Our patient population is tough - many people with chronic health problems but also lots of (too many) people playing the system. They're demanding, most likely drug seeking, malingering.
I find myself driving to work telling myself I'm going to give my patients my best. Then I'm assigned some frequent flyer who either shouldn't have been admitted or is back because they continue their self destructive behavior or they've been totally non-compliant. And I could deal with any of that (I'm not a perfect person and I don't do everything I should most of the time) but they're so manipulative. And demanding. I hate the drama. I feel like I'm running up and down the hallways all day, administering PRNs to people who tell me they have 10/10 pain who, while they may have some discomfort, are nowhere near 10/10.
I know I'm teetering on the edge of burnout and I do have some time off scheduled. Meanwhile, how do I find a way to compartmentalize my frustration and anger? I need to find a better way to cope with this now and after my very much needed vacation. I know many of you struggle with the same frustrations. How do you keep it from eating at you? I'm tired of being tired and angry.
Specializes in Mental Health, Gerontology, Palliative.
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But I still find myself getting pissed off that I pay into a system that these losers milk to the very bone. I work my ass off, and they don't do anything. I've never utilized government benefits, but if I ever needed to go on welfare or get food stamps, I would be hosed. Benefits are denied to so many who do need them and at the same time you have these losers who also have a damn Samsung, while taking benefits.....
At the start of 2014, I had a fall which amoung other things ended up in a compression fracture in the vertebrae. I ended up needing a solid three weeks off work and then a further 2 weeks to rehab back into my job. In that time, my bills continued to be paid due to the system which I paid into.
I don't pay into the system so that I can get something back. I do it so that if something happens like it did to me in 2014 I dont have to end up homeless because I have no money to pay for anything.
We have people here who absolutely IMO rort the system. I've worked with clients in the past who bring home more in benefits that I did working a 40 plus hour week. That said, the system also protects those who will never be able to work to support themselves such as those with intellectual and physical disabilities. IMO we have a moral obligation as a society to care for those who will never be able to fully participate in the economic market place.
The things that you are angry about, can you change anything?
If not, choose not to be angry, choose to spend your energy on the things you can change. And before you accuse me of not knowing what its like. I used to be an incredibly angry person until i realised the futility of being angry about things that I could not change. Its far easier to spend my energy on changing the things I can actually change.
SO I am not a nurse yet, but I worked at the Department of Families and Children Services (CPS and Foodstamps). You have to remind yourself that they are doing what they know, the best that they can with the knowledge they have at the time, and that you may be the only pleasant or nice person that they see. Some are just jerks, but you never know what led them there. Never lose hope that maybe tomorrow they will find their own hope. Do your job to the best of your ability and show compassion without hesitation. Also, never forget that Karma will take care of all that pent up anger and resentment. If all else fails, resort to alcohol and a good laugh.
^^^ALL DAY.
I have been in those shoes; I've had to get on welfare and even had SSDI....spend a day in that office as an educated individual and how they treat people that have nothing, and you will not be a person with sunshine and rainbows, especially when you basically lose your livelihood and it plays on the human psyche, even with the BEST coping mechanisms.
There's a reason these agencies have ombudsman; the people use it, and then when they have to go not another establishment, they are quick to complain, not realizing that people are trying to help them, and even then, they have the right to self-determination.
I have been been fortunate to not experience burnout-much more so since I returned to nursing after my own life after welfare because it made me more in tune with the reason and rationale of people's coping and behaviors regardless of them being on welfare or wealthy, sane, pretentious or mentally health needs. Many people want to feel powerful or empowered, and many people feel less so; I utilize all the information I learned in my mental health rotation; put in perspective by setting a tone of planning and making plans and working a plan (almost like a life coach perspective) as my limit setting, and for the rest, well, I treat everyone the same and usually have no problems even if pts refuse or have pushback, I document and move on to the next thing, cash my check and get to travel, and have the freedom and flexibility to enjoy my free time.
Another reason son why I have been fortunate to not experience burnout is that I always had side job in another setting, whether it be lower paced or a different specialty, it worked out well for years!
Maybe I'm the exception to the rule but I don't really mind drug seeking patients. Generally all they want is their Dilaudid (or cocktail of choice) every 4 hours or so and as long as it's ordered and appropriate I'll give it without any issues. I make them request it, I don't turn PRNs into scheduled meds, but once they ask I don't keep them waiting long. I find this keeps them calm and they don't give me a bunch of crap about it. I don't like it or agree with it, I feel for them and hope they get help, but I'm only there for 12 hours and am not looking to make my shift any harder than it has to be. I do make it clear that I'm not interested in watching them put on a show nor am I going to participate in the histrionics of it all.
