Struggles

     When I was in nursing school I had no idea that ER dealt mainly with non-emergent care.  I wonder if knowing that would have changed my mind about going into that field.  If someone had said "Every day you will have to take care of people who have made bad decision after bad decision and you can't let it get to you or internalize it" if that would have made me stop and think.  Here I am, out of nursing school over 4 years and I still get irritated with patients and unfortunately have the "now I have to clean up the mess" mentality.  Last night I was in triage, and an older lady came stumbling in, she looked moderately wealthy, had her nails done, etc.  Anyways she came staggering in and when I asked her what brought her in she slurred "I am addicted to pain medications".  Turned out a few years back she had been diagnosed with a painful, non-life threatening disease, and was prescribed pain medication appropriately at that time, but did not take the medicine properly and soon became addicted to it and stated she has been addicted to it for the last few years.  Instead of just thinking "ok, whatever, those home fries were good for breakfast" blah de blah and going on my way I found myself thinking "great, now your bad decisions and poor judgment are my problem." 
      On a nightly basis ER nurses have to "deal" with the results of bad decisions, and that is part of the job, whether it is cleaning up pee, poo and vomit all night from someone that drank to much or in extreme cases wheeling someone to ICU or OR or putting someone in a body bag because of poor decisions, it ends up being our problem.  Maybe I should be in preventative nursing instead of tertiary nursing, teaching prevention and education vs. dealing with the poor decisions but I find myself thinking so often at work "this situation could have been avoided" and the "work smarter not harder" part of me throws a little tantrum.  I am still struggling with that aspect of the job and find myself telling myself a hundred times a night "why do you care?  Its no skin off your teeth" but the thing is I do care and I don't know if not caring is a good thing or a bad thing in this case.  Speaking of caring, lately I have adopted the phrase "nobody cares" as my motto and it is a good one for the ER even if it doesn't sound like it.  Let me explain.  It is better to think "nobody cares what you did or why you are in here, but you are here now and we are required to treat you", not "nobody cares about you".  It is not worth it to get involved emotionally or personally so just better to say "nobody cares" and just do your job.  I don't care what you do in your free time, how you live your life, what you ate for dinner, how many people you have killed or how much meth you just shot up in the parking lot, you are here now so we have to deal with it...and then going on and giving good nursing care.  Who knew all the internal struggles I would have while working in a field that goes directly against Darwinism?  Nobody cares... :)