I'm sick of taking care of people who don't care

Annisme · Mar 26, 2009

I'm really feeling burnt out on taking care of people who are self destructive and have no interest in doing anything to make their lives and health better. I'm sick of a system that is like a big, enabling wet nurse to people who are going to go right back out and continue with all the bad habits again, only be back in the hospital to suck on more of the healthcare titty that puts them back together again so they can go out and continue to screw up their health some more. I'm sick of the total lack of responsibility I see every day I work.
I was talking to my stepbrother who is a chiropractor. His clients are a different group. They are interested in health maintenance and are motivated to improve their health through their own efforts. He's really doing something for people. I'm not. Sure, I have a good bedside manner and manage to connect with my patients and gain their trust. But basically I hate the American healthcare system totally and completely. At this point I'm a nurse only for the money.

I didn't take time to read all of the other posts, but I wanted to share a thought with you.

The ONE person who truly needed you, the ONE person you were there for, the one who was scared, sick, hurt, confused, that ONE person is the reason you do what you do. Some days it may not seem like it, but that ONE is there that truly needs you. Thank you for sticking it out...that ONE could be me!

GadgetRN71, ASN, RN · Mar 26, 2009

This is a vent thread...
no one needs or wants your judgment...
Sure people are going of on patients but there are more productive ways to vent then getting all self righteous and judgmental.
It would be nice to vent without people always tsk tsking you.
IMHO that is...

You're right. I'm tired of all the holier-than-thous attacking people. It's not like this stuff is said to patients. We need someplace to vent-if you don't like it, stay away from the thread. Very simple

Enabling these patients is not helping them. I say this as a slightly overweight person, and who has plenty of bad health in her family history. My doctor told me at my last check-up that I was heading toward fat. I respect her for the fact that she tells it like it is. I've lost 5 pounds so far. :up:

You know when my dad quit smoking? He did it cold turkey after his heart attack at 44..his doctor walked into the room, asked to see his pack of cigarettes. He threw them into the trash, basically called my Dad a fat-ass,:chuckle and told him if he wanted to be dead in the next few years, to keep doing what he was doing. My father did a very smart thing then...didn't get all defensive, didn't whine that the doctor was "mean". He quit smoking and hasn't gone back to it. I applaud what that doctor did. :yeah: The OP is right, we are a soft and weak people in this country.

And the OP is a good nurse..it's because she cares that the stupid, careless behavior gets to her. I have more respect for a nurse that mans up and tells his/her patients what they NEED to hear, not what they WANT to hear.

malaski · Mar 26, 2009

at least your honest about how you feel:banghead:

suecbrn · Mar 26, 2009

Okay, so what makes her opinion any less important than yours? Just because it may be different than yours doesn't make it any less important to say. The original message is not a productive "vent". It's someone who is legitimately burned out. There is a TON of judgment in those comments, and a TON in yours. This is not productive in any way.

Everyone is entitled to their opinion whether you like it or not. Especially in the case where people choose to "vent" in public.

"It would be nice to vent without people always tsk tsking you." How about you model the behavior you expect of others?

dadfirst · Mar 26, 2009

At what point do you give up? In a fight do you give up at all? Is the passion to help strong enough to overcome any obstacle? Frustrating? YES!

Ecclesiastes assures us that "if the ax is dull, and the edge is not sharp, more strength is needed, but skill will bring success".

Good luck to you...

suecbrn · Mar 26, 2009

You're right. I'm tired of all the holier-than-thous attacking people. It's not like this stuff is said to patients. We need someplace to vent-if you don't like it, stay away from the thread. Very simple
Enabling these patients is not helping them. I say this as a slightly overweight person, and who has plenty of bad health in her family history. My doctor told me at my last check-up that I was heading toward fat. I respect her for the fact that she tells it like it is. I've lost 5 pounds so far.
You know when my dad quit smoking? He did it cold turkey after his heart attack at 44..his doctor walked into the room, asked to see his pack of cigarettes. He threw them into the trash, basically called my Dad a fat-ass,:chuckle and told him if he wanted to be dead in the next few years, to keep doing what he was doing. My father did a very smart thing then...didn't get all defensive, didn't whine that the doctor was "mean". He quit smoking and hasn't gone back to it. I applaud what that doctor did. The OP is right, we are a soft and weak people in this country.
And the OP is a good nurse..it's because she cares that the stupid, careless behavior gets to her. I have more respect for a nurse that mans up and tells his/her patients what they NEED to hear, not what they WANT to hear.