Ultimately I'd like to see the system get fixed but right now it's totally out of control and stressing out over it each and every shift won't change anything. The doctors are going to continue to admit these patients and order the meds; you have to learn to pick your battles.
"One of the things that has helped me the most is journaling."
Thank you for posting this response. Reflective practice is a part of nursing because we need it, and I'm glad to hear that some nurses get that. When language that I've been reading in this thread like "pathetic" and loser" become an accepted part of our speech, we're in trouble both professionally and as human beings. Words easily become actions.
I agree with everyone who has posted that certain population groups can cause compassion fatigue. Reflective practice will help you assess your needs such as the self-care strategies you mentioned (dog walking).
I believe that reflective practice is a discipline-I like to flop down and chill after work, not rehash what bothered me about the day. However, when I spend a little time on reflection, I always wind up with better tools to deal with the next challenge.
I LOVE your idea about writing it down and burning it!! what a great way to exorcise the dark stuff!
You seem like someone who "absorbs" other's emotions. Meaning your allowing your soul to be sucked little by little by taking a bit of each patients emotions around with you. I user to be like that with everyone, not just patients. It drained me. I had to learn how to remain empathetic but not take away with me the anger and frustration many patients and their family experience. I do have to remain detached but not so much I am not sincere and I kill the patients who are impossible to please with kindness. It sounds so Pollyanna I know, but when your being genuinely nice and helpful to a patient who is being a genuine turd, 99% of the time I've either had a family member tell the patient to chill out or the patient themselves apologize. Now, I have no experience in the hospital, I have worked with several different patient populations and its worked on all age groups. The small amount of patients who keep being ridiculous after my kind shoulder I brush off. I take care of them to the best of my ability but I do not allow them to influence my life or job. If you can do that, you will be good. Plus make sure you are taking care of you!!!! Get yourself a pedicure, new shoes, whatever boosts your spirits when your feeling burnt and crispy.
I agree with do job, count money. Don't take anything personally. DON'T run down the halls! Walk at a steady, reasonable pace. Have a pleasant, detached manner.
Just think how great your life is compared to a pathetic frequent flyer. They have nothing positive going on in their lives other than bad habits and milking an enabling system. It's sad.
STAY DETACHED! You are playing the role of concerned nurse. Play it well!
I count my blessings which have been bountiful and see these folks for the broken people they are. I have thick skin and broad shoulders when it comes to things like belligerence and manipulation. Give me a dying or fatally injured child and that will take me out at the knees.
We all have our non negotiable limits. I left patient care because in my service area I was starting to get parents who I used to sit with at the soccer fields dying of cancers. One of my kids' best friend's mom died tragically under my care. That I couldn't continue to do. I could care for the grandparents but not this younger generation. I knew in my gut that I had to leave it.
If manipulative patients are your limit and all of the good self care in the world doesn't manage your perspective then don't stay there, seek out a different patient population. You can never get completely away from whatever is your kryptonite but you can get it in smaller more manageable doses.
Can I recommend a book that has helped me better deal with challenging people and situations? The Outward Mindset.
Tenebrae, BSN, RN
2,021 Posts
At the start of 2014, I had a fall which amoung other things ended up in a compression fracture in the vertebrae. I ended up needing a solid three weeks off work and then a further 2 weeks to rehab back into my job. In that time, my bills continued to be paid due to the system which I paid into.
I don't pay into the system so that I can get something back. I do it so that if something happens like it did to me in 2014 I dont have to end up homeless because I have no money to pay for anything.
We have people here who absolutely IMO rort the system. I've worked with clients in the past who bring home more in benefits that I did working a 40 plus hour week. That said, the system also protects those who will never be able to work to support themselves such as those with intellectual and physical disabilities. IMO we have a moral obligation as a society to care for those who will never be able to fully participate in the economic market place.
The things that you are angry about, can you change anything?
If not, choose not to be angry, choose to spend your energy on the things you can change. And before you accuse me of not knowing what its like. I used to be an incredibly angry person until i realised the futility of being angry about things that I could not change. Its far easier to spend my energy on changing the things I can actually change.