Attachment to residents...medical field advice

[KendraDZ1902]

I have been trying to figure out where to put this and “daily walk with Christ” seemed like this little thread would fit in that category.

I’m in my second week in training at a long term care facility. I’m waiting on my little card from the state to go take my CNA test. Now, I have always wanted to be in the nursing field. 12 year old Kendra is disappointed that I quit college and am literally starting from the bottom of the nursing field.
Anyway, in the past 2 weeks I have come to enjoy caring for my residents. We have 2 groups on our unit and we rotate each night we have 30 residents on the unit so 15 a piece per night. The night that I am not on a certain group, 2 of the residents ask where I have been since they didn’t see me that night. One man has told me that he wishes that I was there all day. That I’m the sweetest and actually care. He’s up waiting on his coffee in the dining hall when I leave. He tells me to drive safely and get some sleep. lol. The other is a lady that no one likes and she likes no one else, but adores me. Her face brightens up when I wake her up to check and rotate her and she will chat with me. It has surprised everyone.
And there is one lady that I literally make the sign of the cross before walking into her room, she’s abusive…verbally and physically.
Then there is this lady who wasn’t there when I came into work. She was sent to the hospital. I didn’t like going into her room, but I always did, to check her and put her on her turn, make sure she was ok, which she never was. See, she has a stage 3 bedsore on her bottom. She has sores on her feet, even though we have heel protectors and do our best to position her properly, well, I try my best to position her properly. She would yell and cry, because she was in so much pain being repositioned. And that would bother me.

TMI She had a BM and it got into her sore, which not only had to be cleaned with Peri-wash, but the nurse needed to come in and rebandage her. I’m holding her on her side rubbing her back because there was nothing we could do to make her pain go away and she HAD to have her wound cleaned. She was crying and I wanted to cry for her. I couldn’t imagine the pain she was going through.
When I was told that I didn’t have her in my group due to her hospitalization, I was upset. I was very sad for her. The other girls didn’t seemed bothered by this, but they seem rough with the residents, not abusive, but not as gentle as I would want to be treated and I treat my residents like I would want to be treated.
I am already becoming attached and I don’t know if this is Ok. I know Christ said that what you have done to the least, you have done to him. However, I am having a hard time treating these people with human dignity, treating them like I want to be treated, and doing what I am properly supposed to do without having an attachment to them. Maybe long term care isn’t the field I should be in? Maybe I should do another specialty, that is hands on, but not long term once I’m out of school? That way I won’t get close to the patients. Like the OR or something? Or is geriatrics/long term care what I should be doing and attachment is fine? Granted when I am out of school I won’t have as much hands on that I do now. CNAs are with the residents/patients like 80% of the time.
I’m only 2 weeks in and I don’t start on my on until the 22, I’ll probably become more and more attached.

Thoughts?

 

[Casilda]

Bless you for the work you do. I worked in the field before one needed certification, then in home health care. I didn’t have the money or time to get the cert. I do not know how one can not become attached to the residents. Treat them as you would Christ, with dignity, and love, even the difficult ones. You may be the last person to do so.

To answer your questions if this is the specialty you should pursue: I think you have the qualifications to be an awesome elder care nurse.

 

[captainrick]

I was a long term care administrator, and a hospital administrator. It’s easy to get attached to the residents, and very sad when you lose one.

You might like being an ER tech. You don’t have time to get attached, and most patients have good outcomes. Trauma never bothered me, but chronic illness is hard for me to deal with. Some people are the opposite - like my wife. She loved being a CNA, but can’t stand trauma, or even the sight of a syringe!

You should try different areas to see where you’re most comfortable. The good thing about the nursing field is the wide range of choices. Good luck!

 

[marbleartist]

You sound like a caring and compassionate person- and a wonderful CNA! It’s very easy to become attached to people and their families in long term care (or actually any care- I was a CCU nurse) because you have the wonderful opportunity to get to know them. It is a blessing to travel this part of their journey with them! And…it is very painful to lose one. After many years as an RN, I still remember many of those who were in my care- some who were confused, irritable (and irritating), gentle, humble, suffering, challenging- and all were an opportunity to serve God! I assure you that being a good caregiver means giving of yourself as you help others and it is an awesome blessing. BUT don’t lose yourself- take time to enjoy your life, your family, etc. when you are away from work!! Try not to bring the patients and their situations home with you!! While at work, give them all that you can- and when you leave, say a prayer for them and leave them in the hands of God. I will pray for you as you continue this challenging and rewarding career!

