Where can I actually help people??

  1. In your opinion, is there an area of nursing where you actually help people? I mean, I know you can help people in any area, but I feel like most nursing jobs you help maybe 30% of the patients and the rest are noncompliant, drug seeking, crazy. . .and yes, I know these people need help too but I don't feel like I can do anything in the hospital.

    I'm so tired and burnt out.

    I lost my temper with a patient earlier this week - an A&O pt who was being a complete jerk, verbally abusive, manipulative. And I am so mad that I allowed this patient to get under my skin (although in my defense, this patient also made the nursing supervisor, two case managers and a patient advocate very angry too lol)

    I feel like I work my ass off, but nothing changes, the same patients come in over and over with the same problems (SOB, acute back pain, chest pain, CHF exacerbation, AMS) Education goes in one ear and out the other. The patients don't take their meds, don't see their doctors, then come in and demand IV pain meds, benzos, cheeseburgers and coffee NOW and what do you mean I can't go smoke a cigarette and NO I don't want SCDs on or IV fluids and STOP DRAWING MY BLOOD and I want a private room NOW. We get old, very sick demented patients from nursing homes who honestly should be DNRs but instead we stick them and poke them and tie them down and fill them with ABX and eventually put in pegs and do random tests and surgeries and they linger and languish and eventually die.

    I love the days I feel like I make a difference - they are so far and few between. I wish there was more of them.

    Thanks for letting me rant. And I am serious about wanting opinions about areas of nursing where I could actually make a difference.
    Last edit by AlphaPig on Nov 27, '12
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    About AlphaPig

    Joined: Sep '12; Posts: 90; Likes: 154
    RN; from US
    Specialty: 5 year(s) of experience in neuro/med surg, acute rehab


  3. by   umcRN
    I usually feel like I have helped my patients, and sometimes their families. I work in a pediatric cardiac intensive care unit and I love it!
  4. by   loriangel14
    I work on a Complex Continuing Care unit. I get physical rehab pts ( lots of hips),some medical pts, palliative patients and seniors waiting for nursing home placement.I do enjoy getting to watch people get better and go home or help pts and families through that final journey.
  5. by   MedChica
    I work with the elders and the mentally ill.
    I feel like I make a difference in their lives by being there for them.
    We're stepping up when their loved ones are unable to or just flat-out don't want to. You get to know these people and you build relationships with them. There are good times, yes. Lots of them. I'll have to leave LTC for the hospital at some point (to increase my skill level), but I'll definitely miss my geri's.

    The mentally ill, I love. I even like the combative dementia patients. LOL We have one little guy who wanders in out of rooms.
    He'll go in there straighten up the beds. It's funny. He's in his 70's, but he's spry -- and he used to box!
    Let me tell you, something: When he squares up? Get the hell outta there. I was helping an aide change him. He grabbed her and wouldn't let go. I tried to talk him down gently (which usually works because the aides have an act of 'swarming' and grabbing him. Bad idea. If one person loses their grip and he gets a hand free? That's it. Up comes the fists and he's just swinging. Everyone let's go and backs off. He's a little guy, too. 5'5. Slim, but very STRONG.).
    She ran out of the room. He started after her, then came after me. Running.
    I ran out of the room through the bathroom, as I marvelled at his shocking speed. LOL He came out, saw her...and ran after her again, but she took off down the hall. He was cursing in spanish. 5 minutes later, he was wandering down another hall. I gave him a sandwich. He smiled.
    We were best friends, again. LOL

    Granted, some disorders are difficult to handle. I have a little lady with borderline + BP2 disorder. That is the most hell-raising-est woman I've ever met. She once ranted and raved for 4 hours. Nonstop.
    She had her sister calling the nurse's station screaming at me in frustration. Why? The resident was calling the sister nonstop. Crying. Whining. Screaming.

    Bless her heart, but she sucks the pure life out of me. With her screaming 'Rage Attacks' and, when she comes down, with her depressive 'nobody likes me/I'm gonna cry in my room and slit my wrists' moods.
    I have to consciously check my own responses to her as well. Ensure that I'm not treating her any differently simply because she rattles my nerves (arguably, most of the time). LOL She rattles everyone's nerves. Every shift, I'm having to save an aide from her 'Rage Attacks'. She ran her roommate out of their room with her screaming whines.
    In the midst of the tirade, I have to consciously repeat in my head, "She...is not her disorder. She's sick and can't help it. She is not her disorder. She is not her disorder." to maintain my bearings and boundary setting.
    There's a behavioral health seminar coming up and I'm going to attend. Hopefully, I'll learn better ways to manage help and help her manage herself.

    ...but I'm here for her. We all are. She needs help. The mentally ill need our help and support. Society just want to throw them (and our elders) away and it's wrong!

