It's long, dangerous, but worth typing, to me!

missrose · Oct 21, 2007

Connection with the person behind the problem whenever possible is what helps me keep from wanting to strangle some patients. If I can see the person as a person, it helps me. Knowing they have a grandchild or a beagle or a guitar or a tankful of angel fish helps me get past some of the labels, and then I have a greater desire to help them.

Of course, there are those who defy explanation and leave me foaming at the mouth. With that very small percentage, I vent at the nurses' station and work to set reasonable limits. I tell them to list everything they need because I will not be available for a length of time and I don't want them to have to wait. Put in such terms, it sounds like I am going the extra mile for their sake, and I am, but I'm also doing it so I don't commit bodily harm and jeopardize my own mental health and well being. Some still try to push my buttons, but so far I have been able to calmly say, "I'm sorry, but I can't help you with that."

Getting disgusted with nurses who are frustrated doesn't help any more than getting disgusted with patients who have "self-inflicted" problems does. Connecting with a person is more likely to lay the groundwork for some kind of improvement in the situation, even if it's only temporary. Sometimes all you can accomplish are baby steps, but that's okay as long as they still move forward. And venting might be necessary before that can happen.

Thank you for sharing those words of wisdom. And thanks to those of you with the insight to see what my original post was really all about. Reading your words meant a lot to me and made me think. I needed that. Again, I thank you!

I am sorry Babarnurse is "disgusted" by me.

Back to my original post.... I did not say, "Morbidly obese patients disgust me" or "I hate drug addicts"... because that is not how I feel. I should have left those two specific patient types completely out of my post and just expressed my frustrations with overly demanding patients who do not participate in their wellness even a little bit. (Silly me, for thinking that's why they came to the hospital... To get well!!) And yes, I see a "trend"... a significant increase in patients I care for who are morbidly obese or addicted to methamphetamine. Pardon me for making an (accurate) observation. An observation... not a judgement. Big difference.

And to address Emmanuel, I am sorry your opinion of me is so harsh. I got your little dig (if you know what I mean). That's okay, sir. I know I am an excellent nurse. I have numerous unsolicited letters of commendation from nurse managers for "delivering exemplary care" as well as dozens and dozens of cards and letters from appreciative patients and their families. I am very proud of those letters! (Sentimental gal that I am, I keep them in a special box!) I am confident your aunt would have loved me!

I always treat all my patients equally, with the care and compassion all humans deserve, regardless of their weight or choices in life. When I become frustrated and I feel like ripping my hair from my scalp (note I said mine, not theirs), my patients are rarely aware of it... because not only am I a great nurse, but some days I have to be one heck of an actress, too!!

Bottom line for me (as many responders were intelligent enough to pick up on right away): If I didn't care, I wouldn't be frustrated in the first place!

"Life is like playing a violin in public and learning the notes as one goes along." -- author unknown

TrudyRN · Oct 22, 2007

it might be time to move away from the bedside for a while, missrose. or transfer to a different area where you won't have to deal with addicts or the obese.

btw, not all obese people are that way through improper eating, as i'm sure you know. by the same token, you can't ride the subway twice. what??? jk. by the same token, i know of at least a few addicts who were forced by their soon-to-be pimps and, in one case, by her own actual addict mother, who also then forced her, after the girl was hooked on heroin, to start turning tricks. yes. this pathetic teenage girl was now a horrible heroin addict because her own mother had forced this addiction on her so she could help bring in money for the household. so, things just aren't always as simple as 1, 2, 3.

the addicts i have seen portrayed in movies and have worked with in real life would literally sell their own children for that next fix. i am not kidding. it is called addiction and it is hell, absolute hell.

the emotional overeater is also an addict. i don't know if you understand or if understanding will help you but there it is. pray for these poor souls. no amount of reasoning or lecturing will help them, only god can reach them, imo.

and, as i said, and i mean no offense, think about maybe leaving the bedside or at least your present position for a while if you can't handle this right now and if your back is troubling you. i hope things work out well for you. no need to feel guilty, just i hope you find a way to get some happiness back in your work life. i'm sure you're a great nurse and you deserve some happiness.

nursemike, ASN, RN · Oct 22, 2007

I think I may owe the OP a debt of gratitude. I still don't agree with the broad generalizations about "addicted" patients. I'd be stupid not to agree that some patients can be very frustrating, and I'll concede that we all sometimes say things in a rant that we don't entirely mean.

I did learn in an anger management course I attended (in connection with stress management--I rarely get angry and even less rarely express it, which is why they thought I needed the course) that venting is usually not as helpful as we'd all like to believe--that we're as likely to reinforce our anger or frustration as to relieve it. Maybe so, but we all do it, and sometimes it does seem to help.

