Is This Nursing?

[BoyNamedSue]

I started working in rehab several months ago, and now notice that I have emotionally been changed. I'm past the honeymoon phase of starting my career, and sincerely believe that once you start hating you're job, that's when you're a real nurse. I've heard that nurses in general have sick senses of humor, but I don't know if it's entirely healthy. Recently, I've noticed that more things get under my skin: things that coworkers do, families do, and a-hole NPs do. Now, I'm not afraid to let my thoughts be known.

When I was in nursing school I was quiet and reserved. Now, I curse like a sailor. I notice that I'm more open with my emotions - usually ****** off - and I make light of pretty sick **** that I see at work. I don't know if this is just a coping mechanism, or if this is my new personality.

After my new way of coping had become my new personality, I found myself about to speak my mind to a ******-off family member. I held my tongue, and went back to my coworkers to laugh it off. The family was gone by then. Before I made it back to the nurses station I stopped in my tracks. What's wrong with me? I looked in the patient's room and my eyes were open to the family's concerns. The room looked like hell. The bay window was stacked with pillows, the table was cluttered, and the recliner was covered with wheelchair parts. I stood in the darkened doorway of the patient's room, gazing with tearing eyes. Silently I entered, and began to clear the desk, clean the table, make the chair a chair again and not a storage counter, and pick up crumpled paper straw covers from the floor. I looked and saw a tucked-away family photo sitting in the corner. I picked it up and moved it so that the patient could actually see it.

At that moment I saw how I had changed. I can't say that I'll ever regain my old sense of humor, my reserved nature, or that I won't curse anymore; but I know that I will always carry with me an ever-present thread of humility. That night, I left the room hoping that I hadn't entirely forgotten what it meant to be a nurse.

[birthingbabiesrn]

Good for you for being able to look at how you're nursing and notice there needs to be a change. Many people don't do that.

If you're having extra trouble with anything, might be a good time to seek out a therapist. They're good about giving you tools to handle tough situations.

[bluegeegoo2, LPN]

Speaking for myself, I approach my shift as a series of tasks and deadlines and often get my feathers ruffled if someone or some event derails my efforts to complete the tasks or miss the deadlines. When that occurs, I tend to develop a less-than-professional attitude (albeit brief) towards who ever or what ever dared interfere with my progress for the day. I keep my exterior professional looking/acting and take care of the issue but inside I seethe. Then I remember why I'm there. I have to consciously slow myself down and remember that my real goals aren't just getting meds out or getting the charting done or processing orders. My goal is to, if possible, improve the quality of life in who I am able. At the least maintain the quality of life in the rest. Including family. This is a daily struggle for me as I am a very goal-oriented person. I just have to remind myself of what the important goals are.

Speaking for myself again, I have developed a wicked "sick" sense of humor. I do believe that it is part of my defenses against what I see daily in LTC. On occasion, I will stop and really look at what environment I'm in. I see twisted, frail bodies with failing minds, unable to care for themselves in any capacity. I wonder who they were when they had their health. What kind of personality did they have? What stories could they tell? Then I see what life has brought them to. Sitting there in their w/c, alone and "forgotten" until the next round with people rushing past them without so much as a sideways glance. It makes me want to cry. I will go give them a hug, try to fix their hair, something to let them know that someone notices them and I almost always tear up. I believe that is why I've developed the sick sense of humor. It's a way for me to carry on through my day without thinking too deeply on the sad things I see. I couldn't work in this environment if I didn't have a coping tool. It may not be the best option, but it works for me.

[VivaLasViejas, ASN, RN]

I used to wonder about people in LTC too, especially the ones who couldn't tell me their stories. For some reason it was never hard for me to see the humanity behind the lined faces and wrinkled bodies. They were human beings who had loved and been loved; they were children and then they grew up and went to war, worked in factories and on farms, raised children and saw grandchildren born. They went to church socials and house parties and weddings. And most of them were there when their spouse died, and oftentimes they cried when they thought no one was looking.

It's so difficult to nurse in LTC these days, with the emphasis on goal-directed activities designed to get the most work out of the nursing staff while basically treating the residents like widgets on an assembly line. It just broke my heart to have to give meds and fly out of the room like my hair was on fire. All some of them wanted was for someone to listen to their stories, and sometimes I did stop for a few minutes and let myself be transported to a time before I was even born.....and put myself behind for the entire rest of the shift. It was worth it, though, and I knew it made the resident's day to be able to share some of his or her life with me.

