Is 6 times a day too many to visit a favorite patient who isn’t on your caseload?

[SilverBells]

About 4 years ago, I started as a part time nurse in a LTC/Rehab facility. Since then, I’ve moved on to full time nurse, interim nurse manager and now, full time manager. Over the past 4 years, I’ve had the pleasure of working with one lady that I’ve always had a connection with. I used to spend 2 hours getting her to bed, including giving her a nightly foot soak. On Sundays, we used to pray together with Eucharistic Minister that would visit our facility.

Because of the COVID pandemic, they have rearranged patients. Thus, she is no longer assigned to my case load as she is now on another unit. The other staff members and manager do not give her the same amount of attention. She will only eat and drink for me, and is now on hospice. She has no family in her life. Now that she’s dying, I want to spend as much time with her as possible regardless of whose patient she is. I try and always plan my day to start and end with a visit to her, along with four other visits. Because of my dedication to her care, I find myself getting irritated when patients on my unit take up time I’d rather be with her. These patients have family, are not dying and are overall annoying. I even got involved with repositioning the resident and taking her vital signs when a care conference for a different patient was occurring. However, if I do not make regular visits to this lady, she won’t get the attention she needs.

I am just wondering if 6 visits a day is too many? Also, anyone else experience increased dedication when they find out a favorite one is dying?

[SilverBells, BSN]

Update: I have purposely kept myself out of this person's room today. She has aides and nurses who have been offering her nourishment and repositioning. She doesn't need six daily visits from me. From a nursing/medical standpoint she doesn't require anything specifically from me anymore. Also it sounds like family from out of the blue tried to visit her and it sounds like there was a lot of drama involved. They haven't seen her in years. This probably sounds like a good situation to stay out of since I don't need to be there anymore. I actually feel a lot less stress and pressure by not seeing her at all

[Emergent, RN]

My intuition tells me this patient was being manipulative. Patients can do this by showering a caregiver with compliments, and telling them that no others can do the job properly.

I don't know what the family drama is, but it might be related to some toxicity involving this patient.

[Emergent, RN]

I recommend the book "Boundaries".

[Big_time_banana]

From my perspective once you said, "I want to spend as much time with her as possible regardless of whose patient she is. I try and always plan my day to start and end with a visit to her, along with foyour other visits" that tells me right away you are well beyond therapeutic boundaries. Take a step back in time before you met this patient. If you saw another nurse doing that you'd probably think, "6 visits a day and obsessive. That nurse must be off her rocker?" It's like if you saw a baby bird in the grass and you see the nest 10 meters up in the tree. It hurts the heart but there is nothing you can do about it. Honestly I dont see anything wrong with a pop in for 5 or 10 minutes. Up to an hour rarely if the stories are just that dope for the day. Oh and whenever the day comes when she is looking like she is going to pass away, that's understandable to visit her more that would ordinarily be considered 'normal'. But getting emotional at other besides that that lady's health is suffering due to the strong bond you and her formed. She won't eat or drink for anyone else but you, that's a problem. She has no family, of course she would try to clinic to someone being really nice to her. I've had to tell patients I can't visit all the time myself in clinicals. It's a major bummer but you have to do what you have to do. At least you somewhat grasp that there is a problem here or you wouldnt be asking about it, but I fear you might have been looking for validation here. What if you got hit by a bus tonight? Would that lady starve because you were pretzeled up by a greyhound? Does your boss know about this, I'm not gonna say anything but would/do they approve of your attachment? They taught me about boundaries and being firm with them and catching yourself if any transference pops it's head up second semester . Anyway that's my feedback, I'm not trying to be rude or anything, just being straight forward. Good luck in the future.

[SilverBells, BSN]

In all honesty, I had a better day without visiting her. It was almost nice to focus on other people without my judgment being clouded by one particular person

2 hours ago, Emergent said:

My intuition tells me this patient was being manipulative. Patients can do this by showering a caregiver with compliments, and telling them that no others can do the job properly.

I don't know what the family drama is, but it might be related to some toxicity involving this patient.

I have a feeling you're right

[NewRN'16, ADN, RN]

Why would you even "visit" s patient that is not yours? Is your facility allowed family and friends to visit? If they do , then nvm. If only healthcare staff is allowed , then you shouldn't be visiting. You are not THEIR healthcare worker.

[SilverBells, BSN]

11 minutes ago, NewRN'16 said:

Why would you even "visit" s patient that is not yours? Is your facility allowed family and friends to visit? If they do , then nvm. If only healthcare staff is allowed , then you shouldn't be visiting. You are not THEIR healthcare worker.

I visited her because she was a patient I had been working with for a long time who transferred to another unit due to COVID. It’s not uncommon for staff to assist with residents on other units and is expected, if need be. Many of us become attached to patients we have worked with for a period of time, so checking up on a resident actually isn’t unheard of. With that said, in my case, 6 times a day was too many. It wasn’t fair to other residents who needed help or to myself, as it caused me distress that didn’t need to be there

[NewRN'16, ADN, RN]

2 minutes ago, SilverBells said:

I visited her because she was a patient I had been working with for a long time who transferred to another unit due to COVID. It’s not uncommon for staff to assist with residents on other units and is expected, if need be. Many of us become attached to patients we have worked with for a period of time, so checking up on a resident actually isn’t unheard of. With that said, in my case, 6 times a day was too many

I get attached to my patients too. I work in a SNF /LTC facility but mostly of not only I am assigned on SNF. I know all the LTC patients, since they used to be my patients ,, at some point when entering facility.

They don't allow us to visit with pts not on our assignment where I am at..Covid 19 precautions they say..

A pt I knew for years passed recently and I cried (at home) for him and wished him and prayed him peace and light . He was always smiling, always waving at me , even when moved in LTC (we had to pass by their hallways).

?

[BSN-to-MSN, ADN, BSN, RN]

On 6/11/2020 at 8:06 PM, SilverBells said:

I am just wondering if 6 visits a day is too many?

Yes. You have your load of patients that are not getting your care while you visit her. Talk about floating there. Talk to people there about her care needs.

And what is with playing patient favorites?

[RNNPICU, BSN, RN]

OP:

I am glad to see the perspective you have gained.

All of us in this profession become attached, we care about our patients and want them to feel better and comfortable.

Sometimes as you have now seen it is important to take a step back. Glad you have taken steps to see this and taken care of yourself.

[HiddencatBSN, BSN]

15 hours ago, SilverBells said:

In all honesty, I had a better day without visiting her. It was almost nice to focus on other people without my judgment being clouded by one particular person

I have a feeling you're right

This is a good update to read, and I’m glad that giving yourself some space has helped you feel less stress. I think apart from the boundary issues everyone has discussed at length, it sounds like you were carrying a big sense of responsibility that you didn’t need to be carrying.

I still think spending a little time with a counselor digging in to this would be helpful. I’m a huge fan of therapy in general but also specifically as nurses: our jobs can take a lot out of us and it’s important to do things that fill our own cups. Having someone who’s only job is to listen and work on things you’re struggling can make a ton of difference in how you feel, your self awareness, and your self advocacy.

[NurseBlaq]

No ma'am, you're doing way too much. You've lost sight of boundaries a long time ago. Leave that patient be. If you're concerned about family not doing anything, have social work check into it. The part about you being the only one who can do something for this patient is disrespectful to your coworkers because you're basically saying they're not doing their jobs. Nothing is normal, or professional/ethical, about your relationship with this patient.