Substance abusers disillusion me...

[FireStarterRN]

Had another ETOH withdrawal patient yesterday, he was also a mental health patient in real life, chronically unemployed, and had been readmitted after being discharged post knee-replacement surgery (thank you U.S. taxpayer!), meth positive and in full blown ETOH withdrawal.

High-dose protocol, IV Ativan q 1/2 hour, 1:1 sitter in room + wrist restraints. Any time the patient awoke he launched into loud abusive profanity and tried to grab the crotch of the sitter.

I guess one positive in all this is job security for healthcare professionals, including myself. But, I must admit, this type of patient disillusions me...

I ask you, how does a person such as this afford a 1/5 of whiskey a day, plus methamphetimine???

[dorianna]

Amen! It is so discouraging to become aware of the judgmental attitudes. I've dealt with this all my life and have struggled mightily. Most addicts are self-medicating and definitely don't want to be in the situation that they are in.

[dorianna]

"When an addict is hurling profanities and being highly abusive towards healthcare workers, it's hard to have sympathy for them. Nurses are people too, not really angels. I get tired of being expected to be an ascended benevolent being that never judges anyone, no matter how horribly they are behaving towards me."

I work with a number of demented patients and have had this experience. Addicts who are into these behaviors are not usually in control of themselves, just as demented patients have no control. It's hard, but as caregivers we really must do all that we can to understand that some patients are truly not choosing their behaviors. The behaviors are a symptoms of the illness. And, no, we are not angels. We are human beings trying our best to care for other human beings. Venting to our peers is certainly appropriate but it is also appropriate to attempt to learn more about why they are responding as they do.

[tahiti79]

I'm not trying to be insensitive to the stressors that you nurses face, but people with substance abuse issues need to be treated with compassion, understanding, and professionalism. It is true that most current medical professionals view substance abuse as a clinical problem, not a criminal or behavioral one, and many people self medicate with drugs to cope with past traumatic issues in their lives.

I wonder how much compassion some of you have, especially when you label them as "druggies". Perhaps some of you are just in this profession for the money, not because you care about people and want to help them get well.

Also , when you have a negative attitude towards certain patients, that can have a very real effect on the quality of care that they recieve. It is important to be objective at all times.

I understand that dealing with fractious patients can be difficult, and it is healthy to be able to express you feelings about your job.

ilsRN said that they could never be a mental health professional, and some of you seconded that. Well, working in mental health is not such a seperate compartment from mainstream healthcare. Many patients that you will encounter will have some type of mental health issues, and you need to know how to respond to them.

Statements like that are bordering on having an ignorant attitude about psychiatric patients, which usually leads to them being treated differently than other patients, and frequently the result is that they are medically neglected, or even verbally or physically abused.

This has actually happened to me before , even to the point of being abused and neglected ( I have neurological problems that were undiagnosed for a long time and were thought to be psychiatric) . In my case, I wasn't even acting "mentally ill", the staff just treated me badly because I came into the ER with a label of mental illness. I actually had to report that hospital to CMS.

Sorry for the lengthy post, I just wanted to say something about two issues that I feel strongly about.:heartbeat:redbeathe:p

[tahiti79]

I'm not trying to be insensitive to the stressors that you nurses face, but people with substance abuse issues need to be treated with compassion, understanding, and professionalism. It is true that most current medical professionals view substance abuse as a clinical problem, not a criminal or behavioral one, and many people self medicate with drugs to cope with past traumatic issues in their lives.

I wonder how much compassion some of you have, especially when you label them as "druggies". Perhaps some of you are just in this profession for the money, not because you care about people and want to help them get well.

Also , when you have a negative attitude towards certain patients, that can have a very real effect on the quality of care that they recieve. It is important to be objective at all times.

I understand that dealing with fractious patients can be difficult, and it is healthy to be able to express you feelings about your job.

ilsRN said that they could never be a mental health professional, and some of you seconded that. Well, working in mental health is not such a seperate compartment from mainstream healthcare. Many patients that you will encounter will have some type of mental health issues, and you need to know how to respond to them.

Statements like that are bordering on having an ignorant attitude about psychiatric patients, which usually leads to them being treated differently than other patients, and frequently the result is that they are medically neglected, or even verbally or physically abused.

This has actually happened to me before , even to the point of being abused and neglected ( I have neurological problems that were undiagnosed for a long time and were thought to be psychiatric) . In my case, I wasn't even acting "mentally ill", the staff just treated me badly because I came into the ER with a label of mental illness. I actually had to report that hospital to CMS.

Sorry for the lengthy post, I just wanted to say something about two issues that I feel strongly about.:heartbeat:redbeathe:p

[Virgo_RN, BSN, RN]

I'm not trying to be insensitive to the stressors that you nurses face, but people with substance abuse issues need to be treated with compassion, understanding, and professionalism.

Has anyone said otherwise?

[chevyv, BSN, RN]

I think that when you work with pts that are difficult, its just hard to be sensitive all the time. It doesn't mean that you don't care. Quite the opposite actually. There are just times when you need to vent. Many people who are detoxing or come in obviously on something can be extremely difficult (violent, verbally abusive, etc). Sometimes that thick skin that nurses grow has a soft spot.

