Wednesday, August 15, 2012

Compassion Tap Out

Well, I sort of alluded to this a few posts back but some fuckery Nurse K has been showered in lately got me thinking about it a little more in depth.  You can get the full recap here, but the highlights would be 1)Nurse K posts about an shutting down some verbally abusive chick who is obviously drug seeking in a hilarious manner 2)Hijinks ensue when some spiritual healing jackwagon tries to lecture her for not having compassion for the poor drug seekers omegerd.
Fill a number of things into the drug seeking blank and you have the life of anyone who has blog about being involved in any type of medicine ever. One lovely reader a couple of months ago felt the need to go back into my archives and comment on any posts where I talked about making mistakes to call me a "dumb whore", including one in which I was  distraught about an abused child who I had cared for later dying, because I dared admit that I did not always think about the implications of laughing at the poor spelling and grammar on our check in forms. MMkay. Declined to publish all those, but you stay classy now anyway anonymous lady/dude/troll.
Anyway, as I've also talked about before, we may seem to the outside world like we don't care about a lot of shit.  I just want to clarify that it's not so much that as it is that it is absolutely imperative to our sanity and survival in this field that we are selective about what we care about.  I can't for sure speak for anyone else, but I can at least say for myself that I started blogging to work out a lot of tough feelings I was having about what I do.  But no one wants to read all that shit, because it's depressing, so occasionally I throw in things that happened that I found funny at the time. Sometimes the funny and the frustrating and the sad shit overlap, because you know what? When I really think about what I actually do every day, I see a ton of really, really sad shit.
I think the perception of the sad nature of the ER for a lot of people is basically "people die and that's a bummer".  Dude.  That's just the tip of the iceberg.  We see much, much worse.  We see victims of rape and violence, sometimes children, who are completely vulnerable and suffering for absolutely no tangible reason.  We see broken, frail, neglected elderly people covered in sores and wasting away forced to live in pain every day because their families who have forgotten them for years won't let them escape it until their heart fails after weeks on a ventilator. We see people unable to clean themselves or talk after a stroke who are perfectly aware of the world around them, trapped inside their own bodies, watching their families  carry on without them. People wasting away from cancer in horrific pain. Formerly happy, healthy individuals who now live in a completely different world than the rest of us because of mental illness.
Beyond the surface, there are so many more sad stories.  I talked to the sweetest elderly man recently who was telling me about how he lost his house after a prolonged illness- his only option was living in a nursing home which didn't allow pets, so he lost his dog, which was the only thing he cared about.  Seriously.  ALL he wanted was just to see his dog, and he was incredibly depressed because of how much he missed her. We bonded as I was talking to him about my dogs, and I was full on snotty-nosed bawling by the end of the conversation.  So many things will break your heart if you let them.
Nursing is awesome but at the same time, it's also one giant parade of getting bitch slapped with sadness. Depending on your personality, I think we live in a world where it's pretty easy to completely drown in the sorrows of others if you let yourself. There are nights where I sit up alone and think about how much suffering there is and how little I can actually do about it and weep at the pointlessness of what I'm doing in the world.
Point is, if we looked deeper at a lot of the situations we poke fun at, we would find, yes, even more sadness.  Is drug addiction awful and tragic? Absolutely.  Is the general level of education among the people I see in fact a huge downer and a symptom of a bigger problem that is overwhelming to even think about? Hell yes. Are the zany things our homeless patients do probably a sign of a much greater problem which without a doubt, is worthy of tears on it's own? Certainly.  It's not that we don't know these terrible things lie under the surface.  It's that we aren't digging under the surface because one person can only feel so much sadness in one day without going absolutely bat shit crazy.
Some people say that people like us, who laugh at some of the things we laugh at, are a disgrace to the field and we should do something else.  People that think compassion is not a limited commodity and that you don't have to save it up.  I'm telling you that's bullshit.  If you only want people with bottomless compassion to take care of you, stay at home and pray for healing instead of going to the hospital, because I'm pretty sure the only person with limitless compassion who walked the earth was Jesus. Right or wrong, I'm saving mine up for the people who seem to need it the most. I'm perfectly willing to admit I'm not always right on who fits that criteria.  But I'm also pretty confident it's not the girl calling me a bitch while asking for Percocet either.

30 comments:

  1. People who read someone's blog, then complain about it, aren't worth your time. They're like those who complain about TV shows-hey,if you don't like it, don't read/watch it! We have to be able to express ourselves without being judged by people who haven't the slightest idea what we're experiencing.

