RE: How much heart Break? Does it still hurt?

[MMayo]

This thread is a response to another thread entitled: "how much heart break can outake in one week." I have a great of empathy for you , cherrybreeze. You thread discussion has opened up a old wound that I need to vent about. I would say that that is a bad week for regular acute care hosptials. i could go on and rant about how much harder I have in my patient care, but I won't.

I am a CNA and nursing school applicant that works in a long term acute care facility for several years. I care for medically complex patients with chronic issues that are managed and rarely recovered. Drug seekers and medically induced addictions among the patient population are abound. Though we are not a hospice, the suffering at the end of life is more common than not. One to two patients die a week, planned or not with comfort measures.

Another strange feature about my work enviroment is the staff. I work with hard boiled, veteran nurses. It is hard to find a nurse with less than five years experience at my facility. And new nurses rarely last beyond one year at my facility. The staff around me don't even blink when there is a code. The code is just another procedure with protocals to be followed according to ACLS. I recognize that I have become desensitized to the pain and sufferings and I hope that I am not become as insensitive as some of my coworkers are.

I recognized that I have become desentized to pain and suffering reactions of my patients when I was attending a microbiology class. During the lab, the professor showed a film about an Ebola outbreak in Africa. The hospital scenes and the condition of the patients should have been horrifying to me. But they weren't. The students around me, some of who are healtcare practioners, were stressed by viewing the film. I was busy in my head assesing the patients conditons in their quick viewings throughout the film. I talked with my coworkers about the experience and they all replied that i have become a seasoned practioner, ready and willing to do the horrible job at hand. The Micro professor was trying to give a superficial lessen in suffering of patients, a simple demonstration in reality we all must face as healthcare workers. The experience taught me about my character change and my attitude in reflection about nursing.

I know that I am past the thrill and excitement of nursing. I have been wondering if I am of the edge of burn out when I am just starting RN nursing school. I still care about my nursing care, though I ration my caring alot more than I use to. I m assuming the inital stages of inexperience and ignorance about nursing has past me.

[iluvivt, BSN, RN]

There is a huge difference between being a CNA and an RN so I do not think your journey of discovery is over yet. As an RN a HUGE responsibility is placed upon you and expected of you, As a CNA you are delegated to and the ultimate responsibility of that pts care rests with the RN. Yes you are responsible for what you do but only to the highest level that a CNA is able by law. Nursing is truly and art you must be able to perform the nursing care and you are expected to do that with a degree of empathy towards your fellow man. I think what you are saying is that you see a lack of empathy in the nurses you work with. Have you ever asked them how it is that they deal with the heartache and pain they see on a daily basis and how it is that they manage to do that and continue to provide safe nursing care? I think the answers may surprise you. I think it would be a good time to do that,since you are entering nursing school. Yes I am certain some do become hardened and are in "burnout"..then it really becomes their responsibility to rejuvenate themselves.

[ctdismukes]

"I have been wondering if I am of the edge of burn out when I am just starting RN nursing school. I still care about my nursing care, though I ration my caring alot more than I use to. I m assuming the inital stages of inexperience and ignorance about nursing has past me."

As a former Paramedic for several years, I am a new LPN grad (wanted to start out with that because nursing is a whole 'nother beast compared to the street) and I am scared to death. Its funny because on the street , if we are dispatched to a NH or ALF we always want to talk to an RN not a "lowly LPN". I never realized HOW MUCH and LPN actually does for their patients. Its amazing how they stretch the high stress of patient care over 13 hours while we get our 15 of fame and dump them in the ER.

Yes, the excitment does leave you, to a certain degree, after about year five ESPECIALLY as rescrited as a CNA is (kudos to you BTW... I could never do your job as long as you have... I would have burned out in 6 MONTHS!).

My point is this. With each NEW set of letters you get behind your name, you are automatically "inexperienced and ignorant". LOL! And I mean that in the most Christian way possible! Take advantage of the new rank and get into a different field (other than Med/Surg or Geriatrics) to get your groove back, Stella. The thrill of being a dx detective has come back to me and now I can't wait for my BSN!!!

Good luck in school!

[nursel56]

MMayo- Every nurse is susceptible to compassion fatigue. You work around patients who are never going to get better, and in some cases their disability is caused or exacerbated by their own actions. You work around people that don't give a cr*p, it appears. Who would that not suck the life out of??? The same thing happens to Emergency nurses.

