do you know what's sad? when i'm drowning at work and trying to keep 5 people alive and well (one of them being myself), i get real bitchy real fast. i distantly remember the days when i had infinite sympathy and patience. i don't know where it went. it wears me out, doing and saying the exact same things 12 times a day, always having to convince people that i do know what i'm doing and may be able to help them feel better. i'm exhausted by it.
i feel like i have had one patient my entire nursing career. i keep telling them they need to get out of bed and they don't want to. i have to try to convince them that the oral pain meds really will last longer than the IV stuff. you need to do your IS, no you REALLY DO NEED TO DO IT, because you will get pneumonia with all those rib fractures. but it's not just one person, it's dozens. the same thing every day, the same discussions, the same arguments, and the same moment of realization that they come to when they discover that doing all the things i'm telling them to is making them better after all!! shock!! and then they get discharged and we're back where we started, with another version of the same patient that thinks that it's a good idea to lay flat on their back with all the lights off and their head under a blanket and feel really really sorry for themselves instead of doing the things that they need to to get better and get home.
i hate myself for thinking about people this way. i feel like i'm a monster. i used to be a REALLY nice person, and this job beat that out of me. in the beginning, i had so much empathy that i almost couldn't function. i really felt bad for people, and i cried all the time because it was all so sad. i could not do my job like that. i came to the point where it was quit or suck it up, and i sucked it up.
but i'm mean now, sometimes. and i feel heartless. and i have a low tolerance for a lot of things.
yesterday my patient came in with multiple rib fractures after a car accident. she moaned in pain at everything, despite frequent IV meds. everything hurt, whether i was flushing the IV, washing the blood off her hands, or doing something that really did hurt like helping her turn. she insisted that the head of the bed be completely flat and would not even attempt to sit up. she nibbled at crackers, but would not actually eat because she was nauseated, but then said that she couldn't take pills because she had an empty stomach. she complained of 10/10 pain, but would promptly fall asleep after meds. then she would wake up and start shaking and writhing in bed and her family would come to hunt me down. the IV morphine wasn't giving her good pain control (and made her sick, like everything else), so i wanted to change her to orals. of course the order that i had was for oxys, which was one of a list of 3-4 meds that she couldn't take because "they make her sick". so i went to talk to the resident. i was fed up, and said something sarcastic like "i want you to give her something to put her out". and the doctor just stared at me and was all "i'm not putting her out". that's when i started to feel like a horrible person, because a good nurse would never even kid about something like that. and that resident probably still thinks that i wanted to snow that patient. which i didn't. i wanted her to have something that worked, that would make her feel better. I wanted to feel better, by helping her.
but no, instead i had to get all mouthy with the resident and say stupid crap like that, and of course then she thought i was crazy angel of death nurse and didn't want to give me anything i asked for, including the ativan that i really thought would help with the patient's anxiety issues. and first i hated the resident and glared at her and wanted to strangle her neck. and then, instead, i kind of hated myself a little for being an awful person and saying mean, hateful things and putting myself in the position of having doctors think that i am evil and crazy.
and then, this morning, i read this amazing post by one of my favorite nursing bloggers, and i started to feel a little better, just a little. but that's a start.
maybe today i can go and be kind and loving and sympathetic towards people. maybe i can be more patient. maybe i can cut other people a little slack, and maybe i can cut myself a little slack too.
There is something to be said about being a good patient too, I've been so lucky to have had over 30 procedures and or surgeries, something I learned after the very first one, get up, get moving. The nurse told me, "laying in the bed like you're in a coffin is only going to get you there faster" Getting up and walking gets that damned catheter out sooner, gets you home sooner. I would tell my roomies how to recover to get out faster etc etc. Hospital is not a hotel, and I rarely ever hit the call bell, except when my IV infiltrates (common for me). In the hospital, as in life, you get what you give. Chances are little Miss McRib was probably a whiny spoiled brat on the outside too. Yeah, the IV pain meds bash the pain away instantly, and give you that rush that some people like, but they fizzle out quickly too. Live and learn, some people have to find out for themselves. Hang in there, for every Miss McRib you get you will eventually run across pleasant and friendly. Hell, in septic shock, in the ICU I felt guilty that the nurse was there every time I regained consciousness. I didn't know it was 1 on 1 care there, or that I was THAT sick. But I smiled through my pain and made jokes as best I could. When I was transferred out to the floor, I overheard my ICU nurse say that the nicer I got, the more I tried to make her laugh, the worse off I was. The floor nurse was like "can we keep her forever?" The gist of this ramble is to say that don't feel bad for venting, it isn't all your fault. I should write a book on how to behave in the hospital :-)
ReplyDeleteI'm in love with the idea of making posters that say "laying in bed like you're in a coffin only gets you there faster" and hanging them up around the unit. Thanks for the encouragement.
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