The hardest parts of nursing?

[calivianya]

I've definitely found what's hardest for me - and it's when people really open up to me, especially ones that are not doing well. I had a patient this week who was freshly extubated and still in ICU because of heart rate instability, and I really bonded with her over the course of a couple of nights. She was intelligent and a great conversationist, a real gem among the sedated, the barely conscious, the delirious, and the detoxing patients I usually encounter. She told me that she had talked to me more in the past couple of nights than she had talked to her own family members, that she was really going to miss me when I was off work, and that she felt safe with me around. She wanted my address so she could keep in touch, but I explained to her that it was against hospital policy and I didn't want to get in trouble, but she was welcome to come up to the unit and say hello when she was better.

Maybe it's just how I'm programmed, but my patients expressing these heartfelt feelings of trust and attachment put the heaviest weights on me of all. Being responsible for someone's emotional well-being is so much more difficult for me than taking care of their bodies, and it feels like so much more responsibility. These are the types of days when I go home and can't sleep because I feel so overwhelmed.

I will be responsible for people's lives all day long, but please, please, please don't give me their hearts.

What parts of this job are hardest for you?

[No Stars In My Eyes]

I've posted this before in various threads, but for me the hardest thing is the total humiliation I feel about the fact that I. can. not. hit. a. vein. to. save. my. soul.

There are a lot of other things I am a veritable whiz at, but IV's? Fuhgeddaboudit!

[Twinmom06, ASN, APN]

the hardest part - people that come in through the ER with a simple malady - abdominal pain or a cough they can't shake and have stage IV cancer. I work med/surg Oncology and we currently have a patient - late 20's came in to the ER a year ago with abdominal pain - stage IV metastatic colon cancer. She's dying at this point (slowly), and I can't wrap my head around it. Very sad...

[trry699]

For me the hardest part has been my experiences with management and sometimes a co-worker. I love working with my patients.

[SoldierNurse22, BSN, RN]

Agreed. I have a lot of difficulty when patients are really emotionally open with me because I tend to be very emotionally closed, especially with strangers and at work.

The ironic part is that I struggle to temper my response because while I may put up a good front, internally, I'm kinda...mushy. And sincere expressions of emotion evoke that side of me like nothing else. As you might imagine, it can be very difficult to gauge my response to patients like that because of my own tendencies. Because I don't tend to show emotion a lot, when I find myself in a situation where a patient needs support, I'm not always certain of how far is going beyond the professional boundary and how much professional restraint makes me feel withdrawn and alienating to a patient in a dark place.

[lurn1234]

Hardest part has got to be when supporting patient to die painlessly or dnr with a morphine drip ect

[kiszi, RN]

Finding out my patient's devastating diagnosis before they do, and anticipating their reaction when the doctor tells them. Knowing what to say when they ask about their test results.

On the same note, knowing a patient's prognosis is very poor and realizing they either have no idea or don't understand. Trying to tactfully determine what they know to see if the doctor has explained the situation.

[Karou]

Finding out my patient's devastating diagnosis before they do, and anticipating their reaction when the doctor tells them. Knowing what to say when they ask about their test results.

On the same note, knowing a patient's prognosis is very poor and realizing they either have no idea or don't understand. Trying to tactfully determine what they know to see if the doctor has explained the situation.

THIS! Lately, I have experienced this too much. It breaks my heart walking into a patients room when I know what the CT/MRI/lab results say, but they don't know yet. I feel like I am being deceptive because I know they are so hopeful. I always say that the physician has to be the one to discuss it with them and tell them the results. I have lied before and said the results aren't back yet...

I usually ask patients, "what did the doctor tell you about your diagnosis?" Or "what brought you to the hospital?". I am always nervous that they DON'T know and that my asking will worry them.

[TheNurseyNurse]

I'm with some of the others on this thread.

The hardest part is seeing great patients struggle and lose battles.

Breaks my heart.

[Tenebrae, BSN, RN]

One of the hardest things I have encountered was arriving at a palliative patients home to find family members having a free for all and struggling with the urge to want to send them to separate corners.

Simultaneously hard and very rewarding was being able to support patients to be at home when they are in end stage.

[MissyWrite]

Supporting a patient that wants to be a DNR and is fading fast but their hospice consult isn't until the morning and they are still a full code

There is no reason to wait for a hospice consult to get a DNR order. A DNR order has nothing to do with a hospice consult.

for me the hardest thing is the total humiliation I feel about the fact that I. can. not. hit. a. vein. to. save. my. soul. There are a lot of other things I am a veritable whiz at, but IV's? Fuhgeddaboudit!

I hear you! I can draw blood with no problem and even blood gases, when I worked in a hospital that required RNs to do it. But start an IV? Maybe...if I had two more hands and x-ray vision.

The hardest part for me was simply too much to do for too many patients in too little time.

[firstinfamily, RN]

Assisting the MD with telling a terminal diagnosis to a pt and their family. I have had to do this a few times and it never, ever gets easier. I usually make sure the MD is available so that if there are any questions he can answer them, we present all the options available to the pt and also make them aware of the possible outcomes. There is still a lot of medicine that does not have a finite end and to help the pt make the best decision for themselves takes a cohesive effort between nursing and medical representatives. I hate to take away their hope, but I do not want to give them false hope.

[ceccia]

working nights/weekends/holidays/mandated overtime/in the middle of dangerous snowstorms

the ridiculous "customer service" mentality that has pervaded healthcare facilities in the US. this isn't a ******* cruise ship

the ******* insane martyr mentality - yeah i didn't get the memo that working as a nurse means i'm supposed to be a paragon of virtue, a self-sacrificing angel of mercy, who cares more for strangers than for my own life and health, who never has a negative thought about a patient or a moment of frustration, and who would never dream of being so base as to expect money or the right to a personal life.