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  2. The only people who truly understand this whole thing are other nurses and doctors. I'm here to do a job- mainly saving your life, if I let my emotions rule me in my job I won't be able to do it, it's that simple. I too feel bad for the elderly woman who died from a car crash because she wanted to get her grandson ice cream, or the woman whose boyfriend beat her into insensibility,or the 20 year old who fell from a rock climb and might never wake up, but if you are a rude pain in my ass who can't appreciate the fact that I'm here to help you, well, we all make choices, and you chose to be an ass, so I'll conserve my energy when it comes to you.

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  3. I spent a few nights across the hall from a med seeker when I was hospitalized for peritonitis a few years ago. you know what doesn't help you recover? hearing someone moan "someone help me AAAAHHH" over & over again while you're trying to sleep.

    you guys are doing God's work, & if some trolls can't understand that you occasionally need to vent about the frustrating--but not truly heart-wrenching--aspects of your job, then screw 'em.

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  4. Thankyou, Thankyou, Thankyou...

    This was such an insightful posting.

    I used to joke that a huge part of Nursing (especially in the ER) was acting as a grief sponge, supporting people in what might be the worst moment of their lives. Put that grief down deep, and always show compassion.

    A ten year nursing career in the Emergency led me into that deep well and I almost got lost in it. It has been almost two years since returning to work and I don't let myself get as attached and involved. Some days I feel like I am less of a nurse because of this.

    Thankfully I am able to recharge during my parental leave. After this experience I was able to reevaluate my priorities and look forward to moving on.

    Keep writing and releasing the grief. Shaking our heads and laughing helps us all step back from the brink...

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  5. Retired LPN here. I found it to be true, without exception: Those who laugh the hardest, cry the hardest, are irreverent at desperate time, also live the fullest lives. Those health care workers who are employing sarcasm or pointing out absurdities to mentally cope are the sort of people who would reach across the aisle of a burning airplane and haul your butt out with them, without even stopping to think. They're the ones who risk contaminated needle sticks to wrestle down delirious patients. They clean up indescribable messes and deal with intractable pain because someone has to do it -- and they're up for it, rather than turn away and say "I can't cope." They're the ones who buck the system and say "Fire me later. This person needs help right now." when they system fails. When there's "nothing left to do" they stick it out and don't let those helpless people die alone and in pain.

    I know who I'm trusting my life and that of my loved ones to: The doctor who just cracked a butt crack joke. The nurse who "Fa-la-la-dia-la-la-la's" her way down the hallway to a drug seeker. You just talk different in the trenches, that's all.

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  6. Nursing is still just is a JOB. Most of us need them, so we can't afford to go off on the idiots that make that job so much more difficult. We also can't cry at every sad event and definitely hoard the empathy. Those of us who blog or write about our experiences often do it because our family just can't hear any more venting. It makes for a better nurse and saves the family.

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  7. Oldy Moldy nurse here, ED and ICU for 27 (egads) years....I follow nurse blogs as it helps me to remember why I am still a nurse and that the conflicting emotions I feel on a daily basis are valid. Keep doing what you do, keep caring when you can and blow off the bullshit. You all rock my world, every day.

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  8. You compassion lacking bitch!

    Just kidding. Congratulations on one of the best posts I have read in a long time - you really should submit to a journal. Have you read Militant Medical Nurse's blog? It's gone quiet since she moved back to the U.S. but the archive contains many brilliant insights into the shit a nurse has to see/take while still remaining a professional.

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  9. I don't know much about your system - nothing from personal experience - but I do know after a lifetime of me working in/being married to/being a mother of multiple someones in the UK health system: you develop a very different sense of humour. As a defence.

    If those who have never been there don't like us expressing it - use the on/off button people. Don't come here. EDN says it - you can't bottle it up and you can't bury the family in it or you'd all be needing the psychiatric unit pdq. Even close family who live with you don't always get it if they work in an unrelated field. Heck - my son-in-law doesn't get it, my daughter is a nurse, he is in the ambulance service. But he isn't frontline, he's manglement.

    Many of us come here because we DO get it - and want to offer our moral support to the people who get it in the neck day in day out. Leave us to our desire to do that please.

