There are many challenges that come with being a nurse, but even after almost four and a half years, I find difficult patients and families one of the hardest aspects to the job. For new nurses, it is definitely something that takes getting used to. From my own personal experiences, here are some best practices that can help you to have a fair mindset when dealing with difficult patients.

First and foremost, remember that being a patient is not easy for any patient.  I think I have said this in prior posts, but always remember they are at their most vulnerable when they are in need of care.  Just like those days when we were strung out about our Health Assessment exam and we may have taken it out on friends or family, the same thing applies to patients when they are sick!  For example, a patient has been hospitalized for almost a month now, or they just found out they need open heart surgery – they are dealing with a whole mix of emotions!  Whenever a patient is taking their feelings out on me, I always try to remember that I have never been in their shoes (which is a good thing!), and that they likely don’t mean to be this way and are probably just doing their best to make it home.

There’s different kinds of “difficult”; there’s the literally difficult patient where everything you say or do doesn’t make them happy; there’s the rude, inattentive patient who gets irritated by your upbeat presence; there’s the depressingly go-with-the-flow patient who doesn’t care if you give them water or juice with their morning meds; and, yes, there’s even the physically difficult patient that providing care to them is an hour-long process because there’s so much to do for them, needing one thing after the other.  I’m also sure there’s many more different scenarios that I have even yet to come across that is classified as a difficult patient.  It’s helpful to remember that it wouldn’t matter if you went into hospitality management or business, it’s just a part of the job.  There are a lot of things we sign up for by becoming nurses, and difficult patients, and families too, are one of them.

I find that the families are the harder part to deal with, namely because they like to speak up for the patient.  It is very well the case that Mrs. Smith knows what is best for your patient, Betty, her mother, because she provides care for her at home as her caregiver, us as nurses just have to know how to deal, which truly comes with experience.  The best piece of advice I can say in such situations is to keep a smile on your face and a calm attitude and not let it affect the care you are providing to your patient.  I have been victim in the past for letting my frustrations show at times (and I always end up feeling terrible about doing so!) when a patient’s family member is asking a million questions during a discharge when all I want to do is send them home and get back to the millions of things else I have to do!  In this particular case, especially when discharging a patient, making sure they know everything that is expected of them and have all their needs taken care of is extremely important – this is usually why people are readmitted to the hospital – so I always try to remind myself of that because at the end of the day, your patient’s health and safety falls in your hands!

There are so many more situations and specific examples I can talk about, but I’ll keep it short for now.  As aforementioned, most aspects to this profession come with experience and patience truly is a virtue :). Just remember, no matter how difficult a patient was for you, nursing is still the most rewarding thing to do!

Sydney Adelstein is a 2016 graduate of The Ohio State University College of Nursing.

1. We’re Okay with it All – I mean this literally. I have had many patients who profusely apologize for having to walk them to the bathroom, or give them medications for embarrassing symptoms, or because I have to clean up their accidental episode of incontinence. Patients should know their nurse does not mind doing what may be gross or embarrassing because it’s what we signed up for when becoming nurses. I always tell my patients, verbatim, to “not be silly and that’s what I’m here for.” We do these things to make sure they are safe, well and cared for. Personally, I feel like these every day doings are the epitome of nursing.
2. We’re the Eyes, Ears and Voice – I feel like this is a norm of nursing that has been widely adopted and understood. Even patients have assumed a greater appreciation for their nurses but for those that haven’t, I wish they knew we’re so much more than medication givers and pooper scoopers. There’s more than what meets the eye when it comes to taking care of them. Most of it happens when we are outside of their room — we are the ones who vouch for them when we see something transpiring; we make sure they have food to eat long after the kitchen staff has left; we are the ones who usually end up giving a more understood & reassuring update to their family. I’ve found that at the end of the day, most patients are aware of who we are and ALL of what we do, and it’s always fulfilling when they realize that.
3. We’re Constantly Putting Them First – This one goes in hand with number two, but there’s more to be said about the selfless heart we put into being a nurse. For example, many nurses are having other people watch and help raise their children so they can work multiple 12-hour shifts. Many nurses go without a lunch or a bathroom break in a timely manner due to all the tasking; and how about those nurses who end up clocking an extra hour because they made sure their patient had everything they needed before they went to go take care of their family. A lot of the time, we’re in the middle of lunch and have no choice but to go and help clean up a patient; we take away a lot of our well-deserved personal time for our patients, not only because we have to, but because it’s who we are. Our selfless skill is always reinforced when those patients who do understand these things make it known and are forever grateful to us (my most memorable keepsakes are letters from patients ☺︎).
4. We’re Doing the Best We Can – At times, patients may seem like they have no patience themselves (pun intended). Classic situation being, they’re constantly on the call light every three minutes because you didn’t come back with Tylenol for their headache, which to them is the BIGGEST deal and in their world, it is. When patients are in the hospital, they are at their most vulnerable. I know textbook world makes it seem like everything gets done as soon as it’s needed, but that’s far from the reality of nursing. Depending on the floor & the patient acuity, tasks add up and even the simplest things take longer than we envision (I can’t tell you how many times a “simple” med pass has taken me almost an hour to do because my patient’s IV blew). As much as it’s frustrating to us they don’t see our extensive to-do list, it’s far more frustrating when it takes longer for us to return with their dire need. Every one of our patients has a right to be taken care of in a timely manner, so it should be a daily priority to reassure your patients that you’re truly doing the best you can to attend to their every need (within reason ☺︎).
5. This is Far from the Easiest Job, but the Most Rewarding – Since most of you reading this haven’t experienced the aforementioned yet, know there are a gazillion more reasons in addition to the above which factor into why being a nurse is far from easy, so I’ll cut to the chase. We do and see gross things, we watch people take their last breath & families grieve, we use our every last breath to save their life, but the nurses who are in this profession for the right reasons don’t mind at all. For all the downs/stress/angst/etc, there is always more good. Although cliché, there is a mutual reciprocity in terms of touching someone’s life: our patients make just as much a difference in their nurse’s life as we do in theirs. In another life, I would choose being a nurse over and over again. For patients to know this about their nurse it should be exceptionally comforting.