How I wish the corporations that run these places could see something other than cold, hard cash! I wish they could see the light in a pair of ancient eyes when a staff member takes a little time to listen, to fix their hair, to smile and hold their hand for a moment. There's nothing wrong with a resident wanting attention. There's a LOT wrong with putting profits before people. But I'd better not get started on that rant.

[monkeyhq]

First, I want to thank you all for the heartfelt and thoughtful thread and posts. I haven't been in LTC since my clinical days, but there was something uniquely humbling about caring for this particular population. I apologize for the long post, but I wanted to share:

My first LTC location was actually amazing, following the Eden philosophy. The facility was a large horseshoe situated facing a shade-tree lined pond with walking paths circling the pond. In the center of the horseshoe was a playground for the Headstart Pre-school program (located on the same campus), the community vegetable garden, and an enormous courtyard pergola shaded from above with blooming plants. All resident rooms faced the center of the horseshoe so they could enjoy the children, garden, and courtyard. At the end of one horseshoe wing was a full greenhouse, and the other horseshoe wing contained a large recreation room with games, a television, and an array of engaging activities.

Every resident--even those that were bedridden or could not communicate--was assigned a pre-schooler as a 'buddy'. Once per week, the children were paired with their buddy resident and they would engage in planting their community garden, simple games and crafts, reading, and sometimes just conversation. The residents who could not reciprocate the curiosity of their 'buddy' also had an aid who would engage the child, and speak as though the resident were listening and participating, with no notes of condensation whatsoever. It was wonderful for child and elder alike.

All residents, except those for who it was impossible to move from their rooms due to equipment restrictions, were taken on daily strolls on the walkways around the pond. Transport beds, wheelchairs, walkers, canes, gait belts, and steady ambulatory circled outdoors everyday.

The hallways were filled with plants and photographs and home furnishings, just like the rooms. There was a resident golden retriever that freely roamed, and a fat and friendly cat (it is impossible to keep a cat thin with residents slipping them treats all day long). They had a talking parrot, and an aviary in the recreation room. Everyone ate their meals in the dining room, and residents were allowed to order off of a menu whatever they wanted (with the exception of those for whom a modified diet was necessary to sustain life). Family members were welcome any time of the day provided they respected the boundaries of the other residents.

I thought all LTC facilities were like this. Boom, next assignment, 100% different experience.

I won't go into a lot of details, because I am fairly certain you already know. But there was one particular incident that disturbed me by pure psychological cruelty of it, though it may not seem that bad to others who have surely witnessed far worse.

A resident, (primary CVA, secondary dementia, legally blind, slurred speech), would ask me everyday, though I could barely make it out: 'Are you the nurse that brings the music?'. I would of course say, 'Mr. ________, my name is ______, I do not bring the music but I am here to help you today...", etc. He seemed distressed every time he asked about the music, and it really bothered me. This exchange happened every day for three weeks. The head nurse said that the resident had been asking the same question for months of just about everyone, it was just the disease process of dementia, and to keep trying to orient him.

On the last day of that third week, I was in the room preparing him for a physician's appointment, and this LOUD rap music with truly vulgar swearing, and harsh thumping beats, seemed to come from nowhere. It lasted for about 15 seconds then stopped. I looked in the hallway, the room, outside the window, and I could not figure out where the sound was coming from. About 10 minutes later, the same music started again. It was coming from the bed.

Under the bed.

And there it was: When the night-shift CNA left that morning, she forgot her phone, ringer on full-blast and charging, underneath this gentleman's bed.

For months, this poor fellow was being awakened in the middle of the night by aggressive cursing and loud thumping music, coming from beneath his body and bed. The emotional and psychological torture of it, I can only imagine.

The CNA was using his room as a place to stash and charge her phone (the facility had a no-cell policy). And she didn't care how the resident felt about it because she knew he couldn't tell on her.

Except he did. In his own way, he did.

[VivaLasViejas, ASN, RN]

Smh. Unbe-freakin'-lievable.

[monkeyhq]

Smh. Unbe-freakin'-lievable.

For quite a number of days I would be in my own bed and think about it, and how the gentleman must have been terrified. Truly terrified. I would get very angry at wondering how in the world a CNA could be ignorant of the consequences to the resident.

She was either really stupid, or really cruel, either of which should disqualify you from healthcare.

[garciadiego]

Perhaps a Exorcism would help.