Nurse Guilt

I had "nurse guilt" when I first started out. I always wondered why I wasn't deeply affected when one of my LTC patients passed away. I was sad, sure, but certainly not affected the way I thought I was supposed to be. That was until I actually did make a connection with a patient and he died on Christmas Eve. I had to hide in the med room while I balled my eyes out.

It was then that it really dawned on me what my place is. My place is not to have a deep connection to them, not to be their friend, and not to be their stand in family. It was to care for them, and that's it. I can be a comfort, sure, but like the Commuter said, they are in their compartment, and my loved ones are in another one.

I don't feel guilty about that anymore. Ten years later, I still remember that night and how wrecked I was when I found him dead. For the sake of my sanity and my career, I will never let that happen again.

I've never had familial feelings towards patients but I don't think that's what you're referring to.

There was a time where I was much like our new nurses, where I was just trying to finish my tasks and feeling over faced most days. Just this week I described it as feeling like the patient's stress and needs were happening to me, that the stress was mine. That sounds weird but for example, I've ran into situations regularly where I didn't know how to solve an issue, like getting the patients very essential supplies fast enough, say colostomy supplies for a new ostomy because theirs kept leaking and they're calling and basically freaking out which would stress me out because how the heck was I supposed to immediately fix their leaking problem and going through their supplies faster than expected. So I saw it happening to *me* and I'm venting to my coworkers and supervisor.. I didn't/couldn't feel a lot of caring and compassion when what I was really focusing on was how am I going to get this taken care of when I have so much else to do?

Now all of these years later with experience under my belt and knowing many resources and how to project meeting needs I can focus on the poor guy who just had a colostomy placed for cancer which is scary and hard enough on body image as it is but now it's leaking watery stool on his clothes out in public and he's out of supplies because he's had to change the appliance 2-3 times a day over the weekend.

My response to those kinds of situations now is in sharp contrast to what it used to be or how I now see with new/newer nurses. From everything is happening to me as I struggled to just get everything done to loving my ability to be patient focused. At the time I also felt that *guilt* because I could see it but I just couldn't do anything about it because I was in survival mode myself.

Many of us come into nursing with a lot of ideas of what a good nurse should always be. Reality does not match up and sometimes nurses feel guilty.

This is where a good brisk walk with some time alone to think helps me. I try to figure out why I feel the way I do. Is the feeling justified? Was there harm? Did I do the best I could with what I had available? What can I learn from this? After a good brisk walk and time to think things through, I put any residual guilt or other negative feelings aside so I can unclutter my mind.

I understand. I care, but I can't care about patients like family or I'd go crazy. I care about doing a great job as a nurse. But when patients think that being a good nurse means empotionally caring...well, I can't manage it. And I sometimes resent their expectations, especially when I'm running.

I recently had an end-stage cancer patient who developed a connection with me. Before I left my last shift of the week, he went on and on about how much he appreciated my caring nature and attention to his needs and for making him feel so special. That should make me happy. But instead I left feeling guilty because it hadn't meant near as much to me as it did to him

Of course it didn't mean as much to you as it did to him -- and that's okay!! The nursing care was about him, and him-focused. You clearly met his needs regardless how you felt. A human connection was apparently important to him, and that was what he received. Some pts are all business, and that is fine too -- remember it's about them. Should you have forced them into your Caring [Energy] Field (sarcastic reference to the Deepak-endorsed dreck that was my nursing theory text.)? Of course not.

You be kind to pts, care about their well being, provide the best nursing care possible. You maintain healthy professional boundaries. You do not beat yourself up for lacking feelings that aren't part of the Nursing Process anyway.

Thank you so much guys! I'm glad I'm not the only one who's felt like that, and I really appreciate your input on how you've dealt with it. It makes sense when you say it like that, though. Sometimes in order to keep my head clear and do my job to the best of my ability, I may have to forget the emotional side and stick with simply "caring" instead of "caring about."

Thank you so much guys! I'm glad I'm not the only one who's felt like that, and I really appreciate your input on how you've dealt with it. It makes sense when you say it like that, though. Sometimes in order to keep my head clear and do my job to the best of my ability, I may have to forget the emotional side and stick with simply "caring" instead of "caring about."

BINGO! This is absolutely correct.

And it can go the opposite direction as well. A more challenging patient one that can manipulate the best of nurses will use the "don't you care about me" bru-ha-ha to their goal as well.

It is filter development. You will continue to learn which filter works best with which patient. Then at the end of the shift, you leave and don't look back until your next shift.

It is part of our personal lives as well. We filter what we share (or not) regarding our work. It is private, and not something that nurses can easily process sometimes.

I would suggest that you try to make your life outside of work as rich as possible. Put your nursing mind elsewhere. Then, when you go into work, be sure that your goal is skill and being kind. Even empathy.

And if your patient's are responding to that, you are doing something right. And it is part of the nursing process.

Interestingly, there will come a time that YOU feel like a connection was made, and the patient will decide to not have you as their nurse, will see you out in the real world and not even look in your direction, or have some sort of process that they will complain more, get more demanding, may say the most outrageous things....all part of their process of letting go. and that's ok, they need to disconnect. And so do you.

I really have no emotional attachment to pts. Do your job well and don't get emotionally invested.