Leaving the Inner-city-ER-guilt? Advice please..

dfarr · Sep 10, 2008

No need to feel guilty. If people aren't grateful for the care you give them, then screw them. Unfortunately a lot of the population that you serve have grown up getting "free" government care at no cost to them, so they expect to be catered to. I know because I work with the same population, albeit at a large research hospital so the facilities & staffing are probably better.

Overall, do what makes you happy. Don't stick around a crappy hospital with ungrateful, ignorant patients who aren't going to follow your instructions.

soulofme · Sep 10, 2008

Don't stick around a crappy hospital with ungrateful, ignorant patients who aren't going to follow your instructions.

Unfortunately, this sounds like many of the dialysis pts. at the clinics I have worked at. One of our drs. told me once that if they had to pay for the services themselves....most would have a different attitude. :twocents:

lpnflorida · Sep 10, 2008

I do not feel you need to feel guilty.

My next thought is, there is not a one of us when we first start a job anywhere that we are not overwhelmed. Often times as we become better acquainted with our units no matter what they are. It becomes more manageable. It seems to take at least a year.

Talk to you co-workers how are they handling it. If indeed you can see no way to exhist without harming yourself, Leave.

No one should have to taken verbal or physcial abuse. It does happen though. We learn not to take the verbal abuse personally, we confront the verbal abuse in a nonjudgemental way. Clarify what they might be trying to say in a more positive light when possible( however it is not always possible)

FireStarterRN, BSN, RN · Sep 10, 2008

It's a negative vicious cycle with this type of population. They generally are poorly adapted to life, and live around other people like that, and don't interact very well with regular people. They just don't know how an orderly society operates, nor how normal people interact. It's very sad.

My Mom was a teacher who worked with the inner city population, and many of them live in such deplorable circumstances, and have zero coping skills, are barely literate, and their neighborhoods are violent. It takes a great deal of dedication to want to deal with this on a regular basis.

Ruby Vee, BSN · Sep 10, 2008

basically my issue is a moral one. i graduated in april and since then i have been working in a poor, inner-city hospital. this hospital desperately needs good nurses, but i am miserable there. i am overworked, i have way too high a patient:nurse ratio. i feel like an unsafe practitioner, and my patients are miserable, ungrateful, impoverished people, who are more often than not verbally abusive towards me because they are recieveing inadequate care....due to the fact that i have too many patients, and not enough resources. i believe in serving all populations, and i'm not new to the innercity population, but i am become physically and emotionally drained.
this hospital has put many hours into my training, and i feel incredibly guilty at the thought of leaving them for the hospital i previously worked at (which i really liked, but they didn't hire new grads). my nurse manager is supportive and always gives me positive feedback, but it still doesn't balance out the abusive patients, and unsafe conditions. should i feel guilty? should i stick it out? does anyone have any ideas? thoughts?

a supportive nurse manager who gives positive feedback? those are rare as hen's teeth. the ungrateful, abusive patient population is all too common.

Dixielee, BSN, RN · Sep 10, 2008

You are still young and green, so you will suffer from a lot of guilt for a variety of things for a good while, but as you age, you mature and gain experience and will realize that you have to save yourself first!

If you can not take care of yourself, you can never take care of your patients. Look at quality of life for you, then you can give it someone else. Don't stay in an unsafe environment. The problems you experience are far beyond what you can fix by staying there.

I know I am many years past my idealistic stage and am well into the stage where I realize my limitations and the limitations of the system, but trust me, you can not feel guilty for things that are beyond your control.

There is hunger, poverty, and horrible conditions all over the world, but we can only take care of one small thing at a time.

If you still want to give back to the impoverished community, then volunteer at a homeless shelter, work at a soup kitchen, donate to your favorite charities, etc. There are many ways to give back to society if you want to.

It is like the story of the man who was walking on the beach picking up and throwing starfish back into the ocean. Another man walked up to him and said, why are you doing this, you can't save all of them. And the first man said, Yes, but I can save this one, and this one and this one, etc.

So do what you can, but remember you can't do it all.

accessqueen · Sep 11, 2008

Absolutely do NOT feel guilty. If you want to feel guilty, I'll help you--why aren't you working In one of Mother Teresa's clinics?? Why aren't you volunteering to work with Dr. without Borders?? etc. etc. No matter what you do you could always be doing more. The point is some people are driven to do those jobs, And even those people get burned out and decompensate. It is critical that you do a job that you enjoy because you are going to be doing it for a long long time. Your emotional health is very important for you to be able to do a good job.

fins · Sep 11, 2008

I guarantee you, if the hospital where you work needed to reduce payroll, they would jettison you without a shred of guilt. You owe them (and your patients) your best efforts on the days you worked. They owe you your wage. Any idea you have of any relationship deeper than that is an illusion.

I've got to admit, it's an illusion that nurses are suckers for time and time again. No hospital has ever closed because a nurse quit. No unit has ever come to a grinding halt because someone didn't come in on their day off. And yet nurses constantly buy into that "we're family" bull.

Search this site, and you will find dozens of posts with the same theme: "I was at my hospital for xx years, never called in sick, worked OT even though I didn't want to because we were short, and after all that time, they...(fire me/laid me off/made me go to nights/made me go to days/cut back my hours/etc.)"

Atheos · Sep 11, 2008

Basically my issue is a moral one.

Hey, whether you do an hour, a year or a lifetime you have done some good. There is no minimum of good you have to do and you will be doing good at wherever you choose to go. Don't feel bad. You have to take care of yourself first.

Altra, BSN, RN · Sep 11, 2008

I agree the OP needn't feel guilty.

I do have other thoughts on the subject though, of leaving for greener pastures. Will send a pm ... :)

allnurses Guide · Sep 11, 2008

You only have one license.

You need to protect your mental health. Stress leads to illness.

If you don't take care of yourself you will be no good to your patients.

And by showing kindness and concern to your patients I think you probably helped at least some of them and their families have respect for you and our profession.