Where can I actually help people??

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In your opinion, is there an area of nursing where you actually help people? I mean, I know you can help people in any area, but I feel like most nursing jobs you help maybe 30% of the patients and the rest are noncompliant, drug seeking, crazy. . .and yes, I know these people need help too but I don't feel like I can do anything in the hospital.

I'm so tired and burnt out.

I lost my temper with a patient earlier this week - an A&O pt who was being a complete jerk, verbally abusive, manipulative. And I am so mad that I allowed this patient to get under my skin (although in my defense, this patient also made the nursing supervisor, two case managers and a patient advocate very angry too lol)

I feel like I work my ass off, but nothing changes, the same patients come in over and over with the same problems (SOB, acute back pain, chest pain, CHF exacerbation, AMS) Education goes in one ear and out the other. The patients don't take their meds, don't see their doctors, then come in and demand IV pain meds, benzos, cheeseburgers and coffee NOW and what do you mean I can't go smoke a cigarette and NO I don't want SCDs on or IV fluids and STOP DRAWING MY BLOOD and I want a private room NOW. We get old, very sick demented patients from nursing homes who honestly should be DNRs but instead we stick them and poke them and tie them down and fill them with ABX and eventually put in pegs and do random tests and surgeries and they linger and languish and eventually die.

I love the days I feel like I make a difference - they are so far and few between. I wish there was more of them.

Thanks for letting me rant. And I am serious about wanting opinions about areas of nursing where I could actually make a difference.

@MEDCHICA Thank you for making that post. I'm a nursing student in my early twenties. When I was in my early teens I was diagnosed as bipolar with psychotic symptoms and required multiple hospitalizations. I didn't understand my illness and hated taking my meds. Its wasn't till I started seeing a clinical nurse specialist/Nurse Practitioner who sounds a lot like you that I was able to turn around my life. It was her affection and concern that finally helped me get my life together and inspired me to become a nurse. The point of this post is just to say THANK YOU. I know your patients don't always voice their thankfulness but you are an amazing person for the work you do

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Specializes in Nurse Scientist-Research.

I work in NICU and only the oldest babies "play games". None of them can refuse treatments or seek drugs (if they need drugs, they are either in pain or having undeniable physical symptoms). But they all have parents (well, almost all). From the substance users to the incompetents to the plain scared out of their minds therefore super-controlling. . . You will not be free of the frustrations of dealing with difficult human beings unless you move to a field that doesn't involve human beings.

For all of you who work in mental health, bless you to the highest degree.

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Specializes in PICU, NICU, L&D, Public Health, Hospice.

Consider hospice, where the relationship with the patient and family is at the core of the care. The nurses develop meaningful professional relationships with the patient and family and is supported by an interdisciplinary team.

The vast majority of our patients die, but they die well. And their families are by and large immensely grateful for our professional care and concern.

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Specializes in neuro/med surg, acute rehab.

How am I helping the drug seekers? Please, tell me what I am doing for 12 hours getting them coffee, taking their verbal abuse and administering 2mg IV Dilaudid q2h? How is my referral to case management helping when they curse me out for it? How am I helping when I offer education and they laugh at me?

I knew someone would twist my words. I'm not some co-dependent idiot who is desperate for a pat on the back, however, I do enjoy the feeling that my 12 hours of hard work actually BENEFITS SOMEONE. I enjoy teaching the diabetic patient something that will help their blood sugars stabilize, and teaching the CHF patient s/s to look for and when to call the doctor and I enjoy answering questions and changing dressings and teaching about ostomy care. But, I'm sorry, if you have bad COPD and are noncompliant to doctor's suggestions and smoke 2 packs a day and come to my hospital twice a month for a few days of IV steroids and IV pain medication for your back pain and are rude and nasty to me for 12 hours a day regardless of how I act to you, yes, I have a problem with that. And if that makes me a bad nurse, then I guess I am a bad nurse.

And I have no problem with psych patients and homeless patients - the population at my hospital is very diverse and many of them are homeless and this is the only healthcare they are going to get. I try to help as I can.

Thanks for making a bad week for me even worse. I won't vent or ask advice on here again.

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"the population at my hospital is very diverse and many of them are homeless and this is the only healthcare they are going to get. I try to help as I can."

If you provide some people with the only health care they are going to get than you are already in a position to make a huge difference. I have been working in addictions for years. It is extremely difficult to change peoples behaviors, especially those who perceive that there is no benefit in changing (I find these people are the depressed, isolated and feel they have little opportunity in a clean and sober life). If you can focus less on changing the behaviors that are out of your control and focus on the interactions that are in your control it will be more rewarding. For the COPD patient who still smokes- they know they shouldn't already and you will be another preachy nurse- ask them if they have cut down before and what helped, don't impose your own solutions, use theirs. Teach them how to tell if an exacerbation is approaching (harm reduction)

Most of all these people need compassion and if they feel compassion, whether they show appreciation or not it will make a difference. I am sorry you have to deal with so much rudeness, do not underestimate the impact you have. :)

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Specializes in medical.

Hey, AlphaPig, Don't give up on all nurses.com. We are here for you when you want to vent. I enjoyed your post and felt much the same when I worked in the hospital. People can be a pain in the neck! Hang in there! There are better places in which to work.

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Specializes in Pedi.
If you are willing to leave the hospital, being a home care nurse is very rewarding. You can really make a difference in someones life by teaching them how to care for their disease and keeping them out of the hospital. Also you do alot of wound care which is rewarding when the wound heals. Of course, home care has its negatives too but it is rewarding.