[tahiti79]

IAM46YEARSOLD said that they are not there to take care of a patient on a personal and emotional level.

Well, that's only half true. One of the duties of a nurse is to project an attitude of compassion, and provide support and comfort to those that are ill and experience a high level of anxiety. Nursing is not just about being efficient and cold.

Think of how you would want to be treated if you were sick. I am sure you would want to have the feeling that the person caring for you was genuinely concerned about you.

[tahiti79]

After reading this topic I am a little bit disillusioned. It seems that roughly half of you are try your best to be compassionate and not judgemental, but it is the other half that concern me.

I know that nurses get frustrated like everyone else, but I always had the ( apparently false) idea that the majority of nurse were above all else compassionate.

I guess I really have a lot to be thankful for that most of the hospitals in my area ( which are some of the best in the world Cleveland Clinic ect.) do put a lot of focus on projecting a compassionate demeanor from their staff.:heartbeat

[chevyv, BSN, RN]

I think many nurses come here and post when they are stressed. It helps to vent so they can continue. Psych nursing is not for everyone and many admit it. I couldn't do surgery, just not my thing. Nothing wrong with being up front. The occasional pt is one thing, but daily is difficult. Try not to be so disenchanted with comments made here. This is a place to come for support and to vent so the day to day can go on.

[Farmer Jane]

I'm judgmental and don't feel bad about it. I'm not an angel. I'm an educated professional and I will provide quality nursing care whether or not I like that particular patient. I am under no obligation to be all warm and fuzzy and hold them in high regard.

[CountyRat]

I have worked critical care and psych. I have also worked in police jails, providing nursing care to arrestees. (yeah, I do have trouble deciding what I want to be if I grow up, but anyway . . .) While working with mentally ill adolescents I had dinner with an old nursing school buddy who is a psych nurse lifer: Masters in psych nursing from Yale, runs an adolescent psych ward, the whole deal. Really great guy to. Anyway, I was confessing to him that I had doubts about my ability to be a good psych nurse, because I could not remain objective. Specifically, when I met the parents of some of the kids I was caring for, I would get so angry that I had to bite my lip to keep from laying into them. I was ashamed of my judgmental attitude, but I just couldn’t shake it. I figured that it meant I was not a good nurse. My friend listened patiently (did I mention that he was a psych nurse?), looked at me, and asked, “So? Why is having that feeling a problem? How do you think you are supposed to feel when you meet someone who mistreats a kid?” “You mean, Its O.K. for me to be mad at them? That won’t keep me from giving proper care to my patients?” “Of course not!” he replied. “When you no longer feel angry in the presence of an abusive person, whoever that person is, THAT’S when you need to get out of nursing.”

It was a bit of an epiphany. This colleague who I so respected, was saying that having a normal, human, emotional reaction to other people was O.K., even on the job. Of course, I had to control my behavior, but my feelings did not make me a bad person. (Did I mention that he was a psych nurse?)

Well, I do not do psych nursing any more. I liked it, but it is not my strong suit. I changed to a nursing specialty more suitable to my personality. However, I have never forgotten that evening, or what he said. So, let me try to pay back my debt to him by passing some encouragement on to you, my brothers and sisters in this noble tradition: When someone is killing themselves one day at a time, you are going to feel angry. When someone refuses to do what they need to do to obtain better health, you are going to feel frustrated, and question the value of what you do. And, when someone curses at you, hits you, spits at you, lies to you in order to get from you what you should not give, and tries to order you around as though you were stray dog, you are going to have strong, negative feelings of fear and rage. THAT DOES NOT MEAN YOU ARE A BAD NURSE! It means you are human. And it does not mean that what you do for that unpleasant person is a waste of time.

It DOES mean that your hard work will go unrecognized and unrewarded, and that is unfair. You are being robed of the respect you deserve, and the person mistreating you is wrong to do that. Judgmental? Yes, it is. “Judgemental” means that you have standards about how people are supposed to behave, and you feel outrage when people violate those standards. You judge them as rude, or mean, or dangerous, or whatever. Why is that a problem? It is good that you have standards. It is good that your standards are important enough to you that you feel offended when they are violated; that means you are a decent person. Judgemental? Angry? Why is that a problem? “When you no longer feel angry in the presence of an abusive person, whoever that person is, THAT’S when you need to get out of nursing.”

Be well, my friends, and be gentle with yourselves and each other.

[Tweety, BSN, RN]

I'm judgmental and don't feel bad about it. I'm not an angel. I'm an educated professional and I will provide quality nursing care whether or not I like that particular patient. I am under no obligation to be all warm and fuzzy and hold them in high regard.

I think there's a difference between having judgements and having prejudices. I'd like to think all humans are worthy of high regard and not being prejudged of being a certain way because of their lifestyle. But when you prove me wrong with your abuse, manipulations, etc. I'm going to judge you. I have feelings too.

Too many nurses look at a patient a write a story about them in their head without knowing them and attach labels. Those lables "drug seeker", "alocholic", "gang member", etc. comes with a whole set of prejudices.