Poochiewoochie 5,578 Views
Joined: Aug 1, '11;
Posts: 180 (46% Liked)
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I felt a need to comment when I read this post... I think the original poster is asking a question that has been something that I've asked myself in my nursing career, "how do I deal with all this dying around me?" Yes, I agree that it is a natural process. What I don't like, as an nurse, is how unprepared and unaccepting we are as a society in regards to death. So that frequently when I meet a patient that is dying, my experience is that there is no preparation or acknowledgement or acceptance of the event. This especially true for family members.
Please note, I'm am not talking about an untimely death or emergent situation. I am talking about death from old age or death from the natural progression of chronic multiple disease processes or illnesses associated with certain death. This is the most frustrating for me when I am working with a very old patient with heart disease, copd, diabetes, cancer, stroke , etc, etc and family members who are suprised and opposed to death.
It is stressful when a patient or family member does not understand/accept/have any interest in knowing about DEATH. Instead, in the hospital, its made to be some kind of emergency on a physical/emotional basis for the nurse. I find that extremely stressful for myself because the family members want something done right away so that the patient doesn't have to die....The kind of thoughts that go through my mind sometimes include, "are you kidding me?" when I'm told to get the doctor "NOW" to "FIX" someone who is dying.
I haven't been to the hospital to work in a couple of months, so I am resting from that kind of stress. But have spent time thinking about the emotional turmoil I have experienced due to unrealistic expectations around dying patient from family members. I begrudge the fact that there is nothing in the healthcare system to acknowledge my emotional experience or my emotional needs as a result. Sometimes, I feel like having someone to talk to about my experience would be helpful. Or someone I can call when the situation is really off the deep end, that would help me deal.
OP, thanks for bringing this up and acknowledging an area of challenge for at least myself. IMO, you conducted yourself with sensitivity and thoughtfulness. I'm sorry for your loss.
And I agree with Texas. If you smoke and are fat, I don't want you.
It ain't hippa if there are no identifiable factors. You can go on TV and talk about it too.
It's the Exasperated Room, or Everyone's Retarded.
And by retarded I mean Snookie, or Tom Cruise jumping on Oprah's couch. Nobody have a cow.
Two things come to mind:
Elderly lady from the Caribbean, blind on dialysis. About 22 years ago. In a four bed room and she would spend much of the night calling "God, help me! Please God, help me! God, are you there?" Needless to say, the other three pts were not impressed. One night shift we could hear her all the way to the desk calling for God. In desperation, one of the other nurses punched her bed number into the intercom and said "This is God. Go to sleep." Never heard another word from her but she told the day nurses she had "heard God's voice loud and clear last night". Never called out at night again.
Elderly gentleman with dementia. I recognized the name as the same of a benefactor I had heard of through my work with Girl Guides. I was helping change him one day and after we had fixed the blankets and made sure he was okay, I said I had a question for him. I asked him if he was the same Mr X who had been involved in this particular Girl Guide camp. He started to cry and he said to me "You know, that place turned out way better than my wife and I ever dreamed it would. We just thought it would be an okay place for the girls to put some tents, and I can't remember how many girls use it now." I reassured him that it was well used and very well loved and that we would always take care of the land. After that day he could never remember my name, but he knew he had some sort of connection with me that he didn't have with the other nurses, although he could never had told you what it was. But everytime he saw he he would hold out a hand and say "There she is! There's my girl!" He is long since gone, but I still think of him everytime I go to camp.
The thread next to this is how the elderly are devalued. This kind of thread seems to add to that attitude.
A member of my family suffers from dementia, & I find nothing funny or cute about it. There is a thread elsewhere on this site that talks about the elderly being devalued, & I thought of this thread.
Go ahead, let the flaming begin...
"Compassion" is a lot more than you think. It is actually not what you say, which was, "A nurse with compassion is one who truly cares about her patients (sic) well-being and outcome. This nurse treats her patients as she would expect any other nurse to treat herself or own loved ones."
Nice idea, but not remotely relevant to the concept.
Read this carefully. Compassion is defined as "a feeling of deep sympathy and sorrow for another who is stricken by misfortune, accompanied by a strong desire to alleviate the suffering." The "sympathy" part is also generally misunderstood, as it has connotations of pity, expressing sorrow at a loss, for example. But sympathy means "harmony of or agreement in feeling, as between persons or on the part of one person with respect to another, the harmony of feeling naturally existing between persons of like tastes or opinion or of congenial dispositions, the fact or power of sharing the feelings of another, especially in sorrow or trouble; fellow feeling, compassion, or commiseration."
Compassion, therefore, absolutely requires the ability to put oneself in the other's position and fully imagine (not guess) at that person's feelings, needs, and fears, to feel the same as that person. This is far different from what you describe.
It is, however, a necessary attribute of an effective nurse. This is because we must recognize that the patient is the one with the disease (thanks, House of God), and, most importantly, the patient is in charge of the treatment plan. We might not like a patient's decision but we are honor bound to understand and accept it.
THAT is compassion, feeling together.
Without a keen understanding of this very key concept, one can never understand what it takes "to be a great nurse."