Sydney Adelstein is a 2016 graduate of The Ohio State University College of Nursing.

I’m sure we’ve all heard the saying that goes something like, “you have to take care of yourself first before you can take care of other people”. This goes for many things in life: nurses, our relationships, and even  caregivers for a family member. While this applies to nurses, it is just as important for our patient’s because the aforementioned situations likely apply to them too.

In my personal experiences as a nurse, I have watched myself develop a very thick skin and straightforward attitude with my patients. For example, I work in a cardiac step down unit where heart attacks and open-heart surgeries are a hot commodity. Recently I had a patient who wasn’t even in their 40s who came in with classic chest pain, heart attack symptoms and ended up having cardiac bypass surgery in order to save their life. In such a situation, this patient required understanding the extent of their condition, especially when they were asking to go outside for a cigarette; which can be hard for some nurses to allow, especially if they are new.

This is the perfect case scenario where I end up laying it out on the line to my patients about the type of care they need to be providing to themselves: letting them know how lucky they are to have been saved, and this requires a very firm standpoint in the patient-nurse relationship. In turn, it instills trust in you as their nurse, but also gives a higher degree of hope that patients will take care of themselves. In a lot of these situations, I use my own personal life experiences, especially if I think it will help get through to them. Relating to your patient’s initiates a very sound relationship with them. Sharing personal experiences to relay a message about good health can be effective.

My other life motto as a nurse is that we truly should practice what we preach. In order to do this as a nurse  ideally it requires us to take good care of ourselves, which in turn is putting yourself first. Even though our patients have the right and expectation for us to educate them on their conditions, the role may not be taken as seriously if the nurse does not appear to be practicing good health and wellness themselves. For example, if you’re educating your patient on living a healthy lifestyle – not smoking, exercising daily, eating healthy – but you aren’t applying this advice into your daily life, not only does it contradict the care you are providing, but patient’s might be less likely to change their own behaviors. Another example would be to share a fitness or nutrition journey. Discussing the challenges and accomplishments might inspire them to make a change for themselves.

Lastly, this also means that we need to allow ourselves the proper self-care so that we can always be on our A-game at work.  Every year around the time of my birthday I take at least a whole week off so that I can just relax, get some personal things done, and have time to myself away from work. I can enjoy myself and not forget how much I love that! With that being said, don’t be afraid to be your patient’s savior, eat your fruits and vegetables, make time to exercise, and take time to yourself, especially if you need it – and don’t be afraid to need it! 🙂

Sydney Adelstein is a 2016 graduate of The Ohio State University College of Nursing.

