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.

Specializes in LTC, Acute Care, Correctional.

Pagandeva, I feel your pain. I work for a hospital in the city and I am very close to handing in my resignation. I work on the ward and I absolutely hate it. First, on the wards, they dump all the majority of the patients on the LPN. So you end up having most of the contact and/or airborne isolation patients. Second, you have the dope fiends breathing on the back of your neck for their Methadone. Then you have to change out of your scrubs into your police uniform to chase the patients who try to leave the hospital. (I have never heard of anything so bizzaire) Now with all the changes going on in the city hospitals, (uniform code, designated times for lunch) it is becoming more like I am working in a basic training camp than in a hospital. I had to take a leave of absence due to my BP escalating to 210/100. When I get home from working a 12hr shift, I don't even want to be bothered with my children. My preference would be working agency, that way I can work in various setting, when I want and enjoy time with my children. But the reality is that since I have children, I need the benefits (which by the way are not as great as people think). But just hold on....soon you're contract will be over and you can work in Hawaii while on vacation.

Specializes in Alzheimer's, Geriatrics, Chem. Dep..

I love ya Pagandeva - you do your best to adhere to the best standards in an impossible situation. Enjoy that vacation!! And try to forget that place for a while.

I would think that working the wards would mean fewer people over the course of 8 or 12 or whatever hours, so that you could get more info across and more tasks accomplished ... but I assume in 11 yrs you've tried it?

God bless ya baby, praying your spirit breathes and heals a bit while you are off!

Specializes in Onco, palliative care, PCU, HH, hospice.

Pagandeva, I feel for you and can relate, anymore I bring my bottle of Maalox with me to work to settle my stomach. I work weekends and go to school during the week, every Friday when it's time for work I literally want to vomit.

Remember that song "Love is a Battlefield" we need re make it and name it "Nursing is a Battlefield" Big hugs to you!

Specializes in Community Health, Med-Surg, Home Health.
I love ya Pagandeva - you do your best to adhere to the best standards in an impossible situation. Enjoy that vacation!! And try to forget that place for a while.

I would think that working the wards would mean fewer people over the course of 8 or 12 or whatever hours, so that you could get more info across and more tasks accomplished ... but I assume in 11 yrs you've tried it?

God bless ya baby, praying your spirit breathes and heals a bit while you are off!

Actually, I have not worked the floors that often in my nursing career. I just became an LPN in 2006, prior to that, I was a CNA, psych tech, and a few other things. Most times, during my employment at this job, I worked in the clinic, and I choose to remain there. I got spoiled having weekends and holidays off, and don't wish to change a predictable schedule. I have side jobs that I do on the weekends that are much more enjoyable, and it also allows me time to spend with my family. I did do 6 weeks of med-surg as a new grad as a formality and I ran away from there on the first thing smoking...up there, they are even worse, if you can imagine that.

Thanks for your words and vote of support!:redpinkhe

Specializes in Community Health, Med-Surg, Home Health.
Pagandeva, I feel for you and can relate, anymore I bring my bottle of Maalox with me to work to settle my stomach. I work weekends and go to school during the week, every Friday when it's time for work I literally want to vomit.

Remember that song "Love is a Battlefield" we need re make it and name it "Nursing is a Battlefield" Big hugs to you!

That song, along with the theme to Rocky will be my mantras. Thank you!

Specializes in OB.

Pagandeva - like you I signed a contract to pay for LPN school many years ago - I was working in a state psychiatric facility at the time. I found afterwards that the biggest stress was just knowing that I couldn't leave, that I was obligated financially. I actually stayed on even after working off my obligation, but found it easier when I knew I had an option to walk if I chose to. In fact, having learned this I refused their offer to pay for RN school and instead sold my house to pay for it.

Don't convince yourself that there are no good places out there. As a long term traveler I've found the good, like my current contract, where I actually have time to breathe and teach my patients and work with my moms through labor. Of course the bad stressful contracts happen too, but they are more bearable knowing they are temporary and that the good ones are out there.

Specializes in Pediatrics, Emergency, Trauma.
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.

To imply that I'm telling you to cut corners is offensive to me. I'm attempting to tell you is to make you own nursing style while acknowledging that peple are not going to understand you. While you are waiting for interpreter services are you able to check on another patient? The "complicated" patient has tests to obtain, so you can get those tests, then return to the patient. Does your job have internet access to obtain teaching sheets in different languages?? There are too many resources out there for you to be up in arm about patients cultural issues. You must be the advocate, no matter their culture, and the way you vent relly concerns me.

