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Caring under pressure


Compassion is an essential ingredient for great nursing. Without compassion, you might as well come up with another word for nurse. Recently, I visited a local emergency department (ED) for management of a small-bowel obstruction, to which previous surgeries had made me susceptible. I’ve had several obstructions in the past few years; sometimes, I must go to the ED for assistance.

This time, I was told no beds were available. After being triaged, I waited with increasing pain and a distending abdomen. When I started vomiting, I pulled the cord in the bathroom for assistance. I was wheeled to the back, where I sat in an area with three other patients, each divided by curtains. I continued to vomit and retch, but no one came to assess me.

Time passed. I went in search of someone to assist me. Struggling to stand, I reached the nurses’ station, where two nurses were typing on computers. Neither looked up.

After several long moments, I moved down to the doctors’ area, where eight people were doing various things—looking at their phones, conversing, working on computers. Finally, one doctor asked, “May I help you?”. I responded, “Will you? Will you help me?”. She immediately ordered medications, including antiemetics, an analgesic, and I.V. fluids.

My time in the ED continued in this manner, with the nurse coming in to perform duties prescribed by the doctor but not speaking to me. I felt like a thing, not a person. Not once did she inquire about my pain or nausea or ask if I needed anything.

Obviously, it was a busy day and the nurses were short-staffed. A lot was being asked of them; I can empathize. But that’s no excuse.

I left the ED angry at the nurses’ behavior. Most likely, they didn’t realize how disrespectful they were and what consequences their actions could have. That day, they’d treated patients without caring, reflecting poorly on the hospital and our profession.

Impact of negative emotions

When you are angry, irritable, or unhappy and let your emotions drive your behavior, here’s what happens:

  • Your emotions distract you. The conscious mind can focus on just one thing at a time, so if you’re self-absorbed and have trouble focusing on patients, you can’t empathize. You lack the mental “bandwidth” to do so; you’re unable to provide the caring and respect required of nurses.
  • When you’re emotional, you don’t think clearly and are more likely to make mistakes. When your emotions take over, your mind gets left behind.
  • Both you and your patients lose your compassion. When you are so upset you can’t focus or are
    busy thinking about everything you need to accomplish, you miss out on those moments you could be sharing when caring for patients. Suppose you want to spend 20 minutes with a patient but you know you have only 3; instead of being angry because you can’t spend 20 minutes with him, use your 3 minutes wisely. It makes all the difference.
  • Negative emotions are stressful and drain your energy. At the end of the day, you leave work exhausted because your mind has been working overtime maintaining negative thoughts. It takes a lot of energy to stay angry! It’s not a natural state. Something has to trigger it, and then you must “tend it” to maintain it over time. Whew! That’s a lot of work!
  • Your patients become angry and depressed. Everyone has an innate need to feel valued. To respect means to value. To see the value in others, you must treat them with respect. Patients who don’t feel valued or respected may become angry, depressed, lonely, or desperate—which can negatively affect their physical condition.

Empower yourself

To avoid the trap of letting your feelings override your caring and compassion, follow the guidelines below.

Manage your emotions and your mood

They belong to you. Decide what kind of presentation you want to make to the world and what kind of experience you’d like to enjoy as you greet people along your journey. Choose to be your best.

Focus on what you can do and what you can control

Let go of what you have no control over. You’ll find this a huge relief. Much stress arises when you focus on trying to control something you can’t control; for instance, you can’t control how many patients are admitted or how sick they are. You can only control your thoughts, emotions, and behavior.

Trade each moment for something of value

Stay present in the moment. Focus on what’s right in front of you rather than holding onto anger over the past, what you don’t have, or everything you need to do today. Be here now.

Let go of expectations

Know there may be a huge disconnect between the kind of nursing you want to deliver and the kind
you can deliver in the current circumstances. You
can only do your best, and on some days, you can just get by. But when you do your best and are respectful—when you care about your patients despite how busy you are—they will respect that and appreciate what you give them. People understand. On the other hand, when you’re mean, people are less forgiving. It’s disrespectful to treat another person as a problem or an annoyance, and there’s no excuse for treating someone disrespectfully. When you disrespect others, you disrespect yourself. When you forget to care for others, you’re not caring for yourself, either.

So care about yourself. Remember why you became a nurse and what keeps you in nursing. Be the best nurse you can be. Do the best you can. Make someone comfortable. Pay attention to what your patients might need. Don’t ignore them simply because you can’t give them everything you want to give. Instead, give them what you can give and they’ll be forever grateful.

The owner and chief executive officer of Nurturing Your Success, Julie Fuimano-Donley is a coach, writer, and motivational speaker.

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