I agree. I always felt like I was helping people but the big difference to me between hospital nursing and home care nursing is that I feel like I'm making people's lives easier. Being a hospital nurse, it's not like we tried to make people's lives difficult but I think by the very nature of being in the hospital, it was. Like, "Hi, I'm here to hook your child up to beeping machines which will beep all night and as soon as she falls asleep, I'll probably have to come in to wake her up and she can't eat because she's having an MRI at some point tomorrow... I don't know when that is but because it could be any time from 7am to 5pm, she can't eat." I love my current job in pediatric home care... your child needs 6 weeks of IV antibiotics and both of you will go stir crazy in the hospital. No problem, we'll teach you how to administer them and come by several times a week to take care of the labs/PICC dressing and caps.

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Specializes in hospice.

I agree with tewdles. I am a CNA and left the hospital to work in hospice. I actually have time to talk with people instead of just having a list of tasks I have to do to them. There are still PITAs, but way fewer. There is actually an opportunity for relationships and the nurses I work with like their jobs.

There is such a thing as a good death, and helping people and families have that is a unique and blessed role. Think about it.

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Specializes in Med/Surg, ICU.

Funny really. Go into the student forums and you'll find posters preaching all day long how we need more nurses who "care" and are in it "for the right reasons". Now we have a nurse who genuinely wants to find his/her niche in the nursing world (and there are many) and then led to believe by some that she isn't nursing material because she doesn't enjoy were she is working at right now. I put my year in med/surg. I had many patients like the ones described. I never felt satisfied after a shift with those types either. They obviously need help, just not what could be provided on our floor. So I moved on. Found a unit I like better. Still not perfect, but I am much happier and satisified at the end of each day. I'm closer to my niche. I find myself constantly looking for information to improve my practice and go beyond for each one of my patients. It's because I feel good about where I am. I like what I do.

To suggest that someone is a substandard nurse because he or she can't be a personal-savior-in-scrubs for these difficult patients is not productive. Nursing doesn't have to be a "suffer and turmoil" profession where only saints and martyrs need apply. I have a lot of respect for those who enjoy psych nursing. I know it's not for me and therefore I should not be a psych nurse. People who are happy with their jobs tend to be more productive and look for more opportunities to make a difference. I probably wouldn't do that in psych nursing because I would be too consumed with how unhappy I was each shift. I should not be a psych nurse. But I'm getting to be a better critical care nurse each day -> because I seek out for ways to improve my skills -> because I am passionate about my niche and patient population.

So let's help other nurses find their patient population they can enjoy working with. Heck, for some it may be completely away from bedside and thats ok. As long as they go were they are happy and motivated to put their best efforts in to what ever it is that makes them click.

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Sound like me when I left adult med-surg. I'm a huge advocate for pain control. I avoid label people drug-seeking. But there comes a point where being cussed out by alcoholics with pancreatitis because you wouldn't bring their dilaudid outside to the smoking hut gets OLD.

I went to peds. I still get burn out. Parents can SUCK! And the occasional dramatic teenage girl, ugh. But I like it most of the time.

I'd also recommend palliative care. Patient population tends to be bit less "entitled" than your typical med-surg load.

I think no matter where you work though, you have to be careful. Compassion fatigue is VERY real.

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Specializes in rehab.

I know exactly how you feel AlphaPig. I work at a LTC that houses those with mental disorders or is just an unplaceable person at any other place- usually because of accusations or violence. There are days that I spend my whole shift listening to my patients tell me how "you're not a nurse because you won't take me to the bathroom" when I just tried to and they refused to let me take them and ended up trying to kick me because "you don't know how." What's worse are those that do it that are A/O.

Then on top of that you get the ones that know what people will take their side and will come to you demanding why you refused to do care/give meds/whatever despite the fact that they refused said thing they are now accusing you of. I have met some of the most manipulative patients where I work, they know how to work you or what to say to try to scare you into doing what you know you can't do. Luckily I haven't been pulled into that (you want to get me fired, ok go ahead I'm fine with that Mr. Patient).

On top of that when you're slapped, kicked, punched almost daily along with the above abuse it can get tiring and old and burn you out really fast. ESPECIALLY IF THEY ARE A/O.

And then you have the people that want just their pain meds on the clock- even if they are sound asleep not 5 mins before when you checked on them, they have that inside clock saying "it's 4 hours on the dot, need my morphine to survive again," despite having NO pain 15 mins ago when I checked on them. It's very rare to go from 0 pain to 10 out of 10 pain in 10 mins.

I disagree with the you're not meant to be a nurse. Because I feel the same way where I work. I knew nursing wouldn't be all happy. I'm not one of those people that thought as being a nurse I'd save everyone and all my patients would be smiling and just all please and thank you and would never get on the call light.

I know patients out there will punch you and curse you out. I know that I can teach and talk until I'm blue in the face and they won't listen. I know that some people are just evil and I will see them. I know there are drug seekers and addicts.

But at the same time I know how tiring and emotionally draining it is to stay in an area you don't feel happy in. I don't feel happy in my place, but as no one will hire me right now, I'm stuck here. I still provide good care for all. But that does not mean that given the chance to leave I will stand and say "no I'm staying because I want to be a good nurse." When that chance comes I'm running and not looking back.

And it is not because I am a bad nurse, or not meant for this field. It is because I can say this is not my area. That is all. It's not my place to be abused verbally and physically by patients my entire shift.

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You can not control your patient load. But you CAN choose to be positive. Do your best and remember. We nurses are there for our patients, not the other way around. elk, I am replying because I agree with you 100%

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