If your resources are lacking in your site, then you must advocate for the ability to have resources since you may be deciding to stay there. Otherwise, I'll take your place and you can decide which area of nursing can make you happy and more fulfilling :nuke:. Remember: All aspects of nursing are complex, but you must have style that gives you the ability to be safe, able to critically think, and allows you to enjoy your life outside of the career, as I have.:twocents:

Specializes in Pediatrics, Emergency, Trauma.
Don't convince yourself that there are no good places out there. As a long term traveler I've found the good, like my current contract, where I actually have time to breathe and teach my patients and work with my moms through labor. Of course the bad stressful contracts happen too, but they are more bearable knowing they are temporary and that the good ones are out there.

I totally agree with you bagladyrn. You found a way to survive nusing onyour own terms as I have!!:up:

Specializes in Alzheimer's, Geriatrics, Chem. Dep..
...teaching sheets...

Yeah I had that in the back of my mind, thanks for bringing it up. Maybe basic pictographs that translators can help get made up into a book - like a procedure book for patients. Anything that will help convey basic ideas quickly and reduce anxiety.

I mean, say a new pt comes who is Spanish and requires an NG tube - the translator could help draw a picture that shows the procedure with brief description and explaination in Spanish ... that could be kept in a notebook for the next patient in that situation.

Of course then ya gotta take literacy (or not) into account ...

Anyway - it still sounds extremely stressful. I wish there was something that could be done to remove some of the ABUSE out of the equation that Pagandeva and coworkers are experiencing. Anytime someone comes thru our ER's here that is out of line gets warned - and then removed (unless of course the medical condition itself is causing altered LOC etc.). Abuse of staff is not tolerated AT ALL. So as someone said - signs posted (or a handout for pts that tell them their responsibilities) in their own language might help.

I am not even THERE Pagan and I feel like screaming!

Helpers need to be able to recharge their energy and spirit. You may want to look into some strategies that will assist with managing the day to day demands. Vacations are too far apart- so having some tools to help you prioritize, and maintain your 'mental health' may be helpful. This may include focusing to what is priority and realistic for a day. We all need to take a look at what refreshes us, supports us, so that we can be effective, and ultimately give our best efforts. After all, that's where most caregivers derive our satisfaction. I try to keep my focus to meeting the patient care needs. I find that helps me to stay 'focused/grounded' when there are competing demands. I also find that I need to stay in tune with my own frustrations, and act to keep these in check, in other words- realize my own limits. I'm getting better at realizing what I can reaslistically accomplish during my assigned shift.

:-)

Specializes in neuro, ICU/CCU, tropical medicine.
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).

Coincidentally, I'm taking a course in malaria and have to do a presentation in the class. When I brought up the subject of improving quality of care of people who have malaria in areas where people get malaria, my instructor brought up the aspect that in many African cultures people have very different concepts of illness, malaria in particular, and often do not associate complications of malaria (coma, anemia) with what they know as malaria - fever.

I did a literature search on the terms 'malaria' and 'traditional medicine' and came up with 45 studies on the subject of illness concepts among many African cultures.

The question is not 'how do we make them understand what we know malaria to be,' but how do we teach people how to prevent malaria, how to recognize it, and when to seek treatment within their own cultural reference.

The presentation is supposed to be on an "unresolved issue" related to malaria.

Now, let me say this: I hate my job (hating my job is not that same as hating my work - I love my work, hate my job).

My job is temporary - every job I've ever had as a nurse has been temporary because I'm always moving on towards something else. In this case, it's a masters in public health & tropical medicine and eventually back to Africa, which is the reason I became a nurse in the first place.

That's one of the great things about nursing; we never have to stay where we are.

I live in a state of perpetual short-timer's syndrome.

I suggest you think of where you really want to be in a year, five years, ten years, and start doing what it takes to get there.

I know how you Please try and relax, you should not be thinking about work on your vacation. Maybe like one of the posters said, maybe you should find another job that does not have so much stress. Stressing does not make it better.

I know that I should pray more than I do, but I do have a person in my life that loves me so much, and I am thankful for him. Please let go, and tell it to the Lord. He is the only person who truly knows how we feel, think and everything about us.

You sound like a truly caring nurse. Please keep on being a nurse, but take some time to be you.

"Nurses help to provide healing for the body and comfort for the soul"

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