It’s funny that I’m writing this topic on gift giving, as I just finished all my holiday shopping and boy do I have to say it was stressful, but I did it anyway. That’s the key to keeping your cool during the holiday season when multiple priorities end up on your plate; ideally the same type of prioritization we have to do at work. Since it can be pretty tricky to keep our cool when it comes to overindulging on holiday foods, I try to keep the same mind set and control that I do when it’s not holiday season.
Even though I enjoy spending the holidays with family and friends, I always tell myself that it really is just another day but by all means don’t skip out on that potluck at work :). I carry out my same regimen of working out before work (day shift and night shift) even on the holidays because I belong to a gym that is open on the holidays so I can hold myself accountable. Sticking to my normal every day routine, within reason, on my off days and holidays allows me to handle the stresses during this time of year a little bit easier in order to maintain my wellness.
As I may have mentioned in previous posts that our wellness – physical and mental – is of the utmost importance as nurses, allowing us to provide the best care to our patients, and I believe that goes to say for the holidays as well. Sometimes it is hard to not be entwined with family and swallow the fact we’re missing time with them. I find it helps to either keep my phone on Do Not Disturb or let my family know I will have very little time to talk, allowing my FOMO to lessen just a bit. It also helps that most work places allow us to work every other holiday so it makes up for missed time. Just remember that work comes first and keeping in mind that nice holiday pay you’re making, makes it a little less stressful when you finally have time to do your holiday shopping you may have missed out on the holiday before. 🙂

Sydney Adelstein is a 2016 graduate of The Ohio State University College of Nursing. 

1. Buy a book that will keep you refreshed on your nursing skills and any questions that may come up in the midst of work. So you think you know everything (skills wise, per say) now that you’ve spent the last few years feet deep in books and clinical? That’s what I thought too. I’ve been a nurse for almost 4 years now and I still come across things that I haven’t done since nursing school (i.e. chest tubes) or things I’m still sticky about. When this happens while I’m at work, I write on a post-it note to look it up when I get off work and refresh myself. What are these books you speak of Sydney!?!?  I have one that I saved from studying for my NCLEX, which I’m sure every one of you reading this post have heard of, Saunder’s Comprehensive. I also bought a practice area specific book that I find even more helpful, Medical-Surgical Nursing Made Incredibly Easy! You can find in almost every type of nursing track.
2. There’s an app for that!! Yes, yes. Nursing too. Piggybacking (no pun intended) off of my first piece of advice, there are many apps that coincide with and can enhance your clinical practice. Some of them being ones that will reinforce your skills with videos of specific tasks and more. One that I highly suggest is MediCode, and yes, it is exactly what it sounds like; this app reinforces your BLS/ACLS skills and mindset in a different way than manikin activity and textbook reading. Some other apps I recommend keeping handy are a nursing dictionary (I use Nursing Dictionary by Farlex) and subscribing to Medscape, which you may already have through school (I got mine from clinicals at OSU!). This app alerts you of evidence-based research and changes in care (I promise you EBP was required with purpose. It follows you everywhere 🙂 It also has a handy drugs, diseases, and diagnosis tool as well.
3. Befriend every single person you work with. That is if you’re able to. This will make the awkwardness of walking into the break room at the start of your shift as a newbie more bearable. But for real, getting to know as many people as you can has many benefits – almost as many as your degree :). This includes everyone from your manager, fellow doctors/residents, all the way to nursing colleagues in other departments since you will likely be working with many disciplines. When you get a patient back from surgery and the PACU nurse is your weekly coffee buddy, you’ll likely get them returned in above average condition. I know people say work is work and pleasure is pleasure and that the two should remain separate, but for me work is my life, therefore I keep an open mind to as many friends as possible – makes work just a tad less stressed.
4. Don’t fret if you have more than one preceptor. I found this to be one of the most helpful things as a new nurse. Despite starting a new job as an experienced nurse and having a brief orientation with nurses, I still enjoy having them all show me the ropes. It’s nice to pick up on multiple people’s tips and tricks, the way they do things and hone in on their suggestions and utilize all of it in order to find your own way that is efficient for you. We never stop learning as nurses.
5. Get involved!!!! Whether you were or are in extracurricular activities or nursing councils in undergrad, the same justifications for doing so then pertain to now in your professional career. One of the easiest, no-hassle ways to do this is by joining a nursing association (ANA or specialty). Other options of doing so include joining a council at your hospital such as nursing council or shared governance where you can be at the forefront of change and culture on your floor. And yes, of course the bonus of these being resume boosters do pertain, especially if you are planning on going back to graduate school!

Sydney Adelstein is a 2016 graduate of The Ohio State University College of Nursing. 

Hi again!

My name is Sydney Adelstein for those of you who do not know me. I graduated from the College of Nursing in 2016 and I am from Cleveland, Ohio… yes I moved back home because I truly whole heartedly believe that home is where the heart is – after all, while I was studying for my NCLEX the Cavs broke the drought, so it was (and still is) a fun place to be 🙂.

