It’s often said that you need to separate yourself from your patients or you’ll go insane. It’s true. While it is important to be able to sympathize with your patients and relate to them, it’s important to keep that distance so you don’t get attached.
If you don’t do that, it will affect you. I saw several seasoned ICU nurses in tears a few weeks ago when one of our chronic patients, a quadraplegic who had been with the hospital for well over a year, passed away. I was disappointed to learn of the death of that patient, but not to the point of tears. Distance works.
The only place I’ve had trouble keeping my distance in is the NICU. I can not work the NICU, and those who can have my respect, because it’s the one place I’ve ever been that beat me.
When I was in respiratory school, we had to do a four-week NICU rotation at the Major Medical Center in the Big City. I was terrified. With adults you have a lot of room to move before you do something that will kill somebody. With neonates, you so much as breathe on them wrong and they’ll code and die. They are fragile, they are innocent, and they scare the hell out of me.
On my second week in the NICU, we received from an outlying hospital a set of triplets. They were 26-weekers, very tiny, very critical, right on the edge of where they could be kept alive. They hadn’t even been named yet: instead they were Triplet A, Triplet B, and Triplet C. I remember working hard to keep those little babies alive. I remember looking at them and realizing that I could fit them in the palm of my hand. They were so tiny, so fragile, totally helpless. The parents were devastated by the premature delivery, and were involved, caring, concerned.
When I left the first week of my NICU rotation, all three triplets were alive. They were doing very poorly. Prognosis was bad.
When I came back the second week, B had died.
When I came back the third week, C died just after the end of my clinical day.
And when I came back for the final week, A was gone.
How do you prepare yourself for something like that?