Nurse Jobs London

“Compassion fatigue, also known as a Secondary Traumatic Stress Disorder, is a term that refers to a gradual lessening of compassion over time. It is common among victims of trauma and individuals that work directly with victims of trauma. It was first diagnosed in nurses in the 1950’s.”

There’s a lot more in the article, some of which I have quarrels with, but it does explain quite a lot that may allow people on the other side to understand those of us in the helping professions. (I think it also explains a lot of the very dark humor common to doctors and nurses.it’s our attempt to cope with the overload)

I can see how it might well affect the way we look at our patients sometimes, particularly long-termers or “frequent flyers” (a.k.a. “repeat offenders”) whose problems are often of their own making. Case in point: we have a female patient who is about 5 ft. tall and weighs close to 400 lbs. She’s had problems directly relating to her weight for a long time, and sometime within the last couple of years one of the additions to her being has been a permanent tracheostomy. She has respiratory problems, of course; she’s a little person, probably with rather small lungs, inside a positive MOUNTAIN of flesh. I think her current admission has lasted a couple of months, and she’s bounced in and out of CCU several times. The last time she came out of CCU she ended up with us. She’d been in CCU that time because during a transport downstairs to CT or someplace either the oxygen was not turned on or the tank was empty, and by the time she got where she was going, she was unresponsive. Big OOPS. Anyhow, we’ve had her since sometime last week, and over the last few days she seemed to us to be really going downhill. Her O2 sats (a way of measuring oxygen levels) would go into the 80s at night, yet the docs didn’t seem concerned. Since this past Monday or Tuesday night, the nurses have been eyeing her anxiously, watching her levels drop, running in to wake her up and remind her to take deep breaths.but the docs didn’t seem all that concerned. One of them actually said that if they were “88 or so” he wasn’t going to worry. It was like they’d got so used to her looking like crap that they didn’t even see her any more. Thursday night I had her and a couple of other patients.one a gentleman who was going for open heart, the other our lady who’d finally come out of her DTs and was getting blood. Starting about 4:30 I was busier than the proverbial one-armed paperhanger, trying to get my gentleman prepped (we had no tech, of course, which is the norm any more), worrying about my other lady who was having increasing shortness of breath, running in to remind Ms. Big Girl to “breathe deep, get your chin off your trach!”. She was already on 100% oxygen by trach collar, noplace else to go with that. By the end of my shift, I’d had to take my guy downstairs to surgery, and the lady with breathing difficulty was in full-blown pulmonary edema. Did I have time to worry about Ms. Big Girl? Hell no! That night I came in to find the patient who had tanked was all better (amazing how fast you can fix pulmonary edema!), I had a new patient, and.wait a minute, where is she? There’s nobody in that room! Furthermore, the guy I was to get report from looked tired but was grinning like an idiot. Seems he got a bit aggressive with the docs and finally got one to order blood gases.which were so horrible that they had no choice but to ship her back to CCU. (I’m sure they were no more pleased to see her than we had been!) There she lingered, not on the vent yet but continuing to do what she’d done for us.until this morning, when one of my favorite respiratory therapists came by during report, waving some tubing, and said “Guess what? Pressure support to the trach collar, ever heard of such a thing?” That was exciting to us, because it means that she’s essentially on the vent, and *that* means she can’t ricochet back to us, at least for awhile.

A different kind of fatigue is infecting my sisters (I say that because there are very few guys working in any of the critical care units) in CCU and CVICU. I know there have been some horrible things happening there.a 37-year old who came in with what seemed like a fairly simple, though bad, urinary tract infection, who crashed and burned and died of overwhelming sepsis; an 18 year old girl with pneumonia who just isn’t coming off the vent; some guy down in CVICU who doesn’t look all that old but is connected to just about every machine they own; and yesterday a 27 year old kid in CCU who essentially has no heart left, who coded 3 times before they shipped him down to CVICU to work him up for transplant and do whatever it is they do down there that CCU can’t do. When CVICU had a code we all thought it was him, but apparently it was the dude on all the machinery, as they were just cleaning up when I went down to the chute (it’s located in CVICU) to drop off lab work. This morning on the elevator I bumped into Claudia, who works down there. She looked exhausted and just about to cry, and I said to her “You guys had a rough night of it.” She said, “It’s been a rough week! This was my fifth night this week and I can’t come back any more, there are just too many sick, sick people!” I know exactly how she felt. I submit that we all know that at some point.