There is a whole world of nursing out there, it's very diverse. Don't let this one place color your outlook to the point you think you have battle fatigue. I think you will feel energized all over again when you start nursing school. It is so completely different than work as a CNA.

For what it's worth, I can look at the goriest, saddest things imaginable on TV, like Code Blue, and Trauma, I don't feel a thing. But I know I am a compassionate nurse!! It's a matter of perspective entirely.

I hope you will decide to continue your studies, you sound very articulate and caring in a super tough environment. Best of luck!! :)

[SuesquatchRN, BSN, RN]

I care about my residents, passionately and compassionately. Her and there one especially touches my heart. I no longer fall in love with them. I couldn't survive.

[TakeTwoAspirin, MSN, RN, APRN]

"I hope that I am not become as insensitive as some of my coworkers are.'

I wouldn't be so quick to judge what your coworkers are feeling. Just because they don't show emotion, doesn't mean they don't feel it. It just means that they have been around enough of these cases to know how to deal with it in a professional way so that they can survive in a difficult environment.

[RNperdiem, RN]

You were different from your classmates watching the film about the Ebola hospital. Many couldn't see beyond the moral outrage of the conditions. You bypassed that and thought about how you could help the patients there.

[cherrybreeze, ADN, RN]

Having emotion doesn't equate with ignorance and inexperience. Being "hard-boiled" and "veteran" aren't synonymous, either. I've read your post a couple of times, and I'm trying to figure out exactly how it relates, and I'm coming up a little short, I think.

I know for me, I'm not inexperienced, or ignorant, in terms of nursing. I agree with Suesquatch's statement with, not falling in love with people/residents, as that will take you down/out (and I haven't done LTC in a number of years, but know the feeling and atmosphere of it well).

With experience in nursing, yes, you become able to readily function in the face of crises, codes, etc. You don't necessarily bat an eye at the time, you do what needs to be done. Does it mean you can't feel about it later, no matter how many times you've done it routinely before? Of course not. I've seen a lot of difficult sitiations over the course of my career. I posted about this week because yes, this week hit me harder than usual. At the time, I could do my job as well as I always do my job.

I don't think most people ever lose that. That sometimes, you'll see something, someone, that's going to stick with you a little bit more. Had I dealt with any of these situations singularly, maybe, not so big of a deal. All in the course of two days, after taking care of mom, yes....I came home with a heavy heart. I think any nurse can be subject to that at some point in time, and I don't think that's bad. I also don't think it's bad that, on just about every other day you go to work, you can see the same heartbreaking stuff, you can do your job, care for your patients, and come home and carry on like you normally would. You have to be able to do that to live normally.

Hope that makes sense.

[gardengal1, ASN, RN]

I have been in an ER for 24 years and it is a rare occasion that I show emotion. Certain patients or life stories gets to you and tears are shed but that in no way means I don't care. Younger nurses may in fact view me as "hardened" but tears only get in the way of supporting the family that needs me most at that particular time. No one sees the tears as I drive home after that shift, which helps some. No one sees the sleepless night after that shift because I wonder if I could have done more. I accept the notion that I appear "hardened" to death but no one, except myself, knows how I cope with death over and over.

[cherrybreeze, ADN, RN]

I have been in an ER for 24 years and it is a rare occasion that I show emotion. Certain patients or life stories gets to you and tears are shed but that in no way means I don't care. Younger nurses may in fact view me as "hardened" but tears only get in the way of supporting the family that needs me most at that particular time. No one sees the tears as I drive home after that shift, which helps some. No one sees the sleepless night after that shift because I wonder if I could have done more. I accept the notion that I appear "hardened" to death but no one, except myself, knows how I cope with death over and over.

Thank you gardengal. I think this illustrates much of what I was *trying* to say...

[Kooky Korky, BSN, RN]

We can stand only so much pain. Then survival mode kicks in.

Think about people in concentration camps or POW camps or Siberian Gulag prisons or other totally intolerable placess. There is a certain distancing oneself that must take place if one is to survive.

Read Bruno Bettleheim and Alexandr Stolzenitsyn (spelling might be wrong) or any of a lot of other personal accounts of what prison is like - not American prisons, but real torture prisons. People learn to cope by various means - denial, humor, becoming cruel and mistreating other prisoners, suicide, and other approaches.

None of us knows how we ourselves might react when we are truly pushed to the wall.