I don't hear anyone saying that people making bad decisions should be enabled. I agree the right thing to do is to say it straight out. And as someone who agrees with this technique, I am thinking you might agree there are many ways this can be done and some are more effective than others.

It sounds like what your Dad's Doc did with him worked. My guess is that your Dad at 44 also got the message with the heart attack, and was ready to hear the message the Doc had, and make a vital change. That's fantastic! I would suggest though, that this same method doesn't work for everyone at all times.

Has anyone in this group ever experienced "horizontal violence" from a Physician who decided your call or request (a perfectly legit one) was not okay? I've seen it many times, I've experienced it myself. Doesn't really inspire people to approach the same Doc with any other issues in the future. The same situation exists for the patient who is met with attitude and judgment from any health care provider. What's worse is we will miss opportunities to help, because of that perception on the part of the patient.

It's been my clinical experience that if you can meet people where they are at, they are more willing to hear what you have to say. This does not mean hand them the proverbial twinkie. It means actually talking to the person to figure out where their head is at and finding a way to start the steps in the better direction. Sometimes that direction isn't as linear as we would like, and it's frustrating to say the least. But, it is the nature of nursing to encounter these issues and do the best we can to guide people. If they choose not to listen, and we've done our best to reach them, then that's all we can ask of ourselves.

What I see on a fairly frequent basis is that we are all too pressed for time and don't feel we have the best opportunity to do this for our patients during a crazy shift. This is where it can quite depressing coming to work and not finding the ability to effect a positive change for someone while we're up to our eyeballs in things to do.

My question is when is the day going to come when people stop assuming it's the nurse's job to do this..that. .and the other thing.. which takes us away from the bedside in the first place?! And then they wonder why people don't want to be a nurse!

RN BSN 2009 · Mar 26, 2009

You know when my dad quit smoking? He did it cold turkey after his heart attack at 44..his doctor walked into the room, asked to see his pack of cigarettes. He threw them into the trash, basically called my Dad a fat-ass,:chuckle and told him if he wanted to be dead in the next few years, to keep doing what he was doing. My father did a very smart thing then...didn't get all defensive, didn't whine that the doctor was "mean". He quit smoking and hasn't gone back to it. I applaud what that doctor did. The OP is right, we are a soft and weak people in this country.

now-a-days you'd get reprimanded for that in the name of customer service and PG scores. :banghead:

lamazeteacher · Mar 26, 2009

Job satisfaction comes from doing the best job you can. Patient compliance happens when the time is right for them - which may not be in this life.....

Your objective for your patients must be more realistic, as the only person over whom you have any control, is you.

People retain only 20% of what they hear, so repetition is needed to increase comprehension. They retain 40% of what they hear and see, which is why videotapes are needed, or other visual aides. 60% retention occurs when people hear, see and do what's taught, "returning the demonstration" (still not enough for diabetics).

Teaching what has been learned results in 80% retention of learned material. So be easier on yourselves, and your patients when they seem not to have heard what you told them. If you expected your patients to spring to attention with the information you imparted once, you're kidding yourselves.

Also, depression has a way of interfering with learning. That is a common reaction to being told you have a life long illness without a cure.

Keep on keeping on. Eventually you'll see results, if only a patient who remembers that you were the nurse they had last time they were admitted to hospital.

homenurse12 · Mar 26, 2009

I have worked in many areas of nursing and can tell you a few things that are true.

If people want to be healthy, they will be period. I currently am working in corrections, after having worked in home health, hospice and numerous areas of the hospital. People might live in a shack and feed their children cheetos for a mea,l but most of them have a big screen TV. A few are genuinely poor, but most just spend their money on other things instead of healthcare. I see the worst of the worst in corrections. I try to make an impact when I can but have long ago learned that the idea of working for their keep is a foreign concept to most of them. They see it as totally normal and acceptable to use the ER as their PCP. The become an inmate by their own choices and then are angry because I won't treat all the health conditions they have ignored. We only treat conditions that could become life threatening or could be a public health problem. They become angry and start yelling that they want all their conditions treated. People have got to take care of themselves and quit using every excuse in the book to push this simple and basic responsibility off on everyone else, especially the taxpayers. WE all have to make choices. Not everyone that is poor ignores their health, breaks the law, becomes an alcoholic /addict or becomes obese. Be real, it takes some considerable effort to be 400 pounds. Those are their personal choices. I have been a poor single mother before and I still made sure that we took care of our health. It is a matter of personal choices...period.

WantAccel.BSN, BSN, RN · Mar 26, 2009

i do not get worked up over patients who do not care... it might sound bad but it is a way to protect myself from burn out... i worked in social services in a former life... i used to care about the drug out heroin addict more then she cared about herself.... i cared about the kids she breast fed and gave a one-way trip to the nicu... i cared about the suicidal psych patient on my weekends and visited her on my days off to make sure she took her medications.... and much much more!!! well guess what? that hurt my health and my family!
so in nursing i have taken a different approach to people... i provide the best customer nursing service i can... if they care, so do i... (at work only)! if they don't care ... i try my best to teach... motivate... and i move on very quickly. in other words, i do not take the lives of others personally or judge them and i definitely do not bring their problems home.
op: if you are not a place in your life to do as i do, then maybe a different specialty as you have suggested (a wellness clinic) is better for you at this time...?? i used to have trouble separating or letting things go... so i am not putting you down. i am just providing support. gl!
-new grad rn

this sounds familiar. i'm currently working in social services attempting to transition into nursing. caring more than my clients do about their lives happens constantly. i feel like i am getting paid to spin my wheels sometimes, because, as the old adage goes, you can't help people who aren't willing to help themselves. op, try thinking about it this way: you are providing a service to your patients. if they are unable to accept that help, then there is nothing you can do about that but continue to do your job to the best of your ability. for some people, it takes years and years or some sort of life altering experience to get them to a place where they are willing to change their behavior. don't carry the weight of the world on your shoulders, my friend. but don't give up either. when you see the opportunity to influence change in the system, jump on that bandwagon and get everyone you know on it with you!

LadysSolo · Mar 26, 2009

My favorites are the asthmatic/COPD pts who continue to smoke 2 ppd (yes, I know it's hard to quit smoking) who have had patches/Chantix. I can it "fix me in spite of myself." And I have no insurance (my employer does not offer it, despite being a private Dr's office), so don't preach to me about bein unable to afford. These are the Medicaid, getting insurance off my tax dollars, having care I cannot afford.

GadgetRN71, ASN, RN · Mar 26, 2009

I don't hear anyone saying that people making bad decisions should be enabled. I agree the right thing to do is to say it straight out. And as someone who agrees with this technique, I am thinking you might agree there are many ways this can be done and some are more effective than others.
It sounds like what your Dad's Doc did with him worked. My guess is that your Dad at 44 also got the message with the heart attack, and was ready to hear the message the Doc had, and make a vital change. That's fantastic! I would suggest though, that this same method doesn't work for everyone at all times.
Has anyone in this group ever experienced "horizontal violence" from a Physician who decided your call or request (a perfectly legit one) was not okay? I've seen it many times, I've experienced it myself. Doesn't really inspire people to approach the same Doc with any other issues in the future. The same situation exists for the patient who is met with attitude and judgment from any health care provider. What's worse is we will miss opportunities to help, because of that perception on the part of the patient.
It's been my clinical experience that if you can meet people where they are at, they are more willing to hear what you have to say. This does not mean hand them the proverbial twinkie. It means actually talking to the person to figure out where their head is at and finding a way to start the steps in the better direction. Sometimes that direction isn't as linear as we would like, and it's frustrating to say the least. But, it is the nature of nursing to encounter these issues and do the best we can to guide people. If they choose not to listen, and we've done our best to reach them, then that's all we can ask of ourselves.
What I see on a fairly frequent basis is that we are all too pressed for time and don't feel we have the best opportunity to do this for our patients during a crazy shift. This is where it can quite depressing coming to work and not finding the ability to effect a positive change for someone while we're up to our eyeballs in things to do.
My question is when is the day going to come when people stop assuming it's the nurse's job to do this..that. .and the other thing.. which takes us away from the bedside in the first place?! And then they wonder why people don't want to be a nurse!

I basically agree with you..If I'm reading the OPs post correctly, she's frustrated with the people who truly want zero responsibility for their health. There are people who don't want to hear it when you try to educate them. And these are the people who need a smack upside the head...I'm pretty sure she's not referring to people who don't know better. She's referring to the patient who knows damn well that they aren't supposed to have the Twinkie, they have it anyway, and then cry about the consequences..(or threaten to sue, because they have a poor outcome) Two very different kinds of patients...

As a patient, I prefer a healthcare provider who keeps me in the loop and if means they are a little blunt, that's fine. I mean, it's a sad state of affairs where care is dictated by customer satisfaction scores and warm fluffy feelings.