The four patients you describe remind me of the rehab unit in the nursing home where I am employed. Nursing homes have become acute care centers. The hospitals stabilize the patient and then they are sent to a nursing home for further treatment. The nurse often has around fifteen patients to care for and it is challenging and damaging to the soul. Family members often take up the nurse's time with concerns. The documentation is extensive due to medicare notes. So the nurse is quite busy. I do not see future changes because it is all about the money.
Defining the terms and differentiating among them is important, because each requires a different response and management plan. I think it is also important to help healthcare professionals acquire the “armor” needed to function at the bedside. I don’t mean to suggest that individuals become numb to the suffering and focus on the task at hand. Rather, I think that an acknowledgment that the work environment is stressful is required, followed by the statement “and knowing that, here are some practical strategies which you may need to employ to do your job well without having it destroy you”. I am a doctor, not a nurse, so I wouldn’t presume to suggest what those strategies could be. However, having shared various clinical spaces with other healthcare staff, including nurses, I think there are things I’ve observed which appear to be common concerns: opportunities for self-care (the usual ADLs); simple courtesy and kindness to colleagues; no “acting out” drama (to my great regret, I have been guilty of letting my own anxieties about a particular patient impact my actions on a floor or in a critical care unit); and the acknowledgement that remaining vulnerable and open are not personal flaws but rather valued traits for empathic practitioners.
At one hospital I worked at, I was always getting called to the ED for admissions, and when I would arrive, I’d see staff busy with patients tucked in rooms, hallways, wherever there was space, with a constant stream of ambulances bringing in more folks needing care. After a few call nights, I started bringing in chocolate, first for the nurse taking care of my patient, then for the whole group. It eventually ratcheted up to arranging for multiple pizzas to be delivered directly on those crazy nights where the thought of a meal break was unrealistic. My wife, herself a nurse, would remind me that food is not always the answer to stress, or even the best response, and I would acknowledge that, but then tell her it at least provided some relief immediately. As you and others continue to address these issues, Theresa, I imagine you will consider other options which will address these three concerns in a more comprehensive fashion. As a current patient, I want nurses whom I encounter to feel respected, rested, and resilient as they tackle one of the most challenging healthcare jobs in the industry.
Thank you my friend . It’s hard as it was my identity. I recommended your book to a fellow retired nurse. She put it in her list right away . (Your first book) I’m gearing up to read your 2nd book. And always look forward to these emails . Xoxox
Loving your article and supporting the profession in any way I can . However , I resigned last week. Not only is it the stress of the job.... too many patients ... too much documentation....the list is long......but it is how nurses treat each other . I grew tired of upper management’s rude emails and lack of support .
I handed in my equipment yesterday and am beginning to peel away my identity as a nurse and throw myself into my art .
I got anxious and upset just reading about those four patients, and about the impossible choice of whom to help first. It is a disgrace that healthcare is a for-profit industry. There are more important things than enriching shareholders!
Incidentally, while I dislike Pringles, I agree that the best hiking foods have plenty of salt, carbs, and fat. I like beer and cheese on my hikes!
The four patients you describe remind me of the rehab unit in the nursing home where I am employed. Nursing homes have become acute care centers. The hospitals stabilize the patient and then they are sent to a nursing home for further treatment. The nurse often has around fifteen patients to care for and it is challenging and damaging to the soul. Family members often take up the nurse's time with concerns. The documentation is extensive due to medicare notes. So the nurse is quite busy. I do not see future changes because it is all about the money.
Defining the terms and differentiating among them is important, because each requires a different response and management plan. I think it is also important to help healthcare professionals acquire the “armor” needed to function at the bedside. I don’t mean to suggest that individuals become numb to the suffering and focus on the task at hand. Rather, I think that an acknowledgment that the work environment is stressful is required, followed by the statement “and knowing that, here are some practical strategies which you may need to employ to do your job well without having it destroy you”. I am a doctor, not a nurse, so I wouldn’t presume to suggest what those strategies could be. However, having shared various clinical spaces with other healthcare staff, including nurses, I think there are things I’ve observed which appear to be common concerns: opportunities for self-care (the usual ADLs); simple courtesy and kindness to colleagues; no “acting out” drama (to my great regret, I have been guilty of letting my own anxieties about a particular patient impact my actions on a floor or in a critical care unit); and the acknowledgement that remaining vulnerable and open are not personal flaws but rather valued traits for empathic practitioners.
At one hospital I worked at, I was always getting called to the ED for admissions, and when I would arrive, I’d see staff busy with patients tucked in rooms, hallways, wherever there was space, with a constant stream of ambulances bringing in more folks needing care. After a few call nights, I started bringing in chocolate, first for the nurse taking care of my patient, then for the whole group. It eventually ratcheted up to arranging for multiple pizzas to be delivered directly on those crazy nights where the thought of a meal break was unrealistic. My wife, herself a nurse, would remind me that food is not always the answer to stress, or even the best response, and I would acknowledge that, but then tell her it at least provided some relief immediately. As you and others continue to address these issues, Theresa, I imagine you will consider other options which will address these three concerns in a more comprehensive fashion. As a current patient, I want nurses whom I encounter to feel respected, rested, and resilient as they tackle one of the most challenging healthcare jobs in the industry.
Thank you my friend . It’s hard as it was my identity. I recommended your book to a fellow retired nurse. She put it in her list right away . (Your first book) I’m gearing up to read your 2nd book. And always look forward to these emails . Xoxox
Here I am again
Loving your article and supporting the profession in any way I can . However , I resigned last week. Not only is it the stress of the job.... too many patients ... too much documentation....the list is long......but it is how nurses treat each other . I grew tired of upper management’s rude emails and lack of support .
I handed in my equipment yesterday and am beginning to peel away my identity as a nurse and throw myself into my art .
Prayers and positive thoughts welcome 😍😊😊💛💛💛💛
So grateful you are writing about this topic, Theresa. It reminded me of this news:
https://kval.com/news/local/oregon-law-mandating-minimum-nurse-to-patient-ratios-in-all-hospitals-to-take-effect#
I got anxious and upset just reading about those four patients, and about the impossible choice of whom to help first. It is a disgrace that healthcare is a for-profit industry. There are more important things than enriching shareholders!
Incidentally, while I dislike Pringles, I agree that the best hiking foods have plenty of salt, carbs, and fat. I like beer and cheese on my hikes!