Thursday, May 01, 2008

Patient Contact: Missing in Action

My new work life has significantly decreased regular contact with patients, the one-on-one interactions that are part and parcel of most nurses' lives. In a recent post, I mentioned how I'm personally missing some of my former patients and the place that they inhabited in my life. I also find that I am simply missing the types of interactions that can remind me of why I became a nurse in the first place.

My current per diem visiting nurse gig is just not panning out, with several weeks going by without my being needed whatsoever. In my other per diem work, actual patient interactions are few and far between, and when I find myself with a patient in their home, I relish those brief moments of connection.

Due to my health, I am fiercely resisting the psychologically subterranean urge to take a 15- or 20-hour part-time position, but I am applying for two more per diem visiting nurse positions (one with a hospice component) in the hopes that I can have more experiences of face-to-face therapeutic interaction without the nightmare of case management.

So why did I leave my previous job, you may ask, if I miss patient care so much? The fact was that case managing 83 chronically ill people was no picnic, and the detailed coordination of those individuals' medical care---while gratifying and challenging---had such a negative impact on my health that it simply had to end. While I enjoy the interaction, it's the case management and detail coordination that almost killed me.

So, this nurse aches for patient contact but eschews the trap of full-time or part-time work which previously proved so burdensome. Now the secret is to fulfill my yearning while still avoiding burnout........


Anonymous said...

Investigate becoming a peritoneal dialysis nurse. It's some case management of a sort, lots of autonomy, ongoing relationships with patients but enough distance to keep from burning out. Mostly a day job, most of the call is handled over the phone with a rare need to go in on a weekend (depending upon the program) to administer IP antibiotics. Most of the time the patients walk and talk and are fairly functional. It may serve your need for patient contact and involvement but take away most of the niggling irritations of case management. You can even do home visits but they are simple.

Keith "Nurse Keith" Carlson, RN, BSN, NC-BC said...

Thanks, Janet! That's a very kind and detailed suggestion. I appreciate your thoughtfulness.