 

[fred_conty]

My daughter is a nurse and she goes thru the same things you are describing. It is tough but it seems to me that Jesus will bless you a million times over for your kindness…to him.

May God bless and keep you. May God’s face shine on you. May God be kind to you and give you peace.

 

[InNomineDomini]

I am already becoming attached and I don’t know if this is Ok.

Just to make sure I understand correctly: you’re afraid that you’re too empathetic, and that maybe that in some way is an impediment to being a good nurse. You seem to see a difference in your levels of empathy and those of your co-workers. This appears to be reflected in the way patients react to you. Is this correct?

I think it could be the case that certain recent circumstances you’ve found yourself in may have made you a bit softer in the heart, and a bit more sensitive to the needs of others. Could this be an aspect of the levels of care you provide for others? If it is, it may very well pass with time. Likewise, simply having more experience with patients might make it easier for you to separate healthy empathy from unhealthy empathy.

My wife is a nurse: I’ll ask her what she thinks, and post her thoughts a bit later.

 

[CB_Catholic]

I was a nurse for 32 years (retired now) and know the feeling of attachment, even though I worked the ICUs and with trauma patients, some of them were there a very long time and it was easy to get attached. It is OK to have feelings for your patients and like some more than others, and empathize with them and their suffering, but it can be easy to lose your perspective. You must treat all patients with the same care and standards, and not show favoritism. You must also try to avoid the feeling that it’s “your” patient, and no one else can do as good a job as you. That not only can cause staff friction, but families pick up on any possessiveness the caregiver may have, and that can cause some trouble. Also, if the patient senses this, he may refuse another caregiver or criticize them in front of you. I have seen all of this happen over the years.

When people are ill and needing attention, they can become manipulative with the staff, that is something to look out for, and it needs to be dealt with very gently, but firmly. So being attached is OK, being over-attached is not. It doesn’t help the patient one bit if the caregiver is so empathetic she can’t take care of the patient properly.

If you are constantly taking your patients and their problems home with you, that is a danger sign. I agree with what people have said–long-term care might not be the field for you, but you really have to give it a try with a normal patient load, not with what you have in training.

BTW, why are they not medicating the lady with the bedsores before they change their dressings? Just curious.

 

[Casilda]

BTW, why are they not medicating the lady with the bedsores before they change their dressings? Just curious.

I was never a medication aid, but I DO know that narcotics are not safe for elderly patients. I learned the hard way. My dad was about to be discharged from the hospital after a few days dealing with pneumonia and they gave him morphine and oxycodone. He went into a coma. five months later, in for shortness of breath, they gave him Dilaudid and he coded. I have always wondered, after my initial shock when my mom had a stoke, why they had her on propofol. Its what killed Michael Jackson. I hate to think doctors are giving strong narcotics to their elderly patients to kill them off earlier.

 

[KendraDZ1902]

Just to make sure I understand correctly: you’re afraid that you’re too empathetic, and that maybe that in some way is an impediment to being a good nurse. You seem to see a difference in your levels of empathy and those of your co-workers. This appears to be reflected in the way patients react to you. Is this correct?

I think it could be the case that certain recent circumstances you’ve found yourself in may have made you a bit softer in the heart, and a bit more sensitive to the needs of others. Could this be an aspect of the levels of care you provide for others? If it is, it may very well pass with time. Likewise, simply having more experience with patients might make it easier for you to separate healthy empathy from unhealthy empathy.

My wife is a nurse: I’ll ask her what she thinks, and post her thoughts a bit later.

I’m afraid that I may be too empathetic, maybe? I’m not sure. I don’t know if the others just aren’t empathetic. When I go to reposition a resident, I let them know, I count to let them know, I try to be gentle. The other girls just come in and flip them over. I wouldn’t want that done to me. Seems mean.
It wasn’t like the lady who went to the hospital was a “favorite” I don’t have any favorites. It just made me sad for her.

 

[KendraDZ1902]

I was a nurse for 32 years (retired now) and know the feeling of attachment, even though I worked the ICUs and with trauma patients, some of them were there a very long time and it was easy to get attached. It is OK to have feelings for your patients and like some more than others, and empathize with them and their suffering, but it can be easy to lose your perspective. You must treat all patients with the same care and standards, and not show favoritism. You must also try to avoid the feeling that it’s “your” patient, and no one else can do as good a job as you. That not only can cause staff friction, but families pick up on any possessiveness the caregiver may have, and that can cause some trouble. Also, if the patient senses this, he may refuse another caregiver or criticize them in front of you. I have seen all of this happen over the years.

