the fray.

I've taken care of more than my fair share of open-heart-surgeries-gone-badly-wrong lately, and I'm burned out.

Not only is is physically exhausting (Jamie the 95 Lb Weakling Vs. 250 Lbs of Dead Weight Patient) but it's emotionally gut-wrenching too. People walk in, looking forward to getting this crappy heart surgery over and getting on with their lives, and they end up lying in bed with tubes shoved in more places than G-d created orifices, not getting on with anything.

Some of them can't talk to you any more. You ask them questions, and they just stare at you. And it's like, you don't even want to know what they're thinking, and you're not even sure why the hell you're asking the Aphasic Stroke Guy how he feels, because you're pretty sure if he could tell you, which he can't, he'd say he felt like shit.

What I've noticed, is these stroke patients all have the same look in their eyes. If you look in their eyes long enough--and it doesn't take very long--you notice that same, haunted, fearful look.

The look that says, "Oh shit, am I gonna be like this forever?" and "Please fucking take me out of my misery."

I can't bear that look.

So, I have to cope with my role, which is in theory, to help rehabilitate the patient to their highest level of functioning, or whatever.

Usually, though, we "rehab" them to the whatever stage of prognosis, and they stay for weeks or months on the floor, flopping around like mop dolls when we turn them, diligently, every two hours. They're unable to speak, unable to move themselves, unable to enjoy real food or tell their family how much they love them.

And it sucks.

So, I cope with my role by looking at the patient as a series of tasks to perform, a set of vital signs, labs, meds, and assessments.

I stopped a long, long time ago looking at the patient as a real person, because if you stop and take a look at the pictures the family brings in of dad with the kids at a baseball outting, in some pre-stroke, pre-crap life, all of them smiling obliviously into the camera, their future as-of-yet-unknown fate hanging right around the other side of that shutter click, it can drive you crazy.

And I'm crazy enough on my own.

I do not need that shit. No one needs that shit. Because the reality is, it could be anybody lying in the bed like some helpless overgrown baby. Anybody.

The nursing role, personally, gets harder when I have a family member--a well meaning, concerned spouse or partner, or kid--who insists I see the patient as a person with acute thoughts and feelings and a personal past.

It's like, I want to do that bullshit holistic thing they teach you in nursing school, but I can't. Because if I did, I'd have nothing left not only for the other three or four or five other people I have to take care of that day, and I'd have precious left for myself and my people on my days off.

So you let the wife sort of micromanage your care of their spouse, because you kind of get it, that to her, your patient is That Guy who eventually became The One, even though to you, he's literally just some room number and diagnosis.

But, you also feel kind of annoyed and wish you did nursing tasks in a bubble, without family/friends intervening.

At least, I do.

Some nurses are very good at the talk and teach thing.

Being distractable, and a basically misanthropic person, I hate doing the talk and teach thing.

Give me labs, give me diagnoses, give me clinical signs and symptoms and I'm usually pretty good at putting the pieces of the puzzle together.

I just know I'm not going to put the person--or his life--back together again, so that's where I stop, and I know it shows sometimes, and family members probably think I'm as much of a burned out bitch as I feel.

But to them, this medical calamity has just happened: the stroke, the massive MI, the septic shock, the respiratory arrest.

It's personal to them, and it should be.

But it's not to me. It's just work.

Because for me, "this"--stroke, MI, septic shock, whatever--happens almost every day I go to work.

I'm not superhuman. I just can't be warm and receptive and endlessly patient and understanding when I have a multitude of other things to get done before I clock out. Some nurses are very good at hand-holding and coddling family members; I tend to be the sort of nurse that isn't. Some days, I'm not even all that good at faking care and concern. I feel bad about this tendency, but I also am trying to learn to live with it.

I'm not an ogre; I understand these people want the best care for their family member, and I do my share of comfort measures throughout my shift.

But catering to every goddamn request--be it from patient or family member--can be agonizingly annoying to a nurse, and I think I can say that without invoking too much name-calling and demerits on my Good Nurse badge.

The job often feels like playing nanny/mother to a bunch of grown adults who should damn well know better, and it really feels that way when I need a break from the whole kit-and-kiboodle.

I try to look at this way, in order to minimize my own feelings of guilt and job inadequacy, not to mention overall personality fault-finding:

I do my job (whatever the hell that is supposed to mean).

At the end of the day, I've done whatever it is that I can do, and that just has to be good enough.

Does it work?

Nah, not really.

But nothing else seems to, either.