December 1, 2013

I can't believe it's already December.  Two birthdays this month:  little one #1 and mine.  Then Christmas.  I've scheduled all my work shifts for the first half of the month so after December 15, I am off to enjoy the holidays.

I went to work on Black Friday because you can't pay me to shop on Black Friday.  Seriously, any day of shopping where people are killed in the name of bargain-hunting is not a day for me.  Plus I detest crowds.  So I'm willing to forgo rock-bottom sale prices to both live and not have to deal with parking my truck in a crowded mall parking lot.

Anyone, I went to see a coworker.  It was part work, part break.  I had to update him on a mutual patient (no HIPAAs were violated in the making of this conversation), and then after that, we fell into chatting about random topics.

I told him that as horrible as it sounds, after a patient discharges, I really don't care about them anymore.  I know that it's not the most compassionate, "it's expected of a nurse" response, but the reality is that I can't.  At least, not if I don't want to burn out.

I take the best care of my patients that I can whether they're my patients for five weeks or five minutes.  But when I leave for the day, I put them mentally away.  It's very rare that I let my mind dwell on a patient after I've clocked out...usually it's a very sick one that I hope will be OK in the AM, or one of my frequent flyers who is in the facility so often that when admitting calls to admit them, I can give them the report.

When a patient discharges, I wish them the best (and sincerely mean it), but once they're out that door, they're also out of my mind.  Again, the rare exception may be the frequent flyer that I might hear updates about from coworkers or other patients who've seen said patient in the community.  But once the patient discharges, I have to move on and focus on the patients who well as those who will soon arrive.

Part of it is to avoid my burning out mentally and emotionally by always subjecting myself to the service of others that I forget my own self-care.  I think they call it "compassion fatigue."  I learned from my pediatrics rotation how bad burning out could be...hence why I'll never work peds.  I could never mentally leave those kids at work.

I also think that part of it is because of the patients themselves. After years of dealing with patients who need help and don't want to be there, who go AMA, or who keep coming back because the minute they leave the facility they choose to drink/drug again, or choose not to take their meds anymore, or decide going to follow-up care isn't worth it...well, it's hard not to get a bit jaded.

Not so jaded as to provide the best care that I can, though.  And I do have tremendous compassion for my patients...while they're my patients.  But I have to set limits on that compassion for my own mental and emotional health.

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