    The most frustrating thing to me, though? The constant refusal of meds.
    Many of these people had lives and children before their disease took them down. It's sad.
    I still hold out hope that this or that person can be high-functioning if they just tried and we helped them.
    ... but how you explain to someone with paranoid schizophrenia that the meds aren't poison? That they need their medications to manage their delusons and heart conditions. One of my little ladies is the hardest. Once it took another nurse and I AN HOUR to get her to take her antiHTN, lasix and antipsych meds. Had to bribe her with diet coke, too. We usually have to hide her meds in her food. Her insulin? I have to wait until she's in the bed half-asleep.
    She'll still fight me on it, but not as hard.
    She has daughters but they don't come around and I understand. It's difficult thing to be a child of a mentally ill parent. I've had one adult child say that her mother's been sick since she was 12 and it's always felt like... her mother was 'dead'. All that's left of her 'is a shell'.
    Then, she started crying. SMH. She was trying to explain because she felt shame. She thought that we, the staff, looked at her harshly b/c she never came to visit. As if we had this attitude, like "What kind of person are you?"
    No, never that. I couldn't imagine living with the sort of reality. It doesn't take much to understand the real reason why that woman stays away: It hurts her. She mentioned that she was seeing a therapist and that's why she was able to come to her mother at that time.
    Baby steps.
  6. by   anotherone
    I work in med surg so many pts are going to be like the ones you described . But I have found that there is more teaching, really helping with surgical pts. for example a pt comming in for a thyroidectomy, tah/bso usually is more understanding if the need fir lab work, etc than one comming in for the next fix and tray
  7. by   elkpark
    You make a difference and "help people" wherever you practice nursing. If you're upset because you're not getting enough of a feeling of personal gratification from working with your clients (they're not grateful, appreciative, and obedient enough to suit you), I'm kinda concerned about your future in nursing -- you're not going to get a lot of what you are apparently looking for, wherever you practice.
  8. by   MInurse.st
    My surgical floor takes the liver and kidney transplants. Tons of teaching, and these patients are almost always eager to learn (and compliant w/ meds, treatments. etc).
    Last edit by MInurse.st on Nov 28, '12 : Reason: Typo
  9. by   elkpark
    Quote from MInurse.st
    My surgical floor takes the liver and kidney transplants. Tons of teaching, and these patients are almost always eager to learn (and compliant w/ meds, treatments. etc).
    Interesting you should say that -- I work at a major academic medical center with a big transplant program, and we see lots of our transplant people back in the hospital later precisely because they're not compliant with their follow-up tx. Blows my mind ...
  10. by   Daisy_08
    I work palliative. Love it. Lots of care for the pt, education for the family and support for both. I feel like I can help the pt have the most symptom free and dignified death and help support the family though a difficult time.

    I also worked LTC and felt like I really helped them, just by taking a little extra time. I personally like providing care and getting to know my pts.
    Last edit by Daisy_08 on Nov 28, '12
  11. by   paradiseboundRN
    If you are willing to leave the hospital, being a home care nurse is very rewarding. You can really make a difference in someones life by teaching them how to care for their disease and keeping them out of the hospital. Also you do alot of wound care which is rewarding when the wound heals. Of course, home care has its negatives too but it is rewarding.
  12. by   BrandonLPN
    Well, *all* nurses actually help people, of course. And *all* patients need a good nurse. In fact, I'd go as far as to say it's those pain-in-the butt, non-compliant, manipulative med seekers who need a good nurse the most.

    Let's be honest, it's easy to "feel good" about taking care of some cute little 6 year old with an acute, curable condition. God forbid your taking care of some middle aged guy who's a hot mess of various uncurable chronic conditions and co-morbidities. Not so much a "feel good" patient. Never mind that that represents most of our pt population.

    And sometimes it seems like we're preconditioned to believe that the only "real" nurse is the nurse who's
    out there saving theworld and somehow curing everyone. And the only "real" patient" is the innocent ingenue who's faultlessly stricken with some calamity. And we swoop in to the rescue. They get better and they go home. Everyone's a hero. Yay team.

    I don't know about you, but I don't see scenarios that play out this way
    too often. Like elkpark said, I think you might have a hard time finding what you're looking for.

    I'm reminded of that Edgar Allen Poe poem about the knight who
    wasted his life looking for a city of gold that never existed:

    And as his strength failed him at length
    He met a pilgrim shadow
    "Shadow", said he, "Where can it be- this land of Eldorado?"

    "Over the mountains of the Moon, down the valley of the shadow."

    "Ride, boldly ride," the shade replied- "If you seek for Eldorado."
    Last edit by BrandonLPN on Nov 28, '12
  13. by   Jim-El
    Obviously you help people where you practice nursing. I feel like you are twisting the original posters words a little bit here. Personally, I can relate to what they're saying. It has less to do with "receiving appreciation and obedience" and more-so to do with genuinely feeling like you made a difference in their lives.
  14. by   green&uninformed
    @MEDCHICA Thank you for making that post. I'm a nursing student in my early twenties. When I was in my early teens I was diagnosed as bipolar with psychotic symptoms and required multiple hospitalizations. I didn't understand my illness and hated taking my meds. Its wasn't till I started seeing a clinical nurse specialist/Nurse Practitioner who sounds a lot like you that I was able to turn around my life. It was her affection and concern that finally helped me get my life together and inspired me to become a nurse. The point of this post is just to say THANK YOU. I know your patients don't always voice their thankfulness but you are an amazing person for the work you do
    Last edit by green&uninformed on Nov 28, '12 : Reason: grammer