Sunday, April 05, 2009

Things They Don't Tell You In Nursing School, Part Four Hundred Seventy-Two:

Some days suck.

They're not the days with three codes and a couple near-misses. They're not the days when some idiot resident decides now is the time to scream at you in the nurses' station. They're not the days when big things go wrong; they're the days when a multitude of tiny things don't go quite right.

Mostly, it's because of people. Not patients--people. Patients are, though we tend to forget it, basically people just like we are; they just happen to feel like shit and need good drugs. 

There's the patient who has a dozen excuses for why he simply can't walk right now. There's the patient who is inexplicably rude to you, or the one who's offensively rude about you in front of a doctor or family member. There's the patient who, for some reason, you just can't do anything right for, no matter how hard you try. They're all people, and most of 'em aren't as big of assholes as they seem while they're in your hospital.

Some days it's easy to channel your inner Cherry Ames and just keep on plugging. Other days, the sorts of days I'm talking about, you get frustrated and have to stop yourself from running screaming out into the night (or dawn) as soon as your shift ends.

I once had a patient who had a big, nasty brain tumor in her frontal lobes. It turned her from a bearable, if brusque, person into the sort of alkaline bitch you wouldn't want your worst enemy to meet. For a week, I had no problems at all dealing with her, and could even sweeten her mood a bit--all while getting charts open on time and handling five other patients with varied (and more pressing) needs.

This has not been one of those weeks. When a patient was insulting about a resident to me, I snapped back, "Keep a civil tongue in your head" and handed her off to my (angelic) charge nurse without a backward glance. When a patient gave me yet another reason why she simply couldn't turn over in bed just now, I growled "You're turning, and that's final" and then hauled her over on her side before she could protest. When one other patient said to me, after I finished starting a particularly tricky IV, "I bet you don't have a boyfriend; it hurts to hold your hand," I had to get out of the room quickly in order to hide the ridiculous tears that started in my eyes.

That's what they don't tell you in nursing school: that dealing with people is hard. It's rewarding and satisfying, yes, but it's also really, really hard at times. You get lessons on how to handle the really difficult, insane people, but nobody prepares you for the exhausting, grinding, disillusioning work that makes up some days. 

What's worst about those days is how lonely you feel during and after them. It feels like, no matter how much your coworkers sympathize, you're the only person who's ever had a day this bad in the history of nursing. You feel inadequate, you wonder what the hell is wrong with you that you can't manage to take care of four or five sick people without nearly losing your mind by noon, you think seriously about applying at Starbucks. 

The good news is that those days, those weeks don't last forever. Eventually something turns around: the surgeon who's known as a stickler compliments you spontaneously, or the raving bitch in room 9 decides you hung the moon. Sometimes it's as simple as having all your meds and equipment there when you need them, and avoiding the running-around that characterizes so much of the average nurse's day.

So: If you're a new nurse, or a more experienced nurse, or an old, old, old nurse (and, believe me, after a week like the one I've had, you feel old-old-old), don't lose heart. Eventually the moon will move out of Klutz and things will stop sucking as much as they do now.

In the meantime, you still have the end of the shift to look forward to.


Anonymous said...

This is really well put, and true. I hope it's okay that I shared it, of course leading back to your blog. Thanks.

Penny Mitchell said...

*I* love you, and even though they're destroying your house at the moment, Teh Kittehs love you too. I wish I could show up at your door with scotch right now, but I probably would pick out a really sucky bottle at the store, so you're probably not missing anything.

Never forget: It's human nature for the patients who were thankful for you to not say anything. Unfortunately. I know they outnumber the bad ones, though. They do.


Uro*MA said...

I really enjoy your posts, and while I am a Medical Assistant, and not a nurse, I really relate to many of the things you describe in your posts. I have had days where it is truly murphy's law. Everything that can go wrong, will go wrong, and it is hard to suck it up sometimes and keep going... But we all have to. It's always hard to get reprimanded for mistakes, even if not your own and move about the day as if it didn't matter, because it really does. I really empathize with you and I feel that you really express the things that people think in a very eloquent manner. Thank you for doing what you do , i know that if i ever had to be admitted to your unit i know that i would definately want you as my nurse!!! Keep your chin up!!
~ Uro*ma

Kimberly said...

This is a good entry. I am really looking forward to graduating, and this is encouraging, because it feels like I already have those days.

Crazed Nitwit said...

Special empathetic hugs to you HN.


Being a nursing student in my 40's, I can imagine the kind of day you had is much worse than a meeting with evil PTA wenches. ;)

It will get better and I think you rock. Good nurses are a special breed and I totally believe you are one of them.

Hope you have a much better week to come!!!!

GingerJar said...

Hey, I had your day the last night I worked...are you sure I don't work at SunnySide General??? LOL. I came home from my 12 so exhaused I crawled in the bed and didn't budge for 10 hours...then I got up to eat and go back to bed. Nothing like spending your last three hours up to your armpits in puke and poo. That and dealing with Systolic BP over 200 in the poo room and the one with the puke...who managed to hit ya with it before you had a chance to get gloves or jump outta the complaining about belching and wanting you to call the doc for something for belching (after I had already medicated for nausea, changed her linens and gown and fetched ice packs, cool towels, and anything else she could think of). Now where I work if you call a doc at 4 a.m. for antacids you just may be finding your head kicked down the hall the next a soccerball. Anyhow, my 12 hours didn't end until 2 hours after my shift, then I had to go to Personnel to pick up the book for the BSL class, to recert, and that took an hour because only one person can "issue" the book, and she wasn't in the office. Wow. I think I'm still tired.