Something that has been on my mind lately is how we deal with patients who are rude and uncooperative. How can we understand rudeness in our patients and their family members? I believe that the cause of these behaviors is the stress these people are experiencing. They are out of their usual environment, they feel they have no control over what is happening. Depending on their mental functioning they often don't understand what is happening either. Often their life as they knew it has suddenly been torn away from them and they have no idea if or when they will get back to it. They are expected to conform to the routines and rules of the institution, often with no consideration for the routines they have had at home. Of course they are stressed, frustrated, angry.
Occasionally, and unfortunatly much too often, I see and hear in my coworkers a lack of understanding for these reactions from patients. A tendency to react to rudeness with threats, withdrawal of care, retaliation. It concerns me, because we as caregivers are in fact in a position of power, and because of that we cannot, must not retaliate when being unfairly or meanly treated by our patients or their family members. In fact it is my experience that what the rude, uncooperative, anxious and needy patient needs is that we give them even more of our attention, listen harder, understand better, go the extra mile in caring because it is the stress and insecurity that is causing the behavior.
What is it then that causes excellent, compassionate nurses and aides to lose this perspective, and make it impossible to give the psychosocial care that is necessary to rude, uncooperative and needy patients and their family members? Could it be that this too is a symptom of stress, of being stretched thin, too many demands, too many hours. We are all trying to get through our routine tasks, as well as being alert for and react to medical emergencies and on top of that respond to our patients psychosocial crisis'. Could it be that when we as caregivers start to feel overwhelmed, our ability for understanding and compassion becomes compromised?
I too am struggling with burnout and with how to best cope with these kinds of patients. I too often just want to be left alone to do my work, and not have to deal with these issues. I'm not some sort of Supernurse, and recently, when a patient yelled at me, I just fell appart, and spent the next several hours (!) in my pod dissolved in tears, and while I was not exactly a burden to anyone, I was hardly a resource for either coworkers or patients.
Saturday, June 30, 2007
Sunday, June 24, 2007
Midsummer Nights Dream
In the morning Roland and Sharon picked us up to go strawberry picking. They had been to a wedding last week and the conversation in the car was about the meaning of marriage vows. The minister had said that the primary task for the newlyweds was to serve and take care of each other. Sharon quite rightly says no, the primary task is for each individual to take care of himself, becauses only then will he/she be able to give. I agree with this. Caring for another should be a gift given in freedom and love, not a chore or obligation. Marriage should not be about chains that tie a couple to one another, but about journeying through life together as partners, and companions.
In the afternoon we went to see the musical Beauty and the Beast. That play moves me. The themes: that love cannot be about ownership (Gascon wants to own Belle, the beast keeps her prisoner to try to force her to love him); but about getting under the other persons skin, seeing beneath the surface (Belle discovers the vulnerable, the struggling human under the surface of the beast); allowing the needs of the beloved to come before ones own desires (the beast lets Belle go even though he risks never becoming human again, because she needs to help her father).
In the evening Mother and Father's midsummer potluck and bonfire. Before everyone came we celebrated Sharon's birthday (of last week) with presents. A variety of people came to the potluck: old friends of my parents, a couple of ladies from the German folksong group, a family from the Waldorf school, there were young children and a couple of girls in their early 20's that Ingvild could hang out with. There was lots of good food: vegetable curry with rice, macaroni and tuna salad, green salad, baked beans, boiled carrots and pickled red beets. For desert there was jello with pears, strawberry shortcake, and Sharon's carrot-coconut cake with cream cheese icing! When it started getting dark, we all went to the back garden here Father had prepared the bonfire, and as it it burned we sang rounds, the kids made s'mores and roasted marshmallows. Fireflies were flitting about. And in the summer sky, the moon, Venus, and Jupiter like jewels among the other stars...
In the afternoon we went to see the musical Beauty and the Beast. That play moves me. The themes: that love cannot be about ownership (Gascon wants to own Belle, the beast keeps her prisoner to try to force her to love him); but about getting under the other persons skin, seeing beneath the surface (Belle discovers the vulnerable, the struggling human under the surface of the beast); allowing the needs of the beloved to come before ones own desires (the beast lets Belle go even though he risks never becoming human again, because she needs to help her father).
In the evening Mother and Father's midsummer potluck and bonfire. Before everyone came we celebrated Sharon's birthday (of last week) with presents. A variety of people came to the potluck: old friends of my parents, a couple of ladies from the German folksong group, a family from the Waldorf school, there were young children and a couple of girls in their early 20's that Ingvild could hang out with. There was lots of good food: vegetable curry with rice, macaroni and tuna salad, green salad, baked beans, boiled carrots and pickled red beets. For desert there was jello with pears, strawberry shortcake, and Sharon's carrot-coconut cake with cream cheese icing! When it started getting dark, we all went to the back garden here Father had prepared the bonfire, and as it it burned we sang rounds, the kids made s'mores and roasted marshmallows. Fireflies were flitting about. And in the summer sky, the moon, Venus, and Jupiter like jewels among the other stars...
Saturday, June 23, 2007
Taking Stock - a birthday come and gone
I need to start writing again. Life is threatening to overwhelm me, and I think writing will help me keep my thoughts in order - maybe also my feelings. Since my last post I have had a birthday. A little step nearer to 50, a little step nearer to old age. I think I was 33 when I first began to worry that my life might be wasted, might be lived in vain. The thought comes back now and then to haunt me, but usually I push it aside thinking "later. I'm too busy right now." But the next time it comes with a bit more force. I think I should not put it off any longer. Supposing there is a meaning to it all, I think I need to try and figure out something about it...
