The past couple of weeks have been an emotional roller roaster. Just as I was starting to feel like I was adjusting to my job, I got slammed with visits from the Bad News Bears. And boy were they mean.
Last week several of the clients I have been working with most intensively started spiraling downward, and all at the same time. This week one is in the ICU and may not survive. Another is in the hospital and cannot safely be discharged home. Another is giving new meaning to the phrase “one step forward, two steps back” thanks to severe mental illness…every effort I make seems to blow up in my face. And today I stayed late to call 911 on a client experiencing dangerous medication withdrawal.
Not only is my confidence as a nurse shaken (who wouldn’t second-guess their skills with this seemingly black cloud following them around?), but I find myself emotionally drained as well. I have always struggled with shouldering too much burden and taking too much home with me at the end of a work day. When I worked in the PCU, I had nightmares about missing meds or forgetting to document something critical, and could not get the sound of beeping IV pumps out of my head.
Now my nightmares are of a different sort. Even when you set boundaries between yourself as nurse and your patient as consumer/client/call them what you will, community health nursing often calls for an emotional investment beyond what I ever experienced in the hospital. I visit people in their homes, am invited to meet their families and neighbors and walk beside them through long-term struggles. So when clients are found down or have poor outcomes, my own distress is multiplied. This is personal.
My co-workers have noted the emotional exhaustion and we’ve spent considerable time debating the ever-present emotional conundrum: Is there such a thing as caring too much? How do we stay human and do our jobs effectively? What do we do with the pain and suffering we see….where do we put it so that it doesn’t eat away at us? Is the only choice really to care too much and have a breakdown or not care enough and lose your humanity?
What do you think?
3 comments
1 ping
Dee says:
April 21, 2011 at 6:05 pm (UTC -8 )
I swear I am going to be the same way. Nursing school starts in two weeks for me but deep down I know I am going to be so emotionally drained working with patients…it’s just the way I’m wired. Too bad there isn’t an off switch but what would nursing be without overly caring nurses? I guess you just have to keep reminding yourself that you are doing your best and that’s all that matters and that dying is still a part of life.
Sarah says:
April 28, 2011 at 1:56 pm (UTC -8 )
Absolutely. It’s called compassion fatigue. We all experience it at one point or another – you need to find constructive ways to deal with it or it will eat you alive though. I only lasted a month in the NICU – I went home every night and cried. At the end of the month I knew that I wasn’t cut out for that. I now work on the inpatient cancer ward and I find it incredibly life giving to help people through some of their darkest struggles.
There are some really good books out there on compassion fatigue. Some hospitals are offering workshops too.
Good luck!
Karen Harrington says:
May 7, 2011 at 4:27 am (UTC -8 )
I don’t think it is caring too much, but how you cope with the caring. I remember when Daddy and I were first married, the phone rang at all hours and he brought lots of tension home with him. I think he just learned to care, but to set limits on himself and on his patients. Just a thought, maybe Pam would be a good resource for you. She cares tons but I imagine copes well with the stress. She certainly gets involved with her patients. Good luck Tiney, your patients are lucky to have you!
Change of Shift – May, 2011 // Emergiblog says:
May 31, 2011 at 9:44 am (UTC -8 )
[...] community and finds the nurse/patient connection just as strong. So strong, in fact, she wonders Can You Care Too Much? Where do you draw the line? Posted at The Makings of a [...]