I currently am in my 3rd year of being a nurse. I recently transitioned as a Step Down nurse at University Hospitals, which is the same health system I have been working at for the last 2 years. I have a vast array of backwards nursing experience.  I started out in Emergency, and then went to Med/Surg-Tele, and here I am now in Step Down, more so cardiac.

To this day, I still tell people that the push from my parents is what made me want to become a nurse. I switched my major 3 times until they persuaded me to change it to Pre-Nursing the day before OSU orientation, and boy am I glad I did! Nursing is my passion, so I thank my parents for every little push.

I always knew that I did not want to be sitting at a cubicle for the rest of my life (mad props to those that do and love it). I knew I was always going to be in health care one way or another as I watched my major switch between pharmacy, athletic training, and physical therapy. I have to say I was completely blindsided to the fact that nursing was my calling because I didn’t realize how much it was for me until I started working, especially in my second year of being a nurse. Over the years, my passion keeps growing every day. They really do mean it when they say your parents know you best 🙂.

It’s hard to say what the best advice I’ve ever gotten is. If I had to pick something, it would be that life truly is too short to be unhappy and not do what you love, and that you should go for every opportunity available to you. Take chances and don’t stop taking them until you’re satisfied and achieved all you can. Hence why I’ve switched positions three times in my three years of being a nurse and am over halfway done with my Master’s degree. Life is too short to not be happy!

I suck when it comes to delving out fun facts, I find them truly hard to think of but I did just go to Jamaica and stayed at an all-inclusive resort. I am proud to admit I did not go swimming in the pools once. Although I did not hesitate to go zip-lining, ATVing and horseback riding. Can you say bucket list??!?!?!!???

Sydney Adelstein is a 2016 graduate of The Ohio State University College of Nursing. 

Working during the holidays can be a fun and stressful time. Between trying to request off your holiday to work and other coworkers swarming you to swap days with them, it can become a season of mixed feelings.  I for the most part happen to enjoy working the holidays, when I’m on day shift as is the case this year, because I get to make the holiday pay and then spend time with my family afterwards. There’s nothing wrong with making a lil extra money 🙂

Not only is it super stressful trying to rearrange your daily lives, work schedules, and other amenities around working the holidays — if you have no choice — worrying about walking into roomfuls of potlucks and holiday parties can be a concern for some people, like myself. I have always tried to maintain a healthy lifestyle and I’ve found that sometimes this career can get in the way of that.  From patient’s families sending in food for the staff, to coworkers bringing in food, to the end all be all holiday potlucks and employee holiday meals, I have seen it all!  Hopefully I can shed some light on it and show you that it’s actually very manageable with a few quick tips.

Regulate a solid exercise schedule: When I am on day shift I make time to go to the gym before I go into work, as it allows me to wake up and be on my A-game come time to clock in at 7am. Making sure to fit in exercise, regardless of it being holiday season or not, can set you up for much success mentally, physically, and emotionally.

Pack the proper snacks and foods: If you don’t want to partake in any holiday snacking, bring your own food! Or if it’s a potluck and you want to join in, bring healthier options that are shareable — it’s a win-win: healthy food for you and still being able to partake in the potluck. This is a key piece of advice that pertains to almost any day at work.  Most cafeterias have adequate healthy food (mine has hard boiled eggs, a salad bar, and others), but typically it’s best to bring your own 🙂

Send in your requests well in advance: Even months or years if so be it!! This one more so goes along the lines with not getting too stressed during the holiday work season… but, if there’s a holiday you know you absolutely cannot work, request it in advance!  I work with people who have requested off or asked other people to switch well in advance. Now, if your position is rotating holidays like mine you may have no choice, but you can always switch with people. Give and take a little bit.

Don’t forget to take time for your most important patient- YOU: I have probably said this in almost all of my posts, but at the end of the day you are your #1 priority and most important patient. I’ve recently been working a lot, picking up extra shifts because I have a hard time saying no to extra money!! It finally took a toll on me and I became physically and mentally exhausted I had to turn down extra shifts over the weekend. I realized that I won’t be the nurse I strive to be everyday if I am not treating myself in a healthy manner nor doing the things I encourage and teach my patients to do – rest.

Taking care of ourselves physically, mentally, and emotionally will not only get us through the stressful holiday seasons, but helps us every day in the nursing world to keep enjoying what we love! Until next time bloggers 🙂

Sydney Adelstein is 2016 graduate of The Ohio State University College of Nursing. 