When people are ill and needing attention, they can become manipulative with the staff, that is something to look out for, and it needs to be dealt with very gently, but firmly. So being attached is OK, being over-attached is not. It doesn’t help the patient one bit if the caregiver is so empathetic she can’t take care of the patient properly.

If you are constantly taking your patients and their problems home with you, that is a danger sign. I agree with what people have said–long-term care might not be the field for you, but you really have to give it a try with a normal patient load, not with what you have in training.

BTW, why are they not medicating the lady with the bedsores before they change their dressings? Just curious.

No, I don’t have any favorites. I treat them all the same. The little old man who asks for me is independent. I just open his door to make sure he is breathing. He can go to the restroom on his own (he doesn’t even have a urinal that needs dumping) and he definitely isn’t on a turn schedule.
I haven’t really taken anything home with me. I just thought it was odd that I was concerned for the little old lady who was hospitalized and the other girls blew it off and the fact that I’m the new girl and people are “missing” me. They shouldn’t miss me. I just got here! lol.

I’m not sure what medications this resident is on. I do know that this was a temporary fix since this was in the middle of the night.

 

[CB_Catholic]

No, I don’t have any favorites. I treat them all the same. The little old man who asks for me is independent. I just open his door to make sure he is breathing. He can go to the restroom on his own (he doesn’t even have a urinal that needs dumping) and he definitely isn’t on a turn schedule.
I haven’t really taken anything home with me. I just thought it was odd that I was concerned for the little old lady who was hospitalized and the other girls blew it off and the fact that I’m the new girl and people are “missing” me. They shouldn’t miss me. I just got here! lol.

I’m not sure what medications this resident is on. I do know that this was a temporary fix since this was in the middle of the night.

Oh, I am not saying you are doing anything. I am just trying to apprise you of some of the things that can happen when one is taking care of long term patients, which I have seen in my nursing career. You sound like you will be an excellent CNA with your caring attitude.

 

[CB_Catholic]

I was never a medication aid, but I DO know that narcotics are not safe for elderly patients. I learned the hard way. My dad was about to be discharged from the hospital after a few days dealing with pneumonia and they gave him morphine and oxycodone. He went into a coma. five months later, in for shortness of breath, they gave him Dilaudid and he coded. I have always wondered, after my initial shock when my mom had a stoke, why they had her on propofol. Its what killed Michael Jackson. I hate to think doctors are giving strong narcotics to their elderly patients to kill them off earlier.

Casilda, I do agree that one has to be judicious in the use of narcotics, esp. in elderly patients, but they can be used safely. I have administered them safely for 32 years. All patients on narcotics need careful monitoring, and everyone has their own tolerance for them.
But the fear of giving elderly patients enough medication to relieve their pain is very common, and one that has been addressed as a concern by both the Nursing and Medical profession.
To allow a patient to suffer severe and unnecessary pain because of a general fear of overdosing is not acceptable.

I can only speculate on the reason for the Propofol, based on my experience of taking care of head injured and stroke patients for years, and administering the drug frequently. Yes, the drug killed Michael Jackson, but the underlying cause of that was the Dr’s violation of the standard of care. Propofol must be administered by qualified personnel in a health care facility with cardiac monitoring and pulse oximetry. There must also be emergency resuscitation equipment available, such as a crash cart with intubation equipment. To administer it at home without monitoring and emergency equipment is pure malpractice and negligence, and any physician should know this. The product comes with ample warnings. Because the brain in a stroke patient is in essence, injured, it becomes extremely important no further injury occur. Propofol is frequently used to keep the patient sedated so they cannot thrash around and use up precious oxygen which the brain needs to heal, or to prevent further injury or bleeding. The reason it is used preferably over other sedatives is that it clears very quickly from the body, and it only takes minutes for the patient to become awake, whereas the other sedatives take hours to clear from the body.
It is given by infusion, so the infusion can be stopped at any time and the patient awakened to check his level of consciousness.

But it must be used in a monitored area, and only licensed personnel (nurses and MD’s) trained in it’s use and in cardiac and respiratory monitoring are permitted to administer it.

I hope this eases your mind about your Grandma. It is quite appropriate to use this drug in stroke patients who need to be kept sedated, or are on ventilators.