Monday, May 5, 2008


My patience with my patients often wears thin. I work with a chronic disease population (kidney failure), which is totally different than working with people who are acutely ill or injured or have just had surgery. What I do is considered long-term life support, because without their treatments, all these people would be dead within a few short weeks.

They often have huge denial issues about their own condition. Non-compliance with medications, dietary restricts, fluid consumption, showing up for dialysis treatments... all those things can make the difference between life and death and sometimes, they just don't seem to care! Guess if they don't take any responsibility for their own selves, then whatever happens is not their fault and they can't take the blame. ((sigh))

But on the flip side, this type of nursing has some advantages over the traditional type of ward nursing. Here, we get to know the patients and establish a rapport with them that is impossible with someone who comes in ill, is cared for until they are better, and then goes home, to hopefully never be seen again. Dialysis patients are in it for the long haul. They come to know and trust you on a level that doesn't happen elsewhere in the hospital. You get to know some of their family and friends. You follow along with their ups and down, both with their health and their personal lives.

And this area of nursing allows for a lot of patient teaching, given repeatedly over the first weeks, as the person starting on dialysis becomes less overwhelmed and more able to absorb information about what is now their life. But after a while, when they just don't get it, and don't seem to care to get it, you get frustrated and your ability to empathize begins to fail. You tend to get what may appear to be callous - not really caring if they don't take their meds, don't watch their diet and fluid intake, don't take any responsibility for themselves. You can only do so much to help them, and if they won't help themselves, well, you can only do so much.

Sometimes I have the patience of a saint, but most of my patients are far from saintly.... and that frustrates the hell out of me.

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