I originally started to title this post, “I’m Doing the Best I Can.” That’s certainly how I feel most of the time, and occasionally consider having that slogan monogrammed on the front of my scrub top. I just find myself in a difficult place most days on the job.
I know many jobs are like that, where you feel overwhelmed by the expectations placed upon you to perform at such a high standard. I’m sure stress is inherent in other fields, but I can only speak for myself. I can only speak for my specific profession. The nurse. More specifically, the ICU nurse.
It’s not just the knowledge I am required to possess, although that’s a big deal. Indeed I’m expected to hold a vast amount of medical knowledge within my brain. It’s constantly changing, evolving, and being added to, this vault of nursing know-how. It’s not just disease processes and the medications to treat them, but also the complications and possible side effects. Any nurse who has sat in a two day Trauma Nursing Core Course can attest to the feeling that your brain may have reached maximum capacity. But somehow it doesn’t leak out your ears. Instead you just keep learning, and that’s pretty much a requirement for the job. No, it’s definitely a requirement.
Despite this feeling of pressure to know every single thing there is to know, you get past it easily enough. It’s just part of it, and you knew what you were getting into from the beginning as far as that goes. Nursing school is no joke, and with good reason. It certainly gives you a glimpse of what you’re in for, but the real learning doesn’t start until you hit the field. It’s a lot to know. A lot. But that’s not really what bothers me.
There are certain expectations of my employers, but that doesn’t really bother me either. While I’ll admit that the continuous cycle of mandatory in-services, meetings, and continuing education is frustrating at times, it’s understandable. And yes, the series of charting, and more charting, and double-charting seems asinine some days, but I get it. I know why we do it.
So maybe I have a dress code and a standard of behavior that some jobs may not require, but it makes sense to me. I’m expected to be on time, to work overtime, or to stay late, and that’s fine too. Twelve hours are long you betcha, but eight hour shifts aren’t much easier in this field. Not really. So I just take it all in stride. It’s part of the job, and it really doesn’t bother me.
And maybe I have some physicians that come to the bedside for about five minutes, and in that time frame I become their own personal assistant. They expect me to provide a full patient history, list of medications, and current physical assessment to them so they may breeze in and out of the room without ever lifting a stethoscope. Not all doctors do this, but some do. Even if they don’t want me to do their job for them, the others do require me to be their eyes and ears on the ground. That actually doesn’t bother me a bit. I feel honored to be such an integral part of the healthcare team, even if I’m often under-appreciated.
While they may take their lack of sleep or personal problems out on me at times, and yell at me like I’m unworthy of their presence, I try to let it roll off my back. I don’t deserve to be treated like I’m less of a person, but sometimes I am treated that way, and you just get used to it kind of like you do the long hours and never-ending education. It’s just another one of the things you deal with, you know?
It’s not the expectations of me from my physicians, nor that of my employers that really bothers me. It’s not even all the stuff I have to know at any given moment. I think what really weighs heavy on me are the patients and their families. They expect more than anyone else, and I often feel as if I fall short of what they desire of me.
When someone is sick, they want to feel better. When something is wrong, people want answers. Emotions are frail, tempers raw, and naturally expectations are high. Sometimes those expectations are even unrealistic.
If I could say anything to my patients or their family, I would say this. I don’t always know all the answers. It’s not that I don’t want to tell you, or that I’m an idiot, or that I’m not good at my job. Even though I’m a nurse, I don’t always know all the answers. Sometimes the answers cannot be found. I wish people could remember that.
I am an imperfect person. I might make a mistake. I’ll do my very best not to, but every once and a while I may not do everything perfectly. I certainly won’t always deliver up to your expectations. I’m human, and I wish people could remember that.
I’m doing the best I can. The thing is, I really desire to be perfect. I desire to meet and exceed your expectations, but sometimes I won’t because sometimes I can’t. Sometimes, no matter how hard I try, I cannot do what you want me to do. I cannot always make someone better. I’ll try with every fiber of my being, but sometimes I’ll fail.
No one wants to make you or your family feel better more than myself. Trust me. You see, I feel a responsibility to you, to your family, to give everything I can to make you well. But sometimes, it’s just not enough. My intentions and my desires cannot fix you. I wish they could.
When they cannot, and an eventual decline ensues, you’re not the only one grieving. So am I. And while I don’t pretend to know your pain specifically, I do feel the loss deeply myself. When a decline ends with a final gasping breath or the slowing of a heartbeat until only a flat line is seen, I weep too. Sometimes I weep with you, but more often on my own.
Sometimes I fight and fight to keep death at bay, if that’s what everyone wants, but sometimes it comes uninvited and steals a life without my permission. This is really hard, but it’s even worse if you don’t feel like I fought valiantly.
It’s even more devastating when you don’t think we did all that we could. When your grief turns to anger at your nurses it breaks our hearts. When you yell, point fingers, and threaten a lawsuit, it feels like you’re pulling the rug out from beneath my weary feet. I want to scream, “I did the best I could! I promise!” I wish you could see that…
I have to accept the fact that sometimes you won’t. You won’t be able to see past the pain of loss to the heart of your nurse. It’s a heart that breaks when she cannot please everyone. She knows it’s impossible to please everyone, but she tries, and she wishes you could see that.
It’s depressing, but it’s also frustrating. It’s frustrating trying to fill the huge shoes that the majority of your ailing population expects. I am finite, and I am small. I am human, and I am imperfect. I have kids that get sick, and a husband I worry about sometimes. I have health problems myself. I get tired, and I get hungry. I need a rest, and sometimes I need to vent, or laugh, or cry. I’m an emotional being. Sometimes I feel like that’s forgotten, and I just wish I could be held to a realistic standard rather than a superhuman one. But mostly I wish you could know that I’m doing the best I can.
My job would still be difficult. That’s just the nature of the beast. But it would be so much easier of a burden to bear if they only knew and believed that no matter what, I’m doing the absolute best I can do.
Kathy Nolan says
Sometimes my heart breaks when I feel so helpless. I know we are doing better than 40 years ago when I first became a nurse…then there will be that one case that I feel we …or more to the point, the ICU nurses…have failed at the thankless job of being on the side of the patient and the family. Sometimes you just can’t win!!!
brieann.rn@gmail.com says
Thanks for the comment. I agree, sometimes you can’t win…
Rhonda says
You are an awesome nurse. The patients notice trust me. I was asked just last weekend who that nurse was that sings all the time. I told them your name and the next comment was “her voice just fills this place.” All of yall in the SI are awesome!
brieann.rn@gmail.com says
Ahhhh! Thank you so much. I take your encouragement wholeheartedly.
Morag Hagerty says
I have read your blogs for about six months now. The open letter to relatives was the most touching, and believe me it touches a core as molten as your own.
This present one , just sums up all we all seem to be, unrealistically held up to standards even the doctors manage to avoid. We are the buffer the blame can stick to, we’re the reason some parents are still together.
I work in an African Cardiothoracic Peds and neonates unit.
Parents are our daily contacts, and believe me when I say “I hear you”
I think the sun shines out of your bottom
Please never stop sharing …… You are gifted.
brieann.rn@gmail.com says
Thank you so much! Your comment really made me smile!