept saying to myself, we did all we could, and it was in gods hands at this point. obviously, certain kids affect me different than others.

yesterday i took care of a high risk all (new dx). after torturing this poor little thing with po meds, mouthcare and an im chemo shot, all i could think is, he's probably going to die anyway (i took care of 2 others that i got close to, that had the same high risk, that did not make it). i guess i think about it too much. :nono: not a good thing,but human nature, i guess.

btw besides that emotional issue i tackled with yesterday, it was otherwise a decent day (good staffing does make a difference!!)

CHATSDALE · Mar 22, 2005

maybe its time to back off...get a job in regular pedi....you cannot live with the stress you have been described here...you are not going to be good for yourself, your family or your patients

you have to have a certain mind set to work with serious/terminal children...i don't think that you have that anymore

you are not abandoning these children but you do need to move on

BeenThereDoneThat74, MSN, RN · Mar 23, 2005

that's actually my goal. it's a work in progress, as i am per-diem and don't have the ability right now to start something entirely new, which is what i really wanted, but doesn't look like it's gonna happen.

i've worked general peds in the past (and still on occasion per-diem). at first i didn't like it, didn't find it too exciting. i thought the kids weren't really that sick and it was a lot of busy work, and not to challenging. i thought that these parents of otherwise healthy children (that were in for 'minor' things, imo) had no idea what it was like to have a sick child, and would overreact and freak out about every little thing. i've come to realize that if my child were the one with the gastro, or s/p tonsillectomy, i'd be just as freaky!! the work is definately not as challenging, but not as emotionally draining either. so i'm working on picking up more gen. peds, and i'll be starting adjunct clinical instruction soon too.

studentnurse74, LPN, LVN · Mar 31, 2005

I'm a nursing student- getting ready to interview for a peds oncology position. It's the only opening at this particular hospital I want to work at. I'm a bit apprehensive, especially after reading this. I love kids, but just don't know if I could poke and pry on them, and especially don't think I could handle them passing away. Is this what it's like? :crying2:

BeenThereDoneThat74, MSN, RN · Mar 31, 2005

I'm a nursing student- getting ready to interview for a peds oncology position. It's the only opening at this particular hospital I want to work at. I'm a bit apprehensive, especially after reading this. I love kids, but just don't know if I could poke and pry on them, and especially don't think I could handle them passing away. Is this what it's like?

I try not to look at it as "this is what my job is: poking, prodding and death". There really is so much more to it. There are happy endings. It is so great to see a kid you transplanted 3 yrs ago- who doesn't remember a moment of their experience. Many go on to live seemingly normal lives.

Also, I work with many nurses who have been doing this for many years. So I think it depends on the person. I think if you can't handle it, you usually know early on. I think my situation is rare. I liked it for 3 yrs, and now, it's wearing on me.

mydesygn · Apr 14, 2005

I think in every area of bedside nursing, you begin to experience emotional fatigue and burnout. I have been a pediatric nurse for 14 years, never did hem-onc full time; however, but literally every other area medicine. I found that every 2-3 years, I take a break from bedside care. I have left clinical positions for administrative (did admitting and management) and then returned to bedside care. These "sabbitcals" from the bedside help a lot. I suggest taking a position away from the bedside (a pedi hem-onc clinic might be a good choice) for 2 or 3 years and then return, if you still want to do direct patient care. Use these positions to explore new areas and develop new skills. I have been able to really job shop when I need to because I have gained a variety of skills both clinical and non-clinical. Don't be discouraged because you don't enjoy the work the way you used to. You've grown as a nurse and because of this, the job will be routine and not as challenging. Congratulate yourself for that. I now nurses who have worked in the exact same clinical area for virtually their entire careers, some still find the work enjoyable (but not interesting) and some like myself are "rolling stones" and am not emotionally committed to any particular area of nurse.

mydesygn · Apr 14, 2005

I'm a nursing student- getting ready to interview for a peds oncology position. It's the only opening at this particular hospital I want to work at. I'm a bit apprehensive, especially after reading this. I love kids, but just don't know if I could poke and pry on them, and especially don't think I could handle them passing away. Is this what it's like?

I can't tell you how many times families have asked me "How do you do this?" My answer is always "I have kids come in who are so sick and then they get better and go home. This is why I can do this" Beside care is not about poking and prodding and death. You'll eventually be able to handle the occasions when you do have to poke and prod with tolerence because ultimately it is what is right for the child, as long as you never forget that is a child first not a patient, you will be able to "deal". The biggest indicator of burnout is when your attitude and performance begin to reflect that you have lost sight of treating a child but are only treating a patient. The best thing is to do yourself and the kiddos you take care of a favor and take a break.