A very wise nurse once said to me-actually says at least once a month- "you can't save them all". It sounds flippant, but it's not, not at all. I work with ESRD patients. Literally, my entire caseload of patients are dying, A precious few will get transplants, but most will die within a few years, usually of heart disease. They know this, they know they are immunologically fragile, they know they need to eat enough protein but watch their phosphorus and calcium levels, take their binders at meals, eat plenty of fruits and veggies and watch their potassium, etc. They know they need to take their Epogen injections on time, get their Venofer, they know they need to and they know why, and what the potential consequences are when they don't. And some of them just don't do it. They know, but they don't do it.
Sometimes the hardest part of my day is to remain my patient's advocate for the choices they make, when my brain is screaming "This choice is likely to kill you!". Or the patient who gets calciphylaxis and nothing can help with the pain, nothing slows it down, their whole world becomes the pain and I can't tell them it's going to be ok or it's going to get better or easier. Because I will not ever lie to my patients.
Even as I hate what choices they are making I still need to be their champion, educate them, but accept their agency and be the one who safeguards their right to choose.
I also know I make a difference. There are days I have to be reminded of this. I have a patient who I told to put it out there on social media that a transplant would be a life-saving gift. There are now over a dozen people being tested to give a kidney. I made a difference for that patient. That's enough for me, except for the days when it's not,
You're a nurse, no one ever said it was going to be easy. I admire you for doing mental health, it's a specialty we desperately need more nurse to choose, I promise you DO make a difference, to someone, every day you show up.