Never Enough

This week, I'm talking about Jodi Picoult's Small Great Things, a book about a nurse who was sued because a family member saw her performing her job and didn't understand what was happening. They saw what they thought was abuse and because they had already asked for her not to touch his son (because she was black), they thought she was hurting him on purpose.

On Wednesday, I talked about how this book made me think from a racial standpoint. Today, I want to talk about the nursing side of it. Ironically, this is the side that I'm more nervous talking about. Not because I don't have anything to say, but because I'm very cautious about what I say online about work. I'm very conscious about HIPPA, and about protecting the integrity and reputations of where I work and where I used to work.

Here's the thing, I've worked in multiple facilities, mostly long term, as a nurse and CNA. When people are sick, they're not themselves. I understand that. Patients are dealing with pain, dealing with a new diagnosis that has flipped their lives upside down, or with loss that they can't quite accept yet. In a way, it makes sense to lash out at the people taking care of you. They're right there, after all. But in many other ways, it doesn't make sense.

At least, not to me.

My typical workday consists of a twelve hour shift. I usually get to work half an hour early so that I can read up on charts. So that I can prepare myself and know the information necessary to properly take care of my patients. After my shift, I give report to the next nurse, so that they know what's changed, and to promote the best possible care for my patients. Some days, things get hectic. I might have to stay late to chart, or to finish my responsibilities. Maybe one of my patients had a sudden change in status right before I leave. Either way, my typical shift tends to be closer to thirteen and a half hours -- on a good day.

I'm there all the time. It may not seem like it, especially if I'm in someone else's room, but that doesn't mean I don't see what happens.

The problem is I'm only one person. Just one nurse, and even though most of the places I work have great support systems, a lot of the responsibility falls on me. I understand that and I accept it.

There are just too many days when I feel I'm not enough. With my knowledge, with the skills that I'm still perfecting, I'm still never exactly what my patients need. There's so many instances in my shift when I have to make a decision, when I have to choose between two patients who need me. Maybe it's more than two. I can't count the number of times I walk out of a room to see the entire hall lit up with call lights, and know that no matter how fast I work, no matter what I do, I won't get to them in the time that they want.

That's when it sometimes feels like it's too much. When I already know I'm doing everything I possibly can, it's hard to hear patients and families complain that I should be doing more. I'm not allowed to tell you what I'm already doing, or what the other patients need. There's no way for me to tell them that I have a patient next door that's going septic and might need more serious intervention in the next few minutes. Or a patient who's confused and jumping out of their bed, and I want to keep them from falling and getting seriously injured. I can't tell them about the patient who broke my heart because no matter what I do, I can't seem to control their pain. Or the patient who's detoxing from drugs and hasn't stopped screaming at me since I arrived on the floor.

Nurses carry a lot of what they experience in their hearts. I've seen it in so many coworkers. It's a taxing job, and there are times we snap. I know I have, though I've been fortunate that it's never been in a patient's room. There are moments when I have to leave the floor because I can't deal with it anymore. It's frustrating, and often not because of the patients but because of the situation.

My husband often tells me that either you cry or you laugh. He tells me that whenever I'm angry or annoyed. He says "Do you want me to cry or laugh?" That's how it is with nursing too. We have to get these emotions out. Often, it comes out in the form of jokes, in a way of relieving the pressure that we feel. It has nothing to do with what we're really thinking, it's a coping mechanism, one that helps us to be the best we can be with the circumstances around us.

I think the hardest part is knowing that often, the most memorable experiences are the bad. If a patient is upset with their care, it doesn't matter how much we've done for them. It's what more they wanted us to do. Often, I feel like I'm measured by my shortcomings, rather than by my actions.