Living with ourselves and our work

Beka has started a good discussion over at Medscape's In Our Own Words about compassion fatigue. Reading her thoughts and all the comments made me thinkg of something fascinating that happened the other day in our critical care course. Now, pretty much all the students are trauma/ER/ICU nurses looking to work in these settings as APNs. We were having a lecture on care of the critically ill elderly patient and discussing a really good article (Marik, P. Management of the critically ill geriatric patient. Crit Care Med 2006 34(9):S176-S182.) Anyway, I mentioned that I really liked the fact that Marik talks about how we need to reconsider the way we measure outcomes-- i.e. not survival to hospital discharge, but survival at 6 months or 1 year, or even more importantly, return to previous level of functioning. This, then, would give us some more helpful information about *actual* outcomes, and help health care providers, patients, and families evaluate whether therapies can really be of benefit! So I said this, and the room came alive. Suddenly, hands were going up everywhere, people wanting to talk about these very issues. Nurses need and want to discuss this, and the opportunities are not there. It was amazing to watch the discussion. Now, every unit has informal ways of venting and releasing tension, expressing horror and outrage at our daily activities. But we also need opportunities that are structured, have focus, and offer us some kind of hope for change and improvement! We don't usually get that in the break room during an often abbreviated lunch. I was heartened to see that my classmates want to talk about these things... there is hope, and change is possible. How, exactly, I don't know yet...