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Student nurse blog: Caring a little too much?

  • 4 Comments

Saying goodbye to a favourite patient provides some valuable lessons for our student nurse blogger

Never in my life would I ever have expected it to be possible to care too much.

If anything, people don’t care enough. But this week two situations in placement made me think twice about boundaries.

When I returned to the ward after my rest days, I quickly discovered that one of our most animated patients was no longer with us. The poor soul has fallen and broken his hip and was currently residing in the surgical unit.

I was absolutely devastated for him - he had been improving rapidly within our assessment unit. More than that, I was upset for his family. This gentleman had previous had a stay in an acute ward prior to admission with us. While there he was labelled as unmanageable and his family were concerned that history would repeat itself.

My mentor and I had the opportunity to visit our patient in the surgical unit in order to access suitability for returning to the ward. On arriving there we found him asleep in a side room. I’m ashamed to say that at this point all I could think about was when he was last spoken to, whether he had been fed that afternoon and whether his carers were aware thathe needs constant interaction.

Of course, I knew deep down that he would have been receiving the same level of care in that ward as he had previously, but I couldn’t help but think that nobody knew this patient better than our team - and therefore nobody could care for him as well.

Fortunately my mentor decided that we could care for him back in the ward, and shortly afterwards he arrived back to a familiar welcome and his old room. He has of course been treated like a king, and his relatives are happy with his progress.

On reflection, I knew deep down that he was in safe hands, but I almost couldn’t trust another ward to look after ‘my’ patient. These nurses are experts in their field, with years and years more experience than me. So why couldn’t I let go?

Why couldn’t I entrust this patient into their care? Was I criticising them in my head because I care too much, or because I felt guilty for not being there when the accident took place?

The second scenario involved one of our long-term patients. The day had come for him to finally go into long-term care, his room was packed and the taxi was booked. I could see that although he didn’t have insight into what was happening, he looked apprehensive.

I was asked to accompany the patient to his new home and tried to be as positive and reassuring as possible when travelling to the destination. On arrival at the nursing home, I had to gasp. It looked so beautiful - an old country manor house set in the middle of nowhere.

Unfortunately I never did learn the old lesson about not judging a book by its cover. Being met by the matron at the door, I immediately sensed a poor work ethos. The care staff all appeared unhappy and tired. We were shown to his third floor room via a lift from the 1930s. The room smelt damp, the furniture worn. I could see the distress in his eyes.

There I was again, only seeing the negatives, assuming on first impression that my patient, whom I had given countless cups of tea and shaved every morning, could not be happy here.

He sat on the chair in his room and a carer was asked to make him a cup of tea. ‘Milk and two sugars’ I called, ‘and he only likes it half full’.

It took a tremendous amount of professionalism to walk away from the situation and back to the taxi. On saying goodbye I had to restrain myself from whispering ‘any problems at all, you give us a call’.

It was time for him to have a permanent home. It was time for me to realise that his comfort and well-being were number one priority, and that I couldn’t hold onto him for selfish reasons.

Being a student nurse did I simply care to much? Did I feel guilty that we had let them go? Is it natural to believe that no other team can provide holistic care as well as you and your colleagues?

I think in this case that it simply highlighted that although I have been living, sleeping and breathing nursing for over two years, I still have so much to learn.

I have to learn that it is ok to leave these precious patients in other professionals’ hands. I have to believe these people were also born to nurse, and that they will treat each and every one of them like their own mother.

More than anything, I have to learn to not assume no-one can provide care like I do. I need to show confidence in my fellow colleagues. Even when the furnishing isn’t nice and the smiles aren’t always there, I need to assume EVERYONE cares.

  • 4 Comments

Readers' comments (4)

  • Dear Erin,
    on reading your blog i find myself alarmed at the way you assign so much introspection and reflection to things that arealways going to be out of your immediate control. I feel you need to hear that our job is not 'to care' but to 'deliver care' to our patients or clients in order for them to make health gains.
    It isn't you role to worry or torure yourself over the future lives of your patients - nor is it you role to assume some form of parentage over them.
    Your are not their sole protector and the last thing you should be doing is seeing them as unfortunate people requiring your attention and mothering. These things do not make your patients better, merely they make the situation more tolerable - which of course is highly deisrable and necessary.
    Never forget that nursing was borne of warfare and the need to physically return people to health, not the application of emotional support.

    Our role is to promote patient care and independence, not to make them dependent on us or anyone else as far is possible as they are adults and indepedent peope regardless of their illness, disease or situation.
    You must always be wary of letting matters of the heart complicate your role - which by and large depends on empirical science rather than the unrealistic rhetoric of those who put psychology and self-awareness at the top of the pile.

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  • Were not there to care.....but to deliver care!!

    As a registered nurse im actually shocked by that statement. I believe to deliever quality care to your patient you need to 'care'. Not only for the patients needs, but for the job you are doing, the environment you are in and for the people you are working with. If you dont 'care' how effective is your personal nursing care? How strong is your nurse patient relationship? Having being a patient myself im fully aware that patients will have a better relationship with those nurses they feel that care. I always consider my patients emotional status/feelings...after all - we are there to deliver HOLISTIC nursing care!!

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  • Danielle Pryce

    I agree with you Louise, however, I think that we as nurses need to try to not get too attached with our patients and to have faith in our MDT. We are all here to work together ad have to appreciate that we will all do things differently but this does not mean that we are more capable than the next nurse. For our own well being, we should try our best to try leave our work where it is and be the best that a nurse can be when on the wards, out in the community or wherever we choose to practice.

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  • I agree. There is no such thing as a nurse patient relationship unless you count every interaction as being of fundamental value. But where do you draw the line. Must every interaction be therapeutic?
    Must you always be 'on'? It would appear so according to ms murphy.

    How can we investigate the reality of nurse patient relationships. They aren't a strategy. you're still playing it by ear, like the rest of humanity so let's not dress up the abilty to be nice and well meaning as anything other than that.
    This is precisely the rhetorical nonsense that nursing has been wasting its time on. Ridiculous efforts wasted on spelling out the blinding obvious. If people get along then things run smoother, but somtimes they don't and you might have to step in and resolve it. WOW! what a shock!

    Let's get real. You don't know her and she dosen't know you. Be realistic about what your ipact is. YOu wouldn't recognise her in the street 6 weeks later unless she was that definitive looking. She got better because of science. Not because a 'relationship' was played out on the ward.

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