Walking Away

The nurse-client relationship is a tricky thing. They tell you in nursing school that you should ideally be looking ahead toward termination of the relationship from Day 1.

That’s easier said than done.

When I worked shifts in a hospital I knew that I would probably never see 75% of my patients again after 12 hours were over. And I struggled with that. One of the reasons I became a nurse was to enter into a therapeutic relationship and walk beside my patients on a journey toward healing. I didn’t feel that I could do that in acute care in a way that would be professionally or personally fulfilling to me.

So I left and found a job in community health. And I found what I was looking for. I am sure as hell walking beside my clients in a way I never could have imagined. And sometimes I catch myself wondering if I am too invested in the outcomes.

So here comes the tricky question…

How do you know when it’s time to walk away?

I have a client with severe mental illness who is cognitively fine but her decisions have begun to impact her physical health. Our entire team has busted our butts to support her. Her providers have busted their butts too. Everyone has gone above and beyond. Everyone.

And we have made small steps forward.

And then giant leaps back.

It’s not her fault that she is making potentially dangerous decisions. There are days when no matter what we try, the mental illness takes hold and there is no talking sense or reasoning with her. But she’s not an imminent danger to herself (and absolutely no danger to others), so we can’t hospitalize her either.

This situation has made me wonder… Sometimes when people fall through the cracks, could it be because efforts have been exhausted and there’s just nothing left to do?

I have always been a person who has fought against the status quo. Always believed there is another solution around the corner. But perhaps there isn’t.

And that possibility just breaks my heart.

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