I think we need to consider that our personal experiences influence our behavior. I know some chronic pain sufferers that are treated so poorly by the healthcare system that it makes me sad. I have seen dying cancer patients be denied adequate pain relief because they could "become addicted".......ADDICTED????? THEY"RE DYING!!!!!!!!!!!
Your personal experience influences your opinion and maybe personal experience influences Poochiewoochie. "We" (the collective we) as nurses need to keep our personal biases to ourselves and care for our patient as they deserve to be cared for.......with kindness, compassion, and respect. We need to remember we may not always know what someone personal burdens are and temper our responses.
We can all voice our opinions respectfully and respect each others point of view as long it is polite!
Rule #1 for being a great nurse is to be the nurse that you would want taking care of you or one of your loved ones.
Rule #2 see rule number 1
These addicts CHOSE to take whatever substance they are addicted to that first (or second, or third or 50th time...), knowing that the possibility of them becoming addicts existed.
Believe it or not, addiction is a disease. People with addiction actually dream about drinking/doing drugs (whatever they used); they get cravings as in their mouth watering and they can get nauseated, etc.; they withdrawal (DTs and sometimes they withdrawal so bad that they could die).
But, there are those of us that have walked a mile in their shoes that would take care of them. I agree with the OP. Nurses all have education, most (except new grads) have job experience, but personal experience is something that I think definitely gives a person perspective. There are wonderful addiction/psych nurses that are just good sans personal exp., but walking a mile in someone's shoes will definitely give perspective and put someone in their place.
My hope for you is that you or a loved one will never experience psych or abuse, dependency, addiction (had to add them all b/c they are different) issues. But, for me, I am learning humility and trying to turn what's looked at as negative into a blessing.
I graduated from nursing school two years ago, and we never had to ask patients personal questions, especially concerning their finances, to do care plans. Most information is already available in their charts anyway. Just remember if you ask personal questions you do open the door for personal questions to be asked of you.
You are dealing with a demanding patient, family , doctor.. short staffed and no break.
Look at it from the OTHER side of the bed.
The patient and the family is in a life changing , crisis situation!
They are experiencing chest pain... GI bleeding, difficulty breathing ...
They woke up today feeling fine.... and are now dependent on your skills and empathy... to get them through their health crisis.
It's not about us.. it's about the patient.
Thank you! For everyone who had constructive advice and specific examples regarding this topic! I believe there was a lot to be learned here. Some should learn how to communicate civilly on a message board but that's another matter
I think it is easier to know how others deal with frustrating situations at work, whether or not narcotics are involved!
I think the main thing I gained from this is that pain is real to the pt whether it is physically present or imaginative.. If they think they're in pain and feel miserable then they are... Abusers or severe sufferers! It is our job and oath as nurses to help the pt be comfortable and feel well taken are of!
The loss of control these pts receive upon admission is my worst nightmare.. I can't imagine being a pt under the circumstances that we put them in! We tell them when to eat, sleep, go to procedures when they can get meds etc... It is a complete loss of personal control!! I truly feel for them!!!
Thanks again to those who took the time to constructively add to this thread.
In my 17 years of nursing I have never once struggled with this issue. Taking care of patients, regardless of what they want or need, has no personal relevence to my life: I mean whether they take a tylenol or dilaudid, how much, and how often is not my personal business. My life is not affected in any way by what my patients take. Professionally, it is only relevent to the extent that I desire and am required to make sure the administration of a medication is not contraindicated or harmful. In fact I always found it quite useful to know that a patient would be wanting their medication on a "scheduled" prn basis...makes organizing my shift easier and I sleep better not having to worry whether or not my patients were comfortable! lol!
However, on a personal level, many of the comments on here are distressing to me. Over the past year I have made multiple trips to the ER, have been hospitalized at least 6 times, and ultimately had 2 surgeries. Over that period of time I developed quite a tolerance to opiod medications. A few times I heard the nurses in the hall saying that I was a drug seeker or an addict (I take nothing at home besides aspirin)...imagine their surprise when I had emergency surgery not once, but twice to save my life. I happen to be guilty of knowing exactly when my pain meds were "due" for several reasons: the half life of dilaudid is only about 2.5 hours give or take; the doses given were only enough to take the edge off the pain so in 2.5 hours the pain was back full force; I was in a constant state of dread worrying that (given the nurses attitudes) my pain wouldn't be controlled. I've learned to have an upfront honest discussions with the physicians and the nurses caring for me so they can understand my history and my tolerance.
I work in an ER setting now so I understand what ya'll are talking about when you discuss "frequent flyers" and I know about whom you are addressing when you talk about the "seekers". The way I look at it is this: that person made the effort to come to the hospital for SOME reason and it is my duty to treat them in terms of the physicians orders. Could be they want to get high BUT there is the same probability that they need treatment. One of my former charge nurses sent a supposed "seeker" away (EMTALA violation) who presented with a severe headache. She said "you might as well leave, we aren't even going to give you a tylenol let alone narcotics"...the guy died at a nearby hospital of a brain bleed.
Anyway, some people watch the clock because their pain really isn't being controlled as well as it should or they are afraid of getting behind and having worse pain. Either way, it shouldn't be anything personal to the nurses. Do your job, take it in stride, assess and document as appropriate and follow the physician orders. I fail to understand why nurses have such a negative view and take opioid administration so personally.
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