Judge Not Lest You Be Judged

How can we not get frustrated when we work at helping our patients get healthy, only to see them throw it all down the drain?

How do you manage your thoughts and feelings at work if you are going through a particularly difficult time yourself? For example, if you have a family member who is seriously ill, despite trying everything to stay healthy, and you have a patient who is also seriously ill but is not caring for himself properly, do you feel angry? Do you feel frustrated?

I remember when I worked in a medical intensive care, I did find myself resenting some of the patients who were returned frequently because of issues related to their lifestyle. The easiest ones to remember were the alcoholics, who came back time after time with gastric bleeds. After receiving several units of blood and getting cleaned up, they’d be sent up to the floors where they stayed for a few weeks until healthy enough for discharge. I remember caring for them on the floors too; they knew the routine, as well as we did, because we had done it so often. After discharge, some would be with family members, but most often, they’d be alone. That meant we’d be seeing them again soon, as they fell into the trap of their alcoholism again.

But another group of patients that would frustrate me were the ones who would readily admit that they were ill, with diabetes, hypertension, or asthma, for example. However, they wouldn’t take care of themselves. The person with diabetes who won’t follow a diabetic diet or doesn’t care for a cut on the foot that develops into a huge wound. The person with hypertension who feels she doesn’t need her blood pressure meds but then is shocked when she has to be admitted to the hospital because her blood pressure is at such dangerous levels. Or the asthmatic who won’t stop smoking or only takes his puffers when the wheezing or coughing has gotten so bad that the rescue meds can’t work.

These patients aren’t stupid. And, amazingly, many of them can tell you all the ins and outs of their illnesses, and yet, they still don’t take care of themselves. Sometimes, it’s the families who are the problem. I’ve seen many times, patients with diabetes who are brought to the hospital high sugar, high fat foods, despite being told several times that the patient can’t eat them. Many of us have known mothers or fathers who smoke, despite their child’s asthma, feeling that standing under a ventilation fan in the kitchen will make a difference.

How as nurses do we handle this? We’re taught that we’re not to judge — and that I can accept. But how can we not get frustrated when we work at helping our patients get healthy, only to see them throw it all down the drain?

Many newer nurses have a problem with this because they haven’t yet learned how to work around these issues. Many older nurses have a problem because they are tired, burned out, and fed up. But surely, there is a way to deal with the feelings that we feel as a result of our patients’ conditions and how we see them.

How do you manage?