amelia's plum

Wednesday was quite a day in the ICU for me. New location, new ICU, longer drive, meaning I need to get up even earlier. The hospital is in a depressed area so things seem very different in terms of the patient population than the suburban more homogenous hospital where I've done all my other clinicals at so far. My patient from Tuesday was stable enough to be transferred to another part of the hospital so I came in bright and early Wednesday (6:30) and got a new patient. Now getting a new patient is very hard for me because I'm someone that likes to know what I'm getting into. As one instructor mentioned, I have a comfort zone. So as much as I loathe the mountain of preclinical paperwork I'm thankful for it because I spend at least five hours, usually closer to eight, the night before clinicals learning as much as I can about my patient. That way I can try and be on top of things, and try and calm my nerves, when I come in first thing in the morning. But I couldn't do that Wednesday. I also cannot do that in real life, there isn't time, so it was a good experience, if also somewhat terrifying. My patient on Wednesday was someone very young who attempted suicide. It was sad on so many different levels; the patient's age, the spouse at the bedside, who was so unbelievably kind to me, even in the midst what's happened to them, the kindness of other family members. These are the times when I get really close to crying (okay, if you've read any of my blog you realize that I get really close to crying or actually cry quite easily) because the whole situation is, obviously, quite emotional and the patient so young. There's a problem that I keep coming up against in nursing school. It's not so much caring for the patients, although I worry, pretty much constantly, that I'm not doing a good enough job helping them. But I can deal with beating myself up in that area because I want to help them. The thing I can't handle is the lack of sympathy, emotional hardening or downright meanness that I see in some of the other nurses. I do not work in an ICU and I have heard from numerous sources (a good percentage being those who have worked in critical care) that nurses in critical care can comes across as arrogant, in part, because the job is incredibly stressful. People say you have to emotionally distance yourself or you won't really survive in that field. But that does not make the nasty, demeaning comments that this one very seasoned nurse said about my patient right. I don't care if it was meant to be funny (it wasn't) or if it's how that nurse deals with working in the ICU. It was so fucking judgmental and small and outright mean and the patient might have been sedated and vented but that doesn't mean they can't hear you or understand what your saying. For a patient to have so much negativity directed towards them, by the person that's supposed to be caring for them, is unconscionable. Mental illness is so stigmatized and I guess I naively hoped that it would be different in a healthcare setting. From my brief experience it seems that it isn't,different unless you're at a psychiatric hospital, then they're very compassionate towards those with mental illness. And if mental illness is stigmatized, suicide is like the illegitimate child of mental illness that no one wants to talk about. And it's so wrong because for those who attempt suicide (or succeed) and the family members of these victims the grieving process can be far more difficult than for other people that get critically ill or die. There's so much shame, guilt and anger that can be attached to suicide, if anything the patient (and their family) need more care directed towards them, definitely more compassion, not judgment and jokes about 'these kids don’t know how to do it (kill yourself) the right way.' And that was one of the more tame comments. The things I heard just make me seethe. And then I start wondering where can I be nurse where I can make the biggest impact? Should I become an ICU nurse and do my miniscule part to put a compassionate, hand holding, if also very nervous, nurse in that field. I see so many problems within healthcare (and, to me, having a nurse that makes fun of a patient they're caring for is a HUGE problem) but I really want to try and help fix them. I just don’t know how.