Nerves Are Shot!

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I am on vacation this week, and already, I am regretting that this week will be over and I'll be back to the grind on Monday. I sit here shaking sometimes, sad the next and ready to cry. There is a fine line between trying to take care of the needs of the patients, complying to stupid rules and making serious attempts to keep our sanity.

We deal with a high volume of illegal immigrants and poor people who literally have no clue about health care. It is so crowded in the waiting area. Each morning I walk in, I see LINES and LINES of people...some in walkers, wheelchairs, elderly, people bringing in their pre-school aged children to interpet for them, many are argumentative, many are really sick. By the time I get behind the door, nurses are running like insane rabbits trying to see them. By the time the patient gets to us, they are tired, disillusioned, angry, argumentative, placing blame on us. Cognitively, I know that they are unaware of what really goes on behind the scenes of the hospital. But, it doesn't make it easier to deal with them cursing us out. I cannot control the lines, or all of the mess, but I do have to try and practice safely. In fact, the more rushed I feel, the more I HAVE to slow down, before I make a mistake that I cannot take back.

It is hard to try and explain to a person that they are hypertensive or diabetic when they literally do not know that they have blood flowing through their veins (no exaggeration, folks). Sometimes, giving even the simplest explanation confuses them even more. Plenty of times, when I use the language hotline, the phone interpeters have told us that there is nothing they can do for us because this person has no concept of what they are talking about. Many of them do not know their birthdates (some of their countries don't consider this to be important), not even their addresses. Many will tell the interpeters that they do not want to have a phone translator, they want someone in person(...yeah, right...like this will happen quickly). A simple thing like a flu shot that should take ten minutes tops can be a situation that draws out for over one hour. Then, after all of that, to experience this AGAIN with about 10 more people. It can drain your energy to the toilet in two hours. I try to remember that these are someone's mother, father, sister, parent, brother, friend, clergyman, etc...but it is hard. Sometimes, I just want to run for the hills. Sometimes, it looks like a third world country walking in there, and many times, I have had to walk away from people in mid sentence before I say something that I can't take back. And management says to give it your ALL. If I did that, I would have nothing left.

When work is over, I don't want to socialize very often...I want to go straight home to bed. Read about something other than illness and nursing. Read romance, street novels, look at reality TV... I take a cab home each night to avoid more personalities and interactions with people because they are so draining. I have small rituals of pacing the floor each morning to stomp out my plantar faciitis and say to myself "You can do this". I walk out, feel the air, and from then, it is an adrenaline rush to make it back home to safety.

Thanks for listening to me vent guys. And, you all have helped by just existing and reading that I am not the only nurse that feels this way. Thank you.

Isn't this the norm?

Isn't this why there is a shortage.

I have to hand it to you that you survived 11 years. I wish I could have done that. I have kissed the butts of many administrators, co-workers and patients and been in enough hospitals to know that it isn't any better anywhere else.

The fact that you have 11 years of tolerance, you might as well stick it out and retire there. There isn't a happy nursing job out there unless you are one that got out of the patient care and found something else to do.

Angels? That is just a motivational statement with no truth to it. We are never angels. These people could care less about most of the staff that busted their tails to take care of them when they don't do anything to take care of themselves. No matter how much you do, there is little appreciation from the administration, the hospital or the patients. You go home tired, beat and dreading returning to work. Period.

Specializes in Community Health, Med-Surg, Home Health.
Isn't this the norm?

Isn't this why there is a shortage.

I have to hand it to you that you survived 11 years. I wish I could have done that. I have kissed the butts of many administrators, co-workers and patients and been in enough hospitals to know that it isn't any better anywhere else.

The fact that you have 11 years of tolerance, you might as well stick it out and retire there. There isn't a happy nursing job out there unless you are one that got out of the patient care and found something else to do.

Angels? That is just a motivational statement with no truth to it. We are never angels. These people could care less about most of the staff that busted their tails to take care of them when they don't do anything to take care of themselves. No matter how much you do, there is little appreciation from the administration, the hospital or the patients. You go home tired, beat and dreading returning to work. Period.

A small correction: I worked at this place for 11 years, just became a nurse there in 2006. I am sure that in this heavily densed population, there is not much relief anywhere, but we can find solutions that are a bit more desireable than others.

I do work well with the other LPNs and RNs that work in my clinic because we are all basically experiencing the same horrors and do what we can to support each other. If I have to go through this, I'd prefer to work with these ladies who (with the exception of 2) are phenomenal. We pitch in and help each other as best we can, we empathsize with each other, support each other. I would still rather be elsewhere, but, I do have great co-workers, just crappy administrators. At least I have predictable days off (weekends and holidays), and I will use this place as a lab to gain what I can, because if I do have to cut out, I want to have a padded resume. Also, if you work for the city, most hospitals will hire you, because they think if you can survive there you can deal with basically anything.

