Goshen News, Goshen, IN

February 17, 2013

WHOLE FAMILY: Why does your nurse seem to keep her distance?


— Do not feel sorry for me when I tell you this. (After all, I do not feel sorry for myself about it.) I do not have very many friends. Really, I don’t. Oh, I have a lot of acquaintances, colleagues, even “fellows,” I suppose you’d say. But just a few people I’d consider “friends.”

It’s fine with me this way. Maybe it’s my personality — pretty logical, less emotional, driven by getting things done rather than feeling things. Maybe, were someone to psychoanalyze me, he or she would conclude that I am, in fact, suffering from some psychopathology that has me building walls, struggling with intimacy. Whatever. Maybe. It’s not affecting my life adversely. In fact, my tendency to not have very many friends is helpful.

Here’s why:

Many professions require a measure of a worker’s more private, intimate self to be given. Think of therapeutic counselors, social workers, even law-enforcement personnel. Think of doctors, therapists of all kinds. Think of doulas. And nurses.

I can’t imagine what work is more emotionally taxing than helping people — families — through acutely or chronically stressful situations. Childbirth, by the way, can be both. For one, there’s the stress of whatever the clients are feeling. There’s the stress of having to help them find solutions. Then there’s the stress of empathy. Really, when you work at empathy, at “feeling their pain,” it takes a lot out of you.

Add on work that requires a bit of intimacy — perhaps the worker sharing little bits of personal experience or needing to develop a truly human and connective rapport — and you have full-fledged emotional WORK.

Emotional work is exhausting.

Now that I’m sliding deeper into nursing work — just started my psychiatric nursing rotation, if that’s a clue — I am seeing more clearly the need for emotional boundaries for people who do the kind of work I do. For doulas. For nurses.

I glanced at an American Nurses Association (ANA) online journal article about nurses and emotