Any other cold hearted nurses out there?

[sweet~revenge]

Anybody else feel like you're just not as caring and compassionate as other nurses? I think of myself as a caring nurse and I try to do the best I can by my patients. I love it when I leave at the end of a shift and I feel like everything was done well and my patients were well taken care of. However, I've been in some situations where I don't seem to be as sensitive as some of my coworkers when dealing with patients.

For example, one day another nurse needed to place an ng tube on a very confused patient with a bowel obstruction who was not very cooperative. Knowing he was going to be resistant, she asked for help from me and the charge nurse. She premedicated him with iv valium, we went in and his nurse tried to do it the nice way with the patient's cooperation but of course he fought us. Then we finally did it the way I would have done it from the start, which of course involved 4 of us restraining this very strong combative confused man while one of us inserted the ng tube. By the time we hooked him up to suction, it was really obvious how much he needed it.

Afterwards, the charge nurse and the other nurses were all saying how much they hated having to do that and just basically talked about how bad they felt for doing that to him. A new nurse who was there and just wanted to observe was horrified and is probably traumatized for life. Meanwhile I didn't get it. We did what had to be done and the patient was better off for it. If anything, I felt a sense of satisfaction and accomplishment. Am I some sort of unfeeling freak of nature or what? This is just one example of this where I feel like the odd woman out. Does anybody else have this problem?

[royhanosn]

[welcome to the club! its called growing a thick skin, to prevent yourself from being hurt by others decisions, stupidity, or general lack of concern. But be careful, dont let this reflect in your personal life. It could be called Post Trauma stress.

[Perpetual Student]

I totally agree sapphire we nurses need to be compassionate or try being on the other side as a patient and think how you woulf feel of 4 nurses came in and pinned you down--besides I know the patients have every right to refuse anything and if they refise something once on me I call the physician and he usually orders something else but we have to remember thay have the RIGHT to refuse anything whether refusing is for their good or not ---thats the LAW!! Just my 2 cents worth :)

Somebody who is not competent may not be able to refuse and implied consent or consent from their POA would rule the day.

If 4 nurses pinned me down to keep me safe and provide quality care when I was temporarily unable to think clearly (anesthetized, delirious, or whatever) I would buy them all beers later.

[GitanoRN, BSN, MSN, RN]

certainly, i don't recall being cold hearted or refer as one. however, i do recall a situation long time ago when i use to work in a prison. a 45yr. male c/o of sob & mild chest pain was brought to me, and for some reason the pt's offense was known to me, he was a child molester & a wife beater. in addition, when i began to work on him he stated " why they have to send a muscle guy nurse, instead of a pretty young female" he kept complaining, as i held my tongue; then the doctor ordered labs, plus abg's. admittedly, i have never miss on my abg's and most pt's stated that they had never felt the stick; however, he kept bad mouthing me and the officer who escorted him. long story short i got my labs & abg's although i wasn't as tender as usual. once it was all over i had a sour taste in my mouth, since my nursing care to this patient wasn't up to part. unquestionably, from then on, i decided that i must place aside my feelings and treat everyone with the same respect and offer them the highest caliber of nursing care.

[Woodenpug, BSN]

Somebody who is not competent may not be able to refuse and implied consent or consent from their POA would rule the day.

If 4 nurses pinned me down to keep me safe and provide quality care when I was temporarily unable to think clearly (anesthetized, delirious, or whatever) I would buy them all beers later.

Ativan for the ETOH nurses?

The thing for me is doubt. When I get clear results that it was necessary, I feel good. I do have doubts, what if I put it in and no results. It is not always obvious that the pt needs this now! Can it wait; I have reasonable time to take a "kinder and gentler" approach. What is sad is when I guess wrong. Wait a little too long or do it too soon.

[DebanamRN, MSN, RN]

I guess I'm a crusty old bat. I stay calm and don't freak out, don't cry after codes, and think sick old folks should be allowed to go to heaven without a tube stuck in every orifice. I don't like performing painful procedures but know they are in the best interest of the patient. I do feel badly about kids and babies dying but have to compartmentalize those feelings. I have too many other patients to take care of. I usually leave work feeling like I did my best and when I don't I analyze what happened to try and make it better. I pray for patience and understanding for my patients because they can really get on my last nerve.

[FranEMTnurse, CNA, LPN, EMT-I]

"hurt 'em for a minute, help 'em for a lifetime."

This is medical foresight.

[sweet~revenge]

Thanks for all your replies. I'm glad to know I'm not some heartless meanie haha. :) I don't know if I could do it around the kids though, to all of you who deal with that every day, you have my respect.

After he had the ngt put in, the patient was doing much better. The difference in his condition was like night and day afterwards. Although he already had some mild dementia, by the next night, he wasn't nearly as confused as he had been and he was very pleasant and cooperative. He was A&O x 3, able to follow commands, call for assist to ambulate to the BR, and he seemed to understand why he needed to have the ngt. Best of all, he said he was feeling better and I don't doubt it considering how much black fluid was coming out of his ngt. Of course he didn't remember the night before at all when we put it in. Ultimately I'm happy I was able to help him and if I have to be a little cold hearted to do it, so be it!

[nursechris1]

I feel the same as you do. I think what I have is compassion fatigue. I worked with hospice patients directly for about 8 years. The last 2 1/2 years I have cared for cancer patients as an oncology nurse in an infusion center. I have noticed that that last several months, I have started pulling away from patients and that I have a hard time feeling anything. I am thinking of switching to a pre-op/post-op surgery position where I don't feel bad for not becoming really involved with the patients.

I have found it has spread to other parts of my life. I just don't have the energy to care about other people's problems. My ex husband used to get frustrated because I didn't want to go out with our friends on friday nights. I told him that I had been with people all week, I need down time.

[wooh, BSN, RN]

I can definitely sympathize with ^^^.

I've had exhausting families lately. Perfectly nice, but oh so needy. It just drains everything out of you. I get my day off, and all I want to do is hide from the world.

[Ruby Vee, BSN]

i totally agree sapphire we nurses need to be compassionate or try being on the other side as a patient and think how you woulf feel of 4 nurses came in and pinned you down--besides i know the patients have every right to refuse anything and if they refise something once on me i call the physician and he usually orders something else but we have to remember thay have the right to refuse anything whether refusing is for their good or not ---thats the law!! just my 2 cents worth :)

the right of an alert and oriented patient to refuse something is quite different from the rights of a confused, disoriented and combative patient. if he has no capacity to consent (and who in their right mind would attempt to consent a confused, disoriented and combative patient) he has no capacity to refuse. he cannot understand what refusal means or the potential ramifications of his refusal. simply screaming "nonono" and attempting to decapitate the nearest nurse is not informed refusal.

when the patient needs care and lacks capacity to consent or refuse, you kind gotta do what you gotta do. and if that means four people hold him down while one puts in an ng tube, that's real compassion. i for one have the bruises to prove it.

[Cul2]

For a perspective on this topic from a great American poet, short story writer, and doctor, read the

short story, "The Use of Force" by William Carlos Williams. You'll find it here:

The Use of Force--William Carlos Williams (1883-1963)

[Esme12, ASN, BSN, RN]

I don't think you're heartless or cold at all, just realistic. It sucks having to hold a confused person down to perform a scary, painful procedure but when all else fails and it's their health or life on the line sometimes it's all you can do. It sounds to me like you still had the patient's interest at heart, that you had your eye on the prize; improving their health. You said that when you got the tube in you saw how badly he needed it. I shudder to think what must have gotten sucked up into the suction canister(s)!!! The first time I had to give a baby a Vitamin K shot and hesitated because I didn't want to hurt the poor baby an experienced nurse told me "hurt 'em for a minute, help 'em for a lifetime." I remember that every time I have had to do an uncomfortable proceedure and it's been part of my mantra since.

As for the asystolic babies, one of those babies was mine. I couldn't read anyone else's posts after I read the one about not crying over babies. Sorry, maybe because I have buried a child myself I will probably always have a very hard time with peds codes. I think I am finally to the point where I won't be a train wreck and can offer comfort to families in a bad situation and I'm thinking of going into L&D. We'll see.

T

:hug: I am so sorry for you loss. Pedi codes are hard. I may not cry at work, but I'll cry all the way home. There are the parents that need me and the next patient rolling in the door......... what DixieRedHead says is very true....

"Coded many a baby, not a tear for anyone to see. Maybe not even a tear. But they don't see you when you go the bathroom stall, stand in the corner, and just stare at the wall. Coding a baby is no time for tears. Neither is the aftermath. There is work to be done, skills to be exercised, parents tears to be dealt with, yours are not important."