In regard to the patients, well, I'll do what I can, and if nothing else, do nothing legally wrong to the best of my ability. Funny, when I went to see my Podiatrist, I saw a sign with a list of literacy programs for patients to learn English. We need those in our place (wonder why it hasn't appeared so far). I took a flyer, and will pass it on to some of them that show interest. Again, I thank all of you for being supportive. I love it here, I really do.:redpinkhe

Having the support of your co-workers is about the best you can expect in this field. Cherish your co-workers that you have lived with for all those years.

Specializes in ER.

Coworkers make or break the job.

I spent yesterday discussing with my coworkers what kind of jobs we could find that wouldn't involve dealing with other people...we didn't get far. sometimes I would test rectal thermometers for minimum wage if I could flip the bird to anyone who tried to speak to me.

Funny, when I went to see my Podiatrist, I saw a sign with a list of literacy programs for patients to learn English. We need those in our place (wonder why it hasn't appeared so far). I took a flyer, and will pass it on to some of them that show interest.

People have GOT to start learning English. My mom did when she came here, and she marvels at why others don't do the same.

I mean, it would be best for everyone - immigrants and citizens alike. Immigrants can really get ahead when they learn English. I mean, just the rudiments would help!

When I was in Switzerland/Germany last year, I could only speak a few words of German, and let me tell you, it was the most FRUSTRATING feeling. I was glad to lapse back into my rusty French when I could (luckily, most of the Swiss and Germans I met spoke English as well).

I saw a Pneumovax vaccine packaged all in Spanish recently - the nurses were trying to make out what the text meant! Nary a word of English on it! I don't think WE should be the ones learning Spanish!

P.S. I love languages - Spanish, French, German, Italian, etc.... But I don't think we should learn them in order to communicate with our fellow citizens or to-be citizens.

We should learn languages to speak with those from other countries - those not living here or planning to live here permanently - and for the sheer love of learning a language, enjoying opera, etc.

Anyway - sorry for the tangential comment, but just want to clarify.

Specializes in Community Health, Med-Surg, Home Health.
People have GOT to start learning English. My mom did when she came here, and she marvels at why others don't do the same.

I mean, it would be best for everyone - immigrants and citizens alike. Immigrants can really get ahead when they learn English. I mean, just the rudiments would help!

When I was in Switzerland/Germany last year, I could only speak a few words of German, and let me tell you, it was the most FRUSTRATING feeling. I was glad to lapse back into my rusty French when I could (luckily, most of the Swiss and Germans I met spoke English as well).

I saw a Pneumovax vaccine packaged all in Spanish recently - the nurses were trying to make out what the text meant! Nary a word of English on it! I don't think WE should be the ones learning Spanish!

I totally agree with you. I can spend the money to take a Spanish or other language if I wanted to, but how fair is that to me? I have total empathy for people who do not speak the native language, but as cold as it sounds, I live here.

People have to take responsibility for their health. I can see if they just arrived, but many of these patients have been served at this facility for many, many years and have not made an attempt to learn English. I would not be that trustworthy of anyone's patience to just assume that the proper care would be rendered. If I can count money, take the bus, ask for a Metrocard, obtain Medicaid and my medication, then it shows that I do have the ability to learn. There were many listings on that flyer that offer free classes. If they choose to remain here, then, try to adapt somewhat to the culture here.

We don't even have enough literature on drugs such as Coumadin in anything else except Spanish. Those that speak Creole, Punjabi, Hindi, or the other vast languages we serve have none. Some claim to the interpeters that they don't have anyone at home that can interpet or translate for them, so, what are we really doing here??

I am concerned about them due to safety reasons. I would not wish to be in a situation where someone blew me off because I did not speak the language. But, I can tell you that plenty of nurses that work in my hospital (not necessarily in my clinic, but throughout the facility) that have not bothered. They just do whatever and take the chance daily. I am too afraid to do that, but I can understand the frustration when it is just too many of them.

I saw a pro-immigration rally on the news where a spokesperson for the ralliers was speaking in his native language, through an interpreter (this was on English-speaking news) - and he'd been living here for several years!

What's wrong with THAT picture?

And I could say the same to some of my own relatives: If ya don't learn English here, you are behind the curve in SO many ways. I could say this to some of my own cousins, so I'm not being spiteful here.

And, I agree - understanding what is communicated to you by a nurse or other health care provider is so important to maintaining health...

Anyway, frustrating.

Specializes in Community Health, Med-Surg, Home Health.