Career burnout is a hot topic with almost any profession, but it seems burnout is more common with nurses. Working 36 to 40 hours a week, whether it be in three 12-hour increments or four 8-hour increments, it is very easy to get tired of what we do every day, and sometimes our work takes a toll on our everyday lives — that’s usually how you know burnout is approaching.  I recently found myself coming home after a typical shift (which usually last around 13 or 14 hours by the time I get to clock out) and sprawling across my bed unable to move.  Nurses stand on their feet, sometimes sprinting around a hospital, for over 12 hours a day.  I come from a background where I used to workout every day while in school, but I didn’t realize how much more exercise I would be getting at work.  Also it’s not just a physical burnout some nurses feel — they also feel emotional and mental burn out as well.  I won’t go into details, but we all know the types of things we can encounter at work. It can be super tough.

I have found a couple ways that I try to prevent burnout from happening and keep the spark for what I love doing every day alive.  Sometimes the best thing to do is take some time off.  Most workplaces allow for PTO to be accrued and taken as long as it’s available.  I have planned a getaway trip to Nashville in January where I am allowing myself to take much deserved time off from work.  I also periodically request random days off, obviously in advance according to hospital policy, where I can spend time with my family or have a day to myself to do school work or things that I enjoy.  I find that when I have a week where I don’t work nearly as much as a typical week, I start to miss being there and it excites me to go back to work the next shift.  More importantly, if you are having a bad or stressful day at work – which I’m sure we all have or soon will have – I find that it’s best to take a quick break, calm down with some deep breaths, talk it out with a coworker, and quickly pick yourself back up and move on.

We have learned to be resilient as nurses and when we encounter very hard things at work — whether it be with a patient or personal news we may receive at work — we all know that we can’t bring emotions into the patient care area. I find the same adage helps with dealing with a stressful day at work that typically could be the breaking point with nurse burnout.  I recently had a very stressful day at work the other day, on the verge of tears, so I talked it out with a coworker to let out my emotions, picked myself back up, and went on in to the next patient room.  As long as we are caring for ourselves first and foremost, nurses are typically able to handle all facets of the job that are thrown our way.  Don’t forget, we’re just superheroes disguised in scrubs.

Sydney Adelstein is 2016 graduate of The Ohio State University College of Nursing. 

I had switched jobs — not only type of nursing but health system as well. I loved where I left and loved even more where I came to.  I started out my nursing career in an emergency department, which was where I had been throughout college, which is very different than the basic nursing we are all taught in nursing school, and very different than med-surg nursing.  Since you are with patients for a short time, you don’t get that one-on-one bonding with the family you get in med-surg since you typically receive the same assignment day-in and day-out as long as you are working.  That’s one of the big differences.  But there are always the instances where you have special encounters with patients and you realize that it doesn’t matter what type of nursing you do, you still come into contact with patients who you not only make a difference in their life but ones who make a difference in yours.

I had had a patient/family who was very emotional with new diagnoses and issues being hospitalized, so needless to say, she was very vulnerable.  I remember caring for them at change of shift, so all I mainly did was start an IV and draw bloods and do an assessment.  Within that 15-minute time frame, I was able to sit down at the bedside and interact with them as I did what I needed to do.  When I left, the patient’s wife was in tears and “had” to give me a hug “even though [she] wasn’t supposed to” just because of the compassion, time, and attention I had devoted to them during such a difficult time.

About 5 months later, I was at my new job on a night shift.  I was at the nurses’ station and someone had popped their head around and said, “Wait! I know you! Oh my goodness!” and put her hands to her mouth and got teary eyed.  We both remembered each other.  This time she was there with her father, so again it was another emotional time for her.  She proceeded to let me know how happy it had made her feel to see me during such a difficult time and continued to reiterate to all of my coworkers how amazing I was that first time I took care of her family.

This woman having remembered the impact I had on her and her family, along with praising me to my new coworkers about something so personal was a very fulfilling experience to reflect back on why I became a nurse.  Everyone hears people, particularly nurses, say how they’re always reminded why they chose this profession, and this is one of the simplest and purest examples of why.  I have been in the field of nursing for about 3 years (working as nurse for 1) and have experienced many, many joys and reinforcements as to why I became a nurse, but this interaction is the one that will leave a smile on my face for a lifetime.  People aren’t lying when they say to “do what you love and you’ll never have to work a day in your life.”

Sydney Adelstein is 2016 graduate of The Ohio State University College of Nursing.