The thing is, I'm not a great nurse. I'm a fairly adequate nurse who wants to become a great nurse, and one of the things I need to do to accomplish that is to avoid getting "burned out." In the course of this thread, one of the things it has become clear to me that I need to do is to take responsibility for my own attitude. Like some other posters, what I've first noticed is the injustice of painting whole groups of people with the same brush. I've seen rude, demanding, obnoxious patients of every size and shape, but I can say the same of patients I've almost been sorry to see discharged. I can't say I've ever had a meth addict, but I've had a few patients with addictions and a few with chronic pain issues and a high tolerance to opiates. I've had patients who were invariably polite and appreciative, but just so darned needy that they require more attention than I can easily give, a couple who've apologized for family members who've been overly aggressive in trying to ensure that their loved one gets adequate care, and some, God help me, who simply enjoy talking as much as I do...

The thing is, I didn't get into this business blindly. I knew it was a highly stressful occupation. Yes, I've sometimes been surprised just how stressful, but I think I have to view coping with that stress as my problem. PITA patients, sniping co-workers, lazy aides, and uppity docs are part of the package. Shouldn't be, but always has been, and always will be. Maybe, just maybe, I can make a small dent in it, here and there, but far more important is remembering not to let the "anally gifted," sour me toward the many wonderful patients, supportive co-workers, excellent aides, and collegial doctors. It's on me to do that--no one can do if for me, and no one can burn me out, if I don't let them. Just like it's on me to understand that if I have one patient in uncontrolled A-fib and another who wants to go outside to smoke, the smoker will just have to get angry and write nasty letters to my manager, if that's what he needs to do. It has nothing to do with who deserves my attention, but everything to do with who most needs it.

I'm not saying this to show what a saint I am. I didn't sign up to be no martyr, and in the quiet of the med room, I've uttered blasphemies to make a sailor blush. Setting limits for patients (and others) is a skill I very much appreciate, because it's one I need to work on, but neither can I afford to give in to compassion fatigue. What I'm getting at, and as much to myself as anyone, is that judging patients is a direct road to burn out. It puts the burden on the patient to keep me happy--and even the "best" patients typically have more important priorities than that. Moreover, the problem with generalizations isn't just that it's unfair. Hitler used generalizations about Jews to encourage people to abdicate responsibility for their own conditions. I'm not saying the OP is like Hitler; I'm saying that's a human frailty we're all somewhat susceptible to, and though it rarely reaches the level of genocide, it can all too easily lure us to suck all the joy out of our own lives.

I don't know if there's any advice in there that the OP can use. I don't know for sure that ten years from now, when my knees are the size of basketballs and what's left of my hair is gone, that I'll still be able to say, "I love my stupid job." But I'm gonna try.

AllisonLP · Oct 22, 2007

I just have to agree with the quote below. I work for social security and I have SEEN EVERY SELF INFLICTED ISSUE THERE IS and I don't agree with OP although I absolutely understand the frustration. to give just a couple examples....

I see morbidly, rediculously obese people everyday at work saying they can't work because they are so fat, some cry and tell me they can't help it, some laugh and think it's funny I can't get a bp because of the REDICULOUS size of their arm. I had one dude who tried to kill himself and whiney the whole time about he wish he had been successful (in front of his family!), of course he is now somewhat brain damamged and can't work so he needs SSI for himself, wife and children. I see HIV and Hep patients who have completely turned their life around and some that are complete pieces of crap. but you know what, i treat them all with the humanity and understanding i think anyone deserves until they cross a line with me and then i make it clear the attitude stops or so does the pleasantness. Your meth addict wont stop crying while you tend to the cancer patient? Tell her you have patients more urgently in need of your care but you understand her situation and will be there as soon as possible. well, i am certianly glad when I have had issues related to "choice" i had someone understanding and I'm OUTRAGED that when my best friend went to the ER with what she didnt know was a herpes outbreak her fiance had slept around and given her, the nurse thought she had a right or reason to make some comment about how sleeping around and getting STDs is a "choice." :devil:

Allison

I think that I "get it". You don't like to take care of patients that are hopitalized because of something that they have done by "choice". So does that include:
MVA trauma pt that has injuries R/T not wearing a seatbelt?
How about if he had a seatbelt on, but was foolish enough not to have chosen a car with airbags? How about if it only had front airbags and his injuries were from a side impact?
How about a 16yo football player with a C-spine inury? Even though he was wearing a helmet, he did choose to engage in a risky sport.
How about a young woman who has foolishly vacationed overseas and did not take her anti-malarial medication as prescribed, and now has - guess what - yep, she's got malaria. Maybe she should have chosen to visit Canada instead.
What about a police officer that gets shot in the line of duty? There are many, many safer occupations he could have chosen.
Would you want to take care of a nurse that has complications from HIV or Hep B that she contracted through a blood exposure from a patient? Surely she should have been careful.
Are these ridiculous examples? No, I don't think so. They are all about choices. Just as are obesity and addiction problems. Some are little choices and some are big choices. Some are easy choices and some are hard choices. And what may be an easy choice for you or me, may be a hard choice for someone else. Or vice versa.
I am 100% positive that I will never need a knee replacement because I blew out a knee playing basketball or from landing wrong while sky diving. These are not my activities of choice. Will I ever need one because I've stressed my joints from being overweight? I hope not, but I'm not as sure.
I guess I could understand (and agree with) your frustration a little bit more if your complaints were directed at specific patient behaviors than at specific patients.