Yes, it really is. How do you just hand your body over to strangers and not know what they are saying to you for YEARS?? I feel sorry for their school aged children-sometimes, they are kept home from school to interpet and hear complicated information that they have to digest and then interpet to their relatives. Many of them only know medications by color, not names or what it is really for. I can understand if you were visiting and got sick, but if you have to remain in the area, try and learn it. It is only safe for yourself.

Specializes in Pediatrics, Emergency, Trauma.
It is difficult to do time management regarding the explanation of procedures because if people do not comprehend the language and because we have to obtain a telephone interpeter, it will still take time. Once I obtain one, though, I do walk them through as much as I can so that there are no surprises for them. It is the mass of people, though, who are all waiting for various things from appointments, social workers, financial advisors, patient teaching, injections, etc...and they can be waiting for ANY nurse. It is like a swarm of locusts waiting, literally.

Imagine a conference call with the speaker, where an angry person speaking Punjabi is cursing at the interpeter, then, the interpeter has to tell the nurse, for then, the nurse to have to respond. Sometimes, it is downright comical, really, if it weren't so sad. Or a patient that speaks Spanish, where you have to explain how to inject insulin, expect a return demonstration, and then ask what they know in their own words. You are not really sure if what the interpeter is saying is what the patient said, or what the interpeter wrote down and repeating back to you in order to hurry up and terminate that session. Only to have the patient say "I had 'alittle' Diabetes as a kid, I don't have it any longer"...and you just saw the glucose reading that says it is 320mg/dl. No matter how you look at it, it WILL be time consuming.

There are safety issues, also, because Joint Commission wants the patient to be properly identified. I don't want to administer 10 units of regular insulin to the wrong person (many of the patients from similar cultures have the same name). But, they don't know their birth date, barely know their address, can't spell their name, has a 5 year old child that is supposed to interpet, but doesn't comprehend disease entities, and the patient getting angry because they don't want a telephone interpeter. Some of them say that they brought the child because they didn't want someone they don't know in their business. How do you explain to a patient who needs to collect stool samples in an extra large reduction container...an entire host of things that truly involve the intervention of other faceless people (interpeters). I am not disagreeing with your statement, but it is much more than just time management that are the issues that make this very challenging.

I do plan to survive, though, bottom line...

You must remember what I said-Nursing is a balancing act. I have dealt with the phone interpreter mess as well as the joint commission standards. I had a four year old child help interpret Portugeuse for her mother to explain to her about Clubfooot on her youngest sibling. As a nurse we must rember to not get bogged down on the people you serve and nee you regardless of income, nationality, level of simple intelligence. You must learn management of time in order to keep your sanity even if it means constant repition while making your rounds. Wherever you go the loads are just as complex, and it will get better with the type of nursing style you make, not just what they teach you in school-with each patient it gets better every time.

Specializes in Pediatrics, Emergency, Trauma.

Angels? That is just a motivational statement with no truth to it. We are never angels. These people could care less about most of the staff that busted their tails to take care of them when they don't do anything to take care of themselves. No matter how much you do, there is little appreciation from the administration, the hospital or the patients. You go home tired, beat and dreading returning to work. Period.

sigh. unfortunately out of 1000 patients that could care less there are 1,000,000 who are grateful and appreciated and cannot perform the career we choose, they just don't have the current society norm: NO COMPASSION, NO EMPATHY.

I would never consider myself an angel...i'm "just a nurse":p-and I love it! This Nurse does not need validation either!:nurse:

Specializes in Community Health, Med-Surg, Home Health.
You must remember what I said-Nursing is a balancing act. I have dealt with the phone interpreter mess as well as the joint commission standards. I had a four year old child help interpret Portugeuse for her mother to explain to her about Clubfooot on her youngest sibling. As a nurse we must rember to not get bogged down on the people you serve and nee you regardless of income, nationality, level of simple intelligence. You must learn management of time in order to keep your sanity even if it means constant repition while making your rounds. Wherever you go the loads are just as complex, and it will get better with the type of nursing style you make, not just what they teach you in school-with each patient it gets better every time.

Somehow, I am not getting what you are trying to say. Management of time is difficult when many people have similar issues regarding communication, because the bottom line is that you want them to have a basic understanding of how to safely care for themselves, and that, to me, takes more of a priority. I can say that it does get better, but does that mean that you rush just because you want to get it overwith to go to the next person who has even more complicated issues? When you see a person who still clearly looks confused, even after diagrams, obtaining an interpeter, using a family member that does not understand much more than they do...it takes time...sorry.

I can say that it has gotten better with time, because I have no choice. But it doesn't make it favorable.

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