Nursing as a Human Experience

My own experience with "compassion fatigue" aka "too busy and tired to think about the big picture," and the morning that I realize that nursing is more than just work, it is also a human experience. Nurses Announcements Archive Article

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Nursing as a Human Experience

I'm writing this article on my bed, wiping my tears away and making sure that this article makes sense to those who are reading it.

I just finished a 13-hour shift yesterday night at the CVICU. I am in my final semester of nursing school and I am so excited to be on this amazing floor for my preceptorship. For the past three shifts that I have been on this floor, I have been so happy that this floor opened up so many avenues and opportunities for learning. Things I have only read in nursing textbooks (when I do read them) are now being applied in the real setting. Machines, pumps and other alarms consistently needed my attention & care. And the patients that I have are "critical," which means that I get to do a lot for the patients and learn and apply many nursing skills.

So, I finished getting my report from the night nurse, and my preceptor asked me, "What is your plan of action for today and are you ready for it?"

It was a Saturday shift, and it seemed that the floor was quiet (the quietest I've seen it). I answered my preceptor, "I'm ready, it seems that we're gonna have an easy and good day." I shouldn't have said this (which I learned to never ever say this again), or maybe I'm glad I did (because I learned a great lesson). Throughout the day, there were two code blues, one stroke alert, and 3 code ices; all to which one of the CVICU nurses must run and respond.

(Trying to keep this short & sweet & maybe sour - from crying.)

Truth be told, I thought I was ready, but I wasn't. I was not ready for the tears that the wife of my patient would shed, as she left her husband - who was intubated and required continuous dialysis - to travel 6 hours away to go back home. I was not ready to see a grandchild who would give up the comfort of sleeping and eating, just so that his grandmother could rest well. I was not ready to respond to a stroke alert, in which I chose to comfort the crying daughter who tried to be strong, as 5 nurses were assessing her father. I was not ready for the physician to say, "There's no hope for my patient" in the break room just as I was grabbing my first sip of water for the day. I was not ready for one of the nurses to tell me, "The patient died," as I was too focused in her telling me that she had to perform chest compressions with one hand, for the patient was vomiting and expelling secretions from all places in his body. I was not ready.

Being in the healthcare field (I can say this for myself), you forget that people who come to the hospital are really sick; some are more critical than others. You forget that there are so many hospitals in the world, and so many people waiting to be cured. You forget that there are so many more sick and dying people who are not in a hospital bed. You forget that you are in the middle of pain & suffering, as well as faith & hope. During hand-off reports, I became too focused on how many CABGs does the patient have, any lines or drainage, feeding pumps, etc. and charting. You forget that in that chart you only have one line for something, social support. You forget that your own patients are mothers, fathers, grandparents, and children. You forget that you are part of the first line of care for these patients. You forget that whatever you do for these patients directly affects them, whether it is all the medications you give, all the heavy turning & lifting you do, or all the assessments you perform. You also forget the last meal or water break you had, when you last peed or sat down. You forget all of the aching calves and back because you have to hang this med up or cover for a nurse that just ran to the sixth floor to respond to a code blue. You forget that you, yourself, are important.

Being in the CVICU, I learned that there are so many patients in the world, from being discharged to dying. Nursing is not just "work" that we have to get through, it is also a human experience. Call it "therapeutic touch," call it "supportive," or call it "active listening." Don't forget that we are human and that there are human experiences to be recognized every time you step on that floor. I now know the importance of the saying, "treat the patient, not the machine."

So when you walk into your work, or clinical rotation or preceptorship, ask yourself, "Am I ready?"

thywillbedone_ has 3 years experience and works as a Simulation Education.

63 Posts

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Thank you for this perspective. This is such a great lesson/reminder for students, new nurses, and veterans alike.

TeeKay12

94 Posts

I see each patient as someone's relative, and when I start to lose perspective catch myself and remind myself: That could be my mother, my father, my sister, child, grandchild, grandparent, friend.

And then I remember why I got into nursing. It wasn't to wipe behinds and hang meds and complete education assessments. It was to do all of those things while helping another human being and their family during a difficult time in their lives.

Gastrointestinal Columnist

Brenda F. Johnson, MSN

61 Articles; 326 Posts

Specializes in Gastrointestinal Nursing.

Very good article on how intense, crazy and draining nursing can be. You had a very humbling day and I'm sure those family members will always remember your caring so much.

thywillbedone_

63 Posts

Specializes in Pediatric ED, PICU, Simulation Education.

@topher.houston You're welcome. I really wrote this article as a simple reminder and even a challenge to those of us going through a "dry" season. We all need to inspire each other in the field to better our care for the patients and their families.

thywillbedone_

63 Posts

Specializes in Pediatric ED, PICU, Simulation Education.

@Brenda F. Johnson You have no idea how humbling it was and is for me. It is very draining, physically and emotionally. But that's the beauty of nursing, no matter how hard we work and how tired we are, we always find the strength to give more.

thywillbedone_

63 Posts

Specializes in Pediatric ED, PICU, Simulation Education.

@TeeKay12 Are you reading my mind? This is exactly one of my thoughts while writing this article! We can all get caught up with the "skills" but the number one skill to have in nursing is compassion.

anon456, BSN, RN

3 Articles; 1,144 Posts

I work PICU and stepdown and I can relate so much to your article. One of the basics of nursing school that gets forgotten when compassion fatigue and burnout creep in is to set a goal for the patients that day. Part of a basic nursing plan. Oftentimes when I'm feeling burned out my goal is to complete the endless set of tasks that are set before me-- meds, turning, oral care, etc. A human goal needs to be set, too. Education, connection, trust, listening, or comfort.

Two things happened recently that opened my eyes to the fact that we often forget the patients.

We are in the midst of a very busy season right now and the nurses are extremely busy with very sick patients. The parents of a child who had been there for at least a week were in the room and we were discussing the care plan and goals for the night. I pointed to the monitor and showed them my goals for vital signs for the patient that shift. They asked me what the red and blue and white and green numbers meant. No one had ever explained to them! So I taught them what the numbers meant, and how the higher heart rate and blood pressure often means the child needs more pain medication, or how the lower O2 sat or higher respiratory rate sometimes means more oxygen or a breathing treatment. It really empowered them and they started to ask more questions about care, and what needed to happen to get their child home.

That same week I had a chronic cardiac kid of about 6 or 8 years old. I was feeling his pulses and checking cap refill and he knew the routine and was giving me his hands and feet. I asked him if he knew what was I doing and he said no. Neither did his mom. I told them what I was checking and what it meant. I told him I was feeling how strong his heart was working and I was feeling how well it pumped blood into his arms and legs. I taught him about cap refill and what that meant. I then asked him if he had ever listened to his own heart and he had not! I let him listen to his heart, lungs, and tummy and he was really fascinated. I will often invite parents of bronchiolitis kids or asthma kids to listen to their childs' breath sounds and then their own lungs to compare. I will tell them to listen as often as they want with the stethoscopes we keep in the rooms, so they can tell when their child is getting better or if they are getting worse. These things really get the patients more involved and it opens a connection between patients and nurses.

Specializes in Reproductive & Public Health.

I read this great article the other day on the placebo effect, and how it is more accurately referred to as the "contextual effect." It's not that a sugar pill has some inherent magic, it's that the act of being cared for is therapeutic in and of itself.

Placebo, Are You There?

junebug6

3 Posts

Specializes in Critical Care.

Well said and what a great reminder of our reality. So easy to get bogged down in details and forget about the real reason we went into nursing to begin with.

kcmcnamee

5 Posts

You'll never use the "Q" word again!