Spirituality. I am strongly attracted to it. To the idea of a life dedicated to the service of something higher, of higher beings, of God. At the same time I am afraid that embracing spirituality as a way of life would be a denial of the "real world". Which is the Real World? The world of the spirit, or the physical world around us? What if the spiritual world is an illusion? On the other hand, does it make any difference what we do, or that we live at all if we disregard the spirit? We live, we die, so what? A purely material existance seems devoid of meaning. What then, is it I am after? I want my life to have had some value, I want to make a difference.
Let me take stock of my life. I am living it with one foot on either side of the ocean. I have been living in Ithaca, New York, for a year, have begun to feel comfortable. I am close to my parents. I have good contact with my children, the relationship with my siblings is neither better nor worse. In august I am going back to Norway. I wonder if it will feel like a homecoming. Am I even able to feel at home anywhere? Mostly I feel like screaming, like running away, finding a haven, where time will stand still, where demands will cease, where I can figure out this thing about the meaning of life in general and mine in particular.
My husband needs me. He has been "holding the fort" in more ways than one, waiting for me to come back to live with him, after 3 1/2 years of living apart. I look forward to it. To sharing everyday things like sleeping, and eating together, walking the dog, doing things for each other, being close, going out to the movies, orienteering, dancing, traveling. On the other hand I feel overwhelmed with dread that I will be unable to live up to his expectations. I long for my garden, my pets, my house but dread the responsibility of looking after them.
My children are becoming more independent. What does it mean to be the mother of adult children? What transformation must the nurturing take? Only one has her immediate future settled. My 17-year old daughter has been accepted into a bakers apprenticeship. The other 3 are still waiting to hear whether they are accepted into the college/high school programs of their choice.
And there is my job: nursing. I am struggling with burnout again. I try to give so much, but feel painfully my lack of mental and emotional toughness to weather it out. I feel my lack of knowledge and skills keenly. Why, when I know that I am making a difference to my patients, can't I be content. Why am I not happy as a floor nurse, in spite of great colleagues and the possibility to give excellent care? Is it because I always feel that although I give everything I've got, the organisation never feels it is enough. I had only 4 patients pluss an new admit last night. It is a perfect patient load. I can truly give the patients the care they need and deserve in a timely manner, and within the limits of the 12 hr shift. I think if it were always like that, I would stay on the floor. But the usual load is 7 patients, 6 if some are telemetry. But I digress. What do I want from my job? What is my ultimate goal? I think it might be working with disaster relief or in an underdeveloped country. And to do that I need more critical care skills, more critical care experience.
Spirituality. I am strongly attracted to it. To the idea of a life dedicated to the service of something higher, of higher beings, of God. At the same time I am afraid that embracing spirituality as a way of life would be a denial of the "real world". Which is the Real World? The world of the spirit, or the physical world around us? What if the spiritual world is an illusion? On the other hand, does it make any difference what we do, or that we live at all if we disregard the spirit? We live, we die, so what? A purely material existance seems devoid of meaning. What then, is it I am after? I want my life to have had some value, I want to make a difference.
Let me take stock of my life. I am living it with one foot on either side of the ocean. I have been living in Ithaca, New York, for a year, have begun to feel comfortable. I am close to my parents. I have good contact with my children, the relationship with my siblings is neither better nor worse. In august I am going back to Norway. I wonder if it will feel like a homecoming. Am I even able to feel at home anywhere? Mostly I feel like screaming, like running away, finding a haven, where time will stand still, where demands will cease, where I can figure out this thing about the meaning of life in general and mine in particular.
My husband needs me. He has been "holding the fort" in more ways than one, waiting for me to come back to live with him, after 3 1/2 years of living apart. I look forward to it. To sharing everyday things like sleeping, and eating together, walking the dog, doing things for each other, being close, going out to the movies, orienteering, dancing, traveling. On the other hand I feel overwhelmed with dread that I will be unable to live up to his expectations. I long for my garden, my pets, my house but dread the responsibility of looking after them.
My children are becoming more independent. What does it mean to be the mother of adult children? What transformation must the nurturing take? Only one has her immediate future settled. My 17-year old daughter has been accepted into a bakers apprenticeship. The other 3 are still waiting to hear whether they are accepted into the college/high school programs of their choice.
And there is my job: nursing. I am struggling with burnout again. I try to give so much, but feel painfully my lack of mental and emotional toughness to weather it out. I feel my lack of knowledge and skills keenly. Why, when I know that I am making a difference to my patients, can't I be content. Why am I not happy as a floor nurse, in spite of great colleagues and the possibility to give excellent care? Is it because I always feel that although I give everything I've got, the organisation never feels it is enough. I had only 4 patients pluss an new admit last night. It is a perfect patient load. I can truly give the patients the care they need and deserve in a timely manner, and within the limits of the 12 hr shift. I think if it were always like that, I would stay on the floor. But the usual load is 7 patients, 6 if some are telemetry. But I digress. What do I want from my job? What is my ultimate goal? I think it might be working with disaster relief or in an underdeveloped country. And to do that I need more critical care skills, more critical care experience.
Subscribe to:
Posts (Atom)