Caring too much?

[fozzy40]

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Let me preface this with the fact that I just got off of a tough month of ICU. I'm just freakin tired of all the BS:
-lab techs drawing blood 1-2 hrs late
-nurses incorrectly (if at all) carrying my orders
-nonteaching attendings who are MIA
-teaching attendings who don't teach
-family members who think it's better to keep a patient trached @ PEGed so they can sleep at night
-etc., etc.

I work so hard for the good of the patient and at the end of the day I feel like it's all for nothing. At the end of the month, I've learned that the only way that I can deal with this type of frustration is to care less about the patient...it saddens me.

Has anyone else felt like this? How do you deal with it?

 

[Castro Viejo]

Has anyone else felt like this? How do you deal with it?

Read The House of God by Samuel Shem, M.D.

We've all been there.

 

[SocialistMD]

Most everyone feels this way at some point having rotated through the ICU. A lot of it has to do with how you define what is best for the patient. On the floors, it is generally accepted that life is the best outcome. However, in the ICU, that isn't always the case. When you come to terms with that, it makes your life easier. You then see the prolonging of futile care at the wishes of a family (or primary physician) with unrealistic expectations as just another one of those things in your life as a resident that you have to do simply because you are told to. You make the patient as comfortable as possible, even if it means throwing fentanyl and versed at a patient who has no brain stem reflexes because it makes the family feel like he isn't in pain. You babysit the living corpse until the family has come to terms with the reality of the situation and you then do what is truly best for the patient and let them go.

Everyone dies. Your job is to make sure it happens with as much dignity as the family will allow. You can't save everyone and there are some you shouldn't. It isn't caring less; it is understanding mortality and becoming comfortable with your role in the process. None of us went into medicine with the goal of losing patients, but it is going to happen. You just need to do your best to preserve the dignity and wishes of your patient and know that (no matter your beliefs on the afterlife) they are going someplace better.

 

[fozzy40]

Thanks for your thoughts. I think most of my frustrations stem from the ancillary staff and nursing as opposed to death and dying. It's just frustrating when you come up with a treatment plan and it is never truly carried out because nursing, lab techs, xray techs, and phlebotomists etc. are too lazy/don't really care to do their job. I am a realistic person and understand that people are busy but believe me this is not a situation where people are too overwhelmed.

It's really disheartening at the end of the day because I really question what the hell I'm doing: 1) developing a treatment plan 2) ordering it 3) reminding staff of the orders 4) double checking to make sure that they are listening 5) cleaning up the suboptimal care that is the sequela of laziness

Argh...