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  10. Well said. I remember as a pretty new nurse getting sucked in to the drama and sadness of a patient with a hx of cancer, having horrible pain yada yada yada. I came in on my day off to accompany this patient to an open MRI because of anxiety issues. Then found out there was not a damn thing wrong with him and he was just drug seeking. That was a great education. Yes, like you I tend to save much of my compassion for those who truly can't help where they are and often have a hard time with those who hurt everyone around them with their addictions. Yes I have a bit of a twisted sense of humor that lets me see the humor in situations that would likely otherwise leave me broken. I'm also a great nurse. Maybe not an opinion shared by every single patient but to the majority.

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    1. For whatever it's worth, I don't think I've read anything here that hasn't made me believe you're anything less than an excellent and compassionate professional who does their job well.

      Drug seekers are the bane of the medical world. They waste the time of medical staff and they make it more likely that those who actually need help may not get it. I can completely understand the frustrations and the lack of tolerance (no pun intended) towards their behaviors.

      For whatever else it is worth, I think Nurse K is a self-involved nitwit who should get the hell away from patients. I read her posts and I get PTSD-like flashbacks to the very, very few horrific nurses I've had to deal with. I've shown some of her posts to RN friends of mine and they have been equally (if not more) horrified. She considers so many people worthy of her scorn it's sad and pathetic. If I thought more ED nurses were like her I'd die before ever going near a hospital again.

      Karma comes around. If someone makes posts that constantly belittle everyone, eventually people are going to belittle them, too.


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    2. Yet you still go over to Nurse K world and post. Uh why?

      And in general if our friends showed us something we knew they were horrified about, we generally get all "horrified" with them, no matter what we think cause they are our friend.

      In general the horrible nurses to patents are usually just horrible people. They don't have a sense of humor, they aren't funny and they certainly don't write blogs trying to blow off steam. They don't care if they treat people like crap so why bother venting?

      I pretty much agree with everything I have read over in Nurse K world. Because it's true. Now I know you don't personally believe it's true, but it is. And my patients would never know I felt the way I felt because I can actually seperate my feelings from my job, which a lot of folks who don't do this for a living simply canNOT do. I have to or I would have long since gone off the deep end.

      So to end my rant, you keep going to read and post on someone's blog that you hate, why?

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    3. The only time I ever read Nurse K's site is when someone recommends a post there. Even then I always think twice, because I always wind up reading something that is just so blatantly offensive I want to throw up.

      FWIW, my problems with this "Nurse" came long before I ever read her 'blog'. She commented on another blog I read about a post where a father took his disabled 7 yr old to a shooting range and helped her to shoot a gun. Her problem wasn't with the gun, or that it was a child. Her problem was that the child was *disabled*. She made it clear that she believed that disabled people should not be trying to act like "normal" people and that the father helping his child do something any other kid does any other day was, to her, something akin to child abuse. And, of course, as always, anyone who disagreed with her is a "crazee."

      As for nurses separating their feelings from their jobs: I believe that most cannot. From what I've heard and read from others, as well as my own experience, patients can always spot the Nurse K's on the job. You may think we don't see your little expressions of disgust, but we do. You cannot hide lack of compassion.

      Fortunately, for every horrific tale of a nurse with no compassion I can tell you tales of 10 who have it by the gallon.

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    4. Regarding nitwits, for the record, I'm not the one with a spoon on my face.

      And, yes, call me insane, but five year olds (she was five at the time) with cerebral palsy and difficulty moving an arm/hand shouldn't be operating deadly weapons. He indicated that he was letting her do all the work with verbal encouragement and a little stand. Yes, that sounded dangerous to me. Pardon me for expressing concern. If you can't hold a gun, I just don't think you should be shooting it. Sorry.

      At my work, don't worry, I don't hide my disgust because I say very clearly, "You need to speak to me in a respectful tone of voice. When you can do that, I'll be back." Amazing how people STFU right after I come out with that.

      I don't let that shit go. Don't worry, I'll call you on your abusive behavior right away. No secrets. If you treat me with minimal respect, we're good to go. Call me a fucking cunt when you don't get opiates, well, you can just wait while I see the quiet, dying little old lady who doesn't want to bother anyone.

      As Hood Nurse said, you can't let yourself be walked on and get treated like shit or else you won't have anything left for the truly ill. I do just fine at work, but thanks for your spoon-nosely concern.

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  11. I appreciate this blog a whole lot and this post a whole lot. I've been an ICU nurse for a little over a year now. Some people think the sarcasm and laughter is irreverant and yes sometimes it is but if we felt every emotion that a certain situation "warrants" the average time before burnout for a nurse would be three shifts. thank you for your honesty. reading your blog helps me destress and laugh. it helps me to know that there are other people out there who feel the same way as me. press on sister! press on!

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  12. Preach!

    I gave report the other day to the oncoming nurse and was relaying the patient's sad and complicated history and the fact that a DNR/DNI would probably be signed during her shift and she sighed and goes "Really? Ugh. I just don't feel like giving compassionate care today". Did I judge her? Hell no. I fist-bumped her.

    Compassion is not bottomless. We see sad, ugly things EVERY DAY. If you let yourself feel the emotions tied to all of them, it will kill you. You won't be able to do your job.

    I was relaying a poop story to my husband once and he was flabbergasted. He was like "Dude. You have to worry about seeing other people's POOP when you go to work. That is SO foreign to me." He was laughing because he can't remember the last time he saw someone else's poop, let alone had to get all up in it.

    Bottom line: We deal with things in our job that are completely foreign to most people. We see things they'll never see. People that aren't in the trenches with you have no right to judge you for how you deal with it.

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    1. Hahah that's so true. Sometimes when I'm doing something completely disgusting in the ER... Which is basically errday all day... I just shake my head and laugh at how ridiculous the job is. But I love it!!

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  13. Nurse in the hood - you're great

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  14. I'm a nursing student and my mom is a medical assistant. So we have some pretty weird conversations.

    Nothing quite as funny/sad as her telling me about the doctor that had a heart attack and died during a pap smear. There were quite a few jokes tossed around the office the week after. It's part of coping and anyone who doesn't understand isn't there and isn't dealing with things that a lot of people just pretend doesn't happen, or won't happen to them.

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  15. I'm not in the medical field, but I love to read the ER nurse blogs (yep, Nurse K's included - she's one of my favorites). You all have an amzazing gift, and I think a part of that gift is having a great sense of humor - it's a natural way of dealing with the horrible things you see and deal with. Like the other commenter said - don't like it? DON'T READ IT!

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  16. I was recently scolded for laughing outside the ER after a fairly traumatic call (I'm a paramedic). People don't understand that sometimes if I don't laugh at things, I'll end up in the fetal postion crying. If we can't laugh we will end up in a very dark place indeed. I think knowing and recognizing why we have these reactions is the healthiest thing we can do as health care providers. Kudos for speaking up about it and don't let a few bad apples curb your laughter, they probably don't have what it takes to do our jobs.

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  17. There will always be some miserable, disgruntled fucktards who wants to bring you down in order to make themselves feel morally superior before returning to their shitty lives. Do not engage them. Let them wallow in their own filth and frustration. Keep up the good work and keep blogging. I come here for the comedy and reassurance that people as completely worthless as the ones that you describe exist beyond my coworkers.

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  18. You are totally right. It's not just the patients that drain our sanity, it is also hospital administration with their notion to save a buck by understaffing yet demanding more that pushes us to the edge every shift. Our only release is to find the humor in a difficult situation. I know why most people are not nurses...they would never be able to handle it. I love your blog and will be heading over to check out Nurse K's blog soon.

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  19. you are absolutely right! I have been an ICU nurse over 5 years and now I care for injured soldiers overseas. do i make innappropriate jokes? yes. do we nickname people and pull pranks on our co workers? yes. do we detach ourselves as much as possible? absolutely its the only way to cope and continue doing our jobs. people outside of the profession will never understand; so dont waste your time worrying about explaining it to them. keep your head up you rock!

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  20. Hey girly, I hear you on this one. I just wrote a blog about this same thing recently. One has to wonder if you lose touch with humanity and compassion, simply as a result of the things we see and do in our profession.

    Know you certainly aren't alone, and I think these feelings come and go. Hang in there, burn out is rough... someone recently told me that the only way to prevent burnout is to focus on the good things that we are able to do and weigh the bad things with half the value (even a quarter but I doubt that for many of us that that's possible) and you'll usually come out with a postive value indicator, thus making it easier to go on. Good luck tho!!!

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  21. Amazing. Best post yet!

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  22. So true. People who criticize the morbid humor of critical care nurses are ignorant and have absolutely no idea about the horror, sadness and misery that we see day in and day out. Great post, thanks for sharing! Nurses rock!

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  23. I had never really thought about this. Wanting to help people, half of whom are decent, half of whom are awful, but not really knowing which half they're in, because you can't know (not really) which half you're in... I guess that there are a lot of ways to try to cope with this situation. If your way allows you to help people, I doubt anyone will begrudge your doubts over whether or not those people truly deserved to be helped.

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