Healthcare frustrations - a patients’ perspective

In this line of work, there can be moments that stand out to us healthcare workers. Sometimes even the most hardened and seasoned nurses, doctors, therapists, etc. can be moved (even to tears) by their professional interactions. Some may have experienced this before firsthand, or secondhand while passively scrolling or reading emotionally charged stories. Alternatively, some may feel indifferent or emotionally detached. Whether part of our personality before entering the field, or simply the result of being in it, I have seen many become calloused to the plights of others, at times myself included. While the frustrations within the industry abound and it is all too easy to slip into a mindset of perpetual burn-out and apathy, it can be refreshing to take a step back and try to see things through a patients’ eyes.

I will be the first to admit that while I do my best to help others - patients and coworkers alike - and embody a practice I can be proud of, I rarely find myself developing those deep emotional connections. It seems easier to provide the necessary care, be that listening ear and unconditionally compassionate presence, yet maintain boundaries and avoid investing myself into those deep, comprehensive relationships. Reflecting, I imagine it is because building that emotional connection can be daunting and even feel impossible when we are struggling to simply perform the essential tasks and meet the seemingly ever-expanding expectations being laid before us. Valuing a positive attitude and lack of stress in my day-to-day as much as I do, I feel that for me to do my job well AND attempt to build those genuine connections with every interaction would require more energy and effort that would detract from my own. “You cannot give from an empty cup”.

That being said, those connections can be a fuel that drives some people, without distracting them from providing excellent clinical care. I’ve said it before and I’ll say it again, everybody has their strengths and areas that can be further developed. For me, I take pride in my bedside manner and ability to remain calm in situations but am starting to realize just how superficial those nurse-patient relationships can be. I come prepared to work, care and be present for my patients, but then I go home to live my life and put work behind me. Work-life balance is one thing, but creating such a dichotomy seems to create anything but sustainable balance. Perhaps if one feels driven to keep their professional life separate from their overall being, that should indicate an opportunity reflect on if they are in the correct line of work. Or what they can do to develop a better mindset and healthier alignment.

Bit of a tangent, but this particular interaction had me thinking and reflecting on it! I’m glad for it too because it was a nice little wake-up call. Let’s name this particular patient De. De was a wonderful 91-year young patient from home with her hubby (96!), fairly independent who came in initially for one thing and was found with elevated trops and the decision was made to go for a heart cath. Now, knowing the patient (DNR, very much wanting to be home and avoid medical interventions) part of me does have to wonder what the end goal was and if the patient was fully informed when making the decision to go ahead with the procedure. Either way, she had the cath done and returned to the floor.

I returned that night and received updates, including that no intervention was done and the patient was very frustrated feeling it was all a “waste of time”. De was very pleasant and the typical “don’t want to be a bother” patient. I had been running late with her nighttime meds the night prior, so after making sure everyone else was stable I made her my priority. She just looked and sounded uncomfortable, and after a little heart-to-heart, she expressed her mounting frustration with her experience there. Saying things like “I wouldn’t have gone through with it if I had known they wouldn’t do anything”, and “everyone keeps coming and going, I shouldn’t have to call you for you to be here when I need you”. Between communicating with providers, receiving an admission and trying to settle the other 5 patients for the night, I reassured her as best I could and explained that sometimes no intervention doesn’t necessarily mean it was all a “waste”. When all was said and done, I ended up spending the vast majority of the first two hours in her room.

It was hard for me to tell at first if she was just frustrated over the procedure or if she was genuinely declining, but when she complained of increasing difficulty breathing and I saw her heart rate steadily on the rise, I knew something was wrong. Sure enough, listening to her lungs the crackles were obvious, and although I&O documentation wasn’t the greatest, I had no doubt her fluid balance was off. I gave some lasix, did an EKG then escalated to an RRT to receive further interventions faster than secure chatting providers had been providing me. After another dose of lasix, placing a foley and starting her on BIPAP, she was looking much better. I was happy with how quickly we stabilized her, and it was nice to see her look more relaxed before transferring her to ICU for the night.

Easy enough medically, what was more memorable was the patient interaction itself. Here was a patient with very reasonable expectations, the ability to articulate them, and her frustration over having us fall short of them. Yes, her frustration was probably aggravated by her physical condition at the time, but she genuinely felt disappointed in the healthcare industry as a whole. De was upset that people were always on the move and not taking the time to be with and anticipate her needs. She didn’t want to be a bother, using the call bell to beckon us like servants, but expected us as healthcare professionals to be present and meet her needs BEFORE they became urgent. I apologized for falling short on that front, and although she was feeling much better and thanking us by the time we transferred her, her message was worth reflection.

It’s tough trying to meet those expectations, all the while running around performing task after task after task for our many other patients. It can be easy to switch into autopilot and simply “do the job”. And while I appreciate some of the initiatives and changes different facilities implement to improve our overall practice, the application can end up becoming tedious, especially when staff are already feeling overwhelmed. The healthcare industry is imperfect, but our focus should always. Be on. The patient. Not constantly stressing over doing all the little things perfectly all the time. Trying to organize our time and priorities outside the room, but when inside, being present, looking and LISTENING.

I can’t guarantee I won’t go on autopilot and be more task-focused from time to time, but I can promise that I will be trying harder to stress less over racing through the to-do lists and keep my focus on being fully present for my patients, like De.