Note from Adrianne: This is a reflection I wrote after a very challenging shift earlier in the week. I usually keep my chill at work pretty well. I’m known for my patience and as such I’m often given patients with psych or anxiety issues. I’m often told I have a calming effect on these patients despite how detrimental this work can be on my own inner peace. So what you are about to read are my own thoughts after a shift where I didn’t handle myself so well. This journal entry came out of me after I got home and broke down into tears in a long, hot, cathartic shower. I did some editing for clarity, but the underlying message is untouched. I hope this post helps some of you feel less alone in your own frustrations and a little closer to being able to control them when it matters most. -A

I always shower after my shifts - not just for physical cleaning, but to wash away the physical and emotional stress as well. I add a few drops of essential oil under the water for added relaxation. Click this link for a great essential oil shower d… — I always shower after my shifts - not just for physical cleaning, but to wash away the physical and emotional stress as well. I add a few drops of essential oil under the water for added relaxation. Click this link for a great essential oil shower diffuser: https://amzn.to/3cad7d9

Last night, I had two very angry patients. Very angry and verbally abusive the entire shift. And I was their nurse for 12 long hours. And I let myself get angry. I couldn’t get them to do any of the medically important things I asked, and I let my emotions get the better of me.

Only, it’s not what you may think.

I didn't respond in anger directly towards either of them. I did not yell at them. I didn’t say inappropriate things to them. I was not physically forceful. I don’t think it’s in me to do those things.

I was verbally short. I probably had impatience in my voice. I was angry in the space I occupied - my energy was angry. I felt like I was vibrating each time I had to enter their rooms. I’d exit the room unable to stifle my bitching about the interaction that had just occurred. It wasn't fair to the people around me, specifically, my co-workers and my senior nursing student.

Patient whose oxygen level was 68%: “I’ll put that damn oxygen back on when I see a fucking doctor.”

Me: “Well, you’ll probably pass out before the doctor gets here, so let’s put it back on now, ok?”

Yeah, not my best negotiation ever. The patient did not put the oxygen back on for me. Another nurse sweet-talked him into compliance a few minutes later.

In that situation, I let my frustration get the better of me. Even though I am human and imperfect, I should know better after all my years in nursing. I let the situation rob me of my patience and level-headedness. This was not my first encounter with difficult, non-compliant patients. My training should prepare me to handle these encounters.

My coworkers were great, they acted as a buffer for me throughout the shift. They stepped in when they (and I) knew I was in over my head in those moments — when I was too worked up from being screamed at for providing good care. Each time one of the patients would pull off their oxygen and I’d have to intervene, I could feel my heart pounding in my temples. I tried keeping my voice calm, but I could hear myself sounding increasingly impatient, eager to just get this patient’s oxygen back on as he yells and protests and his oxygen level on the monitor drops, and he struggles to catch his breath.

I was called the “oxygen police”, told I was interfering with what the patient knew his body needed, also told I was worried about “shit that doesn’t need worrying”. Important to note these patients all wanted CPR in the event they stop breathing….so it DOES need worrying, Buster! (See? there’s my attitude again!)

In hindsight, I’m most upset that I didn’t recognize in the moment that their anger was not just them being stubborn assholes (though that may have been part of it). It's more likely a result of these two previously independent adults being completely out of control of their situation, feeling very emotional, and not knowing what to do with these emotions. In reality, each of their situations are really sad. (HIPAA prevents me from saying more.)

Sometimes you can try to be kind, tender, and therapeutic, and they’re just pissed. That’s not a license to be pissed off back. This is harder than it sounds for many of us nurses.

I would be devastated, in fact, if I found myself in either one of their shoes - robbed of their independence by illness and disease processes, unable to go home, not even wearing their own clothes, in pain, tethered to the wall by oxygen tubing. They are old men at the hands of young female nurses who don't truly understand what they're going through, and who they perceive are just telling them what to do all the time. I’m sure there’s a range of emotions there and I’m just scratching the surface.

So what I’m getting at is that I know better, or at least, I should know better. I should react not with anger and immaturity when I have poorly behaved patients. I was cursing at the nurse's station at shift change (to be fair, I wasn’t yelling), being an overly-animated vexation - someone that I wouldn't want to be around myself. I was internally worked up, trying to let it out slowly, like a squeaking balloon.

Can you just feel how freaking over it I am? I also had dropped my surgical mask on the bathroom floor so I had to put on my KN95 mask which smelled like candy from being in my workbag, and I have on my scarf because I was freezing. I am a hot, hot … — Can you just feel how freaking over it I am? I also had dropped my surgical mask on the bathroom floor so I had to put on my KN95 mask which smelled like candy from being in my workbag, and I have on my scarf because I was freezing. I am a hot, hot mess.

Some coworkers said I was kinder than I gave myself credit for in the moment. I didn't get any dirty looks from the oncoming shift, and everybody seemed to understand why I was frustrated. They laughed with me as I tried to laugh off the negative feelings, they empathized with me, and some complained along with me having been through it themselves on previous shifts. The empathy from my nursing brothers and sisters was there.

But, in hindsight, is that the energy I want to bring? Is that the trail I want to leave behind me and the example I want to set for my senior nursing student? Now, I don't know what my relationship is with God, but God bless her. She was the calm level-headed one that interceded when I was trying to prevent my own head from exploding. She was the one that was going into these patient rooms smoothing things over, pretending she knew nothing of the conflicts just had by me and them. She was the proverbial Good Cop to my Bad Cop. In this case Good Oxygen Cop. haha. (Disclaimer: These patients posed little to no physical risk to my student.)

Her encounters with them were just more evidence to me that though my words were not angry, my energy was. Her energy was chill and they responded better to her. They opened up to her a bit more, and while they were still angry, their responses toward her were much more tempered and less reactionary. I stood outside the door, out of sight, like a Momma Bear ready to pounce if either one of them took a swipe at my cub. Fortunately, she’s stellar and needed no protecting. Despite her excellent intercession, my reaction toward my own attitude still sucks.

I’ve been reflecting on this a bit. This experience is an example of something that takes away my confidence as a leader. Feeling that emotional is not a quality I want to boast as a bedside clinician and teacher - though I recognize I am an imperfect human. You know, I first think about how walls have ears. You never know who's listening, you never know who's gonna hear, follow that lead, be hurt or upset. You never know who's gonna put this on your next evaluation and judge you for it, or be influenced by what you’ve said or done.

And it's not even purely about the external judgment, I judged myself for it. I know I have the ability to moderate my emotions better at work…because I’ve worked hard to build that muscle. It wasn’t always easy for me. Learning to control emotions in an environment that is LOADED with INTENSE emotions like a hospital is a skill you learn and practice over time. You have to or you’ll be a struggling ball of emotion all the damn time and that’s not sustainable.

There’s no sense beating myself up for it, which of course, is my natural tendency. The point is to learn and move forward, stronger.

When I feel my emotions starting to pool up, I need to remember that inside every patient that is angry, there are other emotions there, too. Maybe they are lost, scared, confused, angry and they don’t know how to process or express those emotions let alone with strangers. I know that if I went in the hospital for a bad cough and while I was there somebody told me I had to go to a nursing home, and that I couldn't go home with my partner the emotions would be incalculable for me. While I’m no punching bag, I have to remember that they’re lashing out because of the storm inside them. I am allowed to feel annoyed, but I can’t let them hear I am annoyed. It’s a subtle, but important, distinction for how we carry ourselves as providers.

After that shift, I got home and got in the shower like I always do, and I was listening to this music video that my friend sent me. What's funny is that it was a video that she had texted me at the beginning of the month and I didn't see it until now, weeks later. It's kind of good that I didn't see it because I probably wouldn't have appreciated it the way I'm appreciating it right now after this particular shift and the way I was feeling.

It is basically a song that is like, “are you okay? do you have food? do you have good memories? are you safe?” And it made me think like “yeah, I'm in my own shower and I'm going to put on my own clothes and lay in my own bed. I'm, I'm pretty lucky, and those two patients that pissed me off and made me struggle to get through those last hours of my shift are still living that storyline, and still have those problems and are still in that hospital and are still angry, and feeling those emotions and some other nurse is dealing with that and trying to keep her cool. Hopefully, they're doing a way better job than I did”. Here is that song that I, at first, found really sweetly dorky, and then found really cathartic.

The Full Length Visual Album is now live on Broadway on Demand!https://livestream.broadwayondemand.com/keep-going-song/The Keep Going Song: Live From Our Hou...

So, I think I need to keep the lesson and throw away the experience because I feel really crappy about the way I behaved, but I think that there's an important lesson here to be learned. I decided to get these thoughts down so that I could share them with other people that maybe have a similar kind of hot-headed experience.

I’m not just a nurse. I’m a person, with feelings and I don’t deserve to be treated like crap by patients. I also am responsible for controlling my emotions in response to patients that need me as a protector in their most vulnerable times.

And all joking aside, I'd also like to say that I drank half an energy drink last night and I never drink energy drinks. So, in retrospect, I'm also not going to drink energy drinks at work ever again.

One last shout out to my nursing student, she knows who she is. She is going to be a great nurse for some lucky hospital. I will write any recommendation letter that she asks me for after taking care of that assignment for a few shifts. I can’t imagine what those nights would have been like without her help and the lessons she taught me.

Now my tired, moody ass has to go to bed.

Peace,

An ever-evolving, emotional nurse