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Interacting With Patients
Compassion with Distance
Staying professional in the midst of suffering.


It was one of those days in the pediatric intensive care unit you’d love to forget.

One child, a 6-month-old girl, was in a vegetative state, both blind and deaf.  Her mother decided it was too painful to have any contact with her and had stopped visiting. The little girl’s father wanted everything done to save her.

One morning, five minutes after Jana, a second year nurse, took report from the night nurse, the baby coded.  Over the next 12 hours, they worked a code on this baby, doing cut-downs on her wrist, trying to get in an IV. In a recent conversation, Jana said, “I thought, If she can feel what’s happening, that’s so wrong. And if she can’t feel the pain, then why are we trying to save her?” Jana said she spent the entire 12 hours praying the baby would die.

Eventually, she did die—but not for another two weeks. For Jana, the experience opened her eyes to the reality that she wasn’t cut out for a job where so many children suffer, and eventually die. Jana said she couldn’t separate herself from the patient’s suffering; it was too emotionally draining. Within weeks, Jana called it quits, and found another nursing position.

Looking back on this scenario—and other times in her nursing career when she became emotionally involved with a patient—Jana offers key advice about what to do when you’re “in too deep.”

Find the Right Fit
While it’s really difficult not to become emotionally involved with some patients, if you continually go home defeated and emotionally bereft, then Jana says you might consider finding a different nursing position—one that fits your personality.  Jana still loved nursing but found that family practice was a better match for her personality. She says, “It plays to my strengths. I get to have long-term relationships with people now.”

Just because you don’t feel cut out for one nursing position doesn’t mean you are not cut out for nursing all together.

Be Professional but Not Impersonal
For nurses who feel too deeply for patients, keep in mind that you can control your emotions. You are there for a time in the patient’s life—and that’s all you’re intended to be there for.  Your job is to be the best patient-care advocate for that time. Jana says, “As a nurse, you are the professional, and they’re the patient, and you need to treat them that way.”

That doesn’t mean you should have a stone-cold bedside manner. Just don’t let your patient relationships leak into your private life.  Jana recalls a patient who sought her outside of work to meet for coffee. After meeting once, Jana realized that the woman was emotionally needy. She began calling Jana at home and asking her to take care of her kids. What she really needed, Jana realized, was a friend. “If I wasn’t her nurse,” Jana states, “perhaps I could have been her friend. But I couldn’t be both.”

Lean on Other Nurses
When you can’t leave your work at work, Jana suggests talking about your concerns with other nurses. Jana states, “If there’s something really bothering me about a patient, the first thing I do is talk to other nurses at the clinic who also know the patient.” Talking on a regular basis with other nurses helps you figure out how to gain some emotional distance. The conversation with other nursing professionals reframes the issues—and is the best preventative for emotional overload. And it beats the alternative of taking it home to your family.

Melissa Parks is the editorial director of RealityRN and has worked in publishing for 10 years. She did her post-graduate work in English literature at Loyola University in Chicago.


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3 Responses to “Compassion with Distance”

  1. James S. Says:

    I see this all the time–my co-workers getting emotionally tied to their patients. When I suggest they “get ahold of their emotions” I’m accused of being cold. Anyone encounter this?

  2. M. Foster Says:

    I find that sometimes I think I have a great relationship with a patient — just the right balance of caring, listening, responding, and professionalism. Then I realize that at some point I have said or appeared to the patient as cold, demanding, autocratic. For instance, I recently had an elderly lady who was preparing for a procedure, and needed to drink a gallon of fluid in 6 hours. We had been laughing, smiling, and I thought she was comfortable with me. Later she told me that I had “ordered” her to drink and she was worried about drinking the gallon quickly enough. I apologized and said that I thought I had gone out of my way to assure her she had plenty of time and did not need to rush, but I could see that damage was done.
    In these situations, I want to cry more than at any other, because I feel a sense of hopelessness. I keep modifying my communication style, but occasionally I still get shocked by situations such as this. Do you have any advice?

  3. kdaniellel Says:

    I am very torn at this moment. I don’t know if my area of nursing is the right fit for me…As I come to the close of my first year as an Oncology nurse I have to say that I am emotionally wiped out and it’s not because of the patients dying or being perpetually sick. I love giving total care, compassion and comfort to my patients and families.

    I work on a GYN-ONC unit and the patients are overwhelmingly needy, anxious and controlling. I am called constantly from room to room and sometimes it’s for something like fixing a pillow. I find it so difficult to really connect with the patients like I want to at this point because the families put so much of their emotional burden on the nurses– through constant calling or questions. Also I feel like certain patients don’t consider that the nurse is not THEIR personal nurse and that we do have multiple patients at all levels of the cancer spectrum (from newly diagnosed to a few hours from dying).

    I hate to vent and feel so guilty because I genuinely care and there are days I feel so appreciated and really love the work—then there are others (and they are getting more frequent) when I want to just walk away. I wonder if its time to move on?

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