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

LadysSolo · Mar 26, 2009

ansspa: I have been a nurse for nearly 30 years, and consider myself compassionate (25 years in oncology.) But I also get angry when people tell me they can't afford to eat right, complain when I get them on pt assistance programs where they have to pay $10.00 for $360.00 of medications while talking on cell phones (which I cannot afford) with their perfectly manicured artificial nails and tattoos, with cigarettes visible in their purses. It's all about choices

Long Term Care Columnist / Guide · Mar 26, 2009

Hey, you forgot the new/expensive car and the Doritos.

If I had a nickel for every post that included the words "cell phone", "cigarettes", "artificial nails" etc. when discussing poor and uninsured patients, I'd be able to retire on Maui. Today. And what I want to know is, how do these posters know what the poor carry in their alleged Gucci bags?? Are y'all searching them when they come into your facility?

From the nature of such posts, someone who doesn't know much about life in these United States would assume that every single low-income American owns one or all of these items, which are invariably of better quality than what the nurse, who works so hard to support their butts, can afford. The trouble is, this is nothing more than a stereotype, which demonstrates not only intellectual laziness but a distinct lack of empathy.

I myself fought my way out of poverty over fifteen years ago, and it angers me to see so many of my nursing colleagues perpetuating the worn-out prejudices that I once suffered. Believe me, I never had nice things back then; I guess I wasn't smart enough to work the system. And while I too have seen a good many poor folks with some or all of the above, I don't believe that they are all lazy, greedy and just out for whatever they can mooch. I'm shocked that so many here apparently do.

No one's arguing that it's not OK to blow off steam; we're only human, and all of us have experienced frustration with patients who "just don't get it". But it's not OK for learned professionals to look down their noses at an "undesireable" population, because those feelings WILL show up when dealing with these challenging patients. I've seen it all my life. And I pray that no one I care about will ever be subjected to the tender mercies of nurses who harbor this sort of antipathy toward poor people. Or fat people. Or addicted people.

That's MY "vent". I am done here.

LadysSolo · Mar 26, 2009

VivaLasViejas, I too was very poor: If I used a coupon, I could have margarine and bread instead of just bread to eat till payday. I also did not know how to work the system. And I was behind people in the grocery store that night who were using food stamps to buy steak and potatoes, and went out and got into a brand new car. And many are "disabled," and before I am flamed for that comment, I am also disabled. They are allergic to everything but Percocet, but when they are seen in town out of the office, it is amazing how undisabled they are! It is people who abuse the system who make us cynical....but that's another topic....It is also true that not all people abuse the system, but it is becoming more pervasive.

Long Term Care Columnist / Guide · Mar 26, 2009

Thank you, LadyS. I'm sorry you're disabled, and Lord knows it's got to be hard to see patients who are "allergic" to every pain reliever under the sun except for "oh, it starts with a 'D', what is it........oh yeah, Demerol or something like that". We've all seen people who abuse the system. But if we allow the minority to make us hardened and cynical, I don't think we can do a very good job of helping the vast majority who DON'T abuse it. That's my concern here.

It's funny. I've lived a fair number of years and been through a lot, but for some reason I still prefer to see the glass as half-full. I got optimism built into me like a robin with one end of a ten-foot earthworm in its beak. I'd rather look for the good in people and encourage it than assume the worst. Maybe it's a naive way to live life, but as I often say: "that's just me".

pagriffin123 · Mar 26, 2009

It's a tough place being in the healthcare field. We as nurses try to do our best in teaching patients and though most of the time it's like "talking to a brick wall". I worked Home Health over the last four years and believe me it is much harder to try to help my patients. I've had good experiences and bad. But we just have to keep on trying because we know that we can't always help all of our patients needs.

Kei35 · Mar 26, 2009

I totally agree. The health system and our culture needs to change into one in which we educate our people from youth. You can't change people overnight. We need to start taking responsibilities for our own health. I can't even convince my husband, who appears completely fit and healthy (5'10'', 155 lbs), but just got diagnosed with hypertension @ age 29, to make diet changes. It, if ever change will come, will be very gradual.

I decided to go into home care because more pts look forward to YOU, the RN, and appreciate and attempt to follow your pt teaching. I'm glad I'm not the only one who was thinking this way, but it's true.

Much respect and appreciation for you RNs who do it all despite the current health care situation.

Crayola · Mar 26, 2009

I find this very frustrating issue too. I've recently come across a patient (a full code) that would regularly refuse his dialysis treatments at his nursing home. It would eventually result in a trip to the ER and an expensive stay in the ICU with tax payers paying for it. I don't believe that we can completely become a socialized medicine nation, but if this patient were in Canada and he kept refusing his dialysis treatments, he would be allowed to die instead of being given returning trips to the ICU.

dorothy.whitton · Mar 26, 2009

I'm a Board Certified Holistic Nurse. I too was sick of taking care of the same people over and over because of their sick lifestyle. I have been doing presentations at hospitals, and network with other nurses regarding doing more of the caring with changing behaviors that don't help people staying healthy. I've also become a Hypnotist, and a Reiki Master, and Healing Touch practitioner. So I now have a thriving private practice as well. I was interviewed for the Nursing Spectrum 2/23/09, so you can see me there as well. I now love what I do in private practice and connect with other holistic practitioners in my area.

Crayola · Mar 26, 2009

Thanks for your information. I've been thinking of redirecting my efforts as a nurse to more wellness and holistic areas. I was also considering getting trained to work in a medical spa. (Anyone with more info on that?)

Another problem with having to care for patients that continually don't care for themselves is that, we as nurses who have to care from them, are regularly being exposed to MRSA. I've cared for patients one day in the ICU to return the next day to find the same patient is now on isolation because their nare swab came back positive for MRSA. Very frustrating!

AdvTechSondra · Mar 26, 2009

Wow, this post has definitely sparked a lot of discussion. On many points I agree, that a patient who refuses 'health maintenance care' (ie dialysis) shouldn't be sent to the ED/ICU because clearly he doesn't want to live or makes a choice to be 'non-compliant'. As a general rule people who use the Emergency Department as the PCP and are in every few weeks for mundane things not only slow down treatment for 'urgent care' but drain not only financially the healthcare industry but the morale and empathy of the staff.

No one would argue that Healthcare in the US is in trouble, no matter what side of the political aisle you're on, however further complicating the issues is the basic societal problem of lack of responsibility for our own decisions. Blatently obvious to us are the health issues/behaviors (smoking, poor diet, noncompliant meds) but these are merely the ones that we see everyday. In addition is the rampant 'feeling' that "I should be taken care of", "I am not measured based on my skill set or abilities but just for showing up", "There are NO consequences to my actions that I won't be 'saved' from". I first noticed this when orienting new nurses to our unit. No one wanted to assume total responsibility for their patients, as if someone else will take care of that (trash in the room, respiratory treatments, follow up appointments, setting up test with other departments) no one thought it was up to them. Trying to teach this to new nurses has been a challenge and when I started looking for literature/teaching aides I realized how rampant this is throughout the 'workforce'. So, until we figure out a way to at least begin to change the way society thinks/feels we will continue to face issues like the above mentioned.

I am a pediatric ICU nurse, and one of the (many) reasons is simply that MOST of the things that places a kid in my unit is not their fault, they aren't responsible for not buckling their corificeats, or being beaten by their caregivers. So perhaps, my view is a little skewed. If a patient is not getting the care we need we can have the child removed. However when my Dad was hospitalized earlier this year with COPD and vented the attitude of the nurses caring for him was "He's a smoker what do you expect?" As a family member I found this attitude very cold and distant and as a nurse I found it quite embarrassing. Yes, he has smoked for 50 plus years (since he was 12) and this is his first hospitalization so to simply right him off as a 'lost cause' doesn't seem right either. He has since quit but the 'shame' was not a factor in his decision.

Reading back over this post I may seem a bit two sided, however we're not caring for 'the fat diabetic' or 'the asthmatic who's parents smoke' we're 'responsible' (or at least the good ones are) for someones child, brother, sister, mother, father, friend a real person with challenges that they won't share with us because we're 'so busy' or 'they don't want to bother us with.' So I think we should approach each shift as an opportunity to make a difference during those 12hours and leave the rest to God or 'the universe'. Knowing that I am doing everything possible and in MY control has to be where my satisfaction comes, not from 'making them do what I want them to do', even though it's the healthy choice.

:twocents:

Purple_Scrubs, BSN, RN · Mar 26, 2009

In all honesty, we don't know what is going on in people's minds, hearts, or lives when we see them. They could be on the verge of making a positive change in their lives, but when they feel that their caregivers have given up on them, well, why should they not give up also? We have to be able to meet people where they are, and not everyone is ready for a change. If it was easy, there would be no overweight people, no smokers, no alcoholics, no drug abusers, no wife beaters, no vices left at all. It is not easy to change, regardless of what got you there. Support is an absolute necessity, and unfortunately many people do not have that support system at home and rely on us.

On the other hand, it is frustrating on our end and thank goodness we have someplace like this to vent it out. Sometimes I do not think I could be a nurse at all if you took away my opportunity to vent to people who actually get it!

NewTexasRN · Mar 27, 2009

Seems to me like you need a shift in where you work. You should look into working somewhere else where you feel that you are actually being apart of helping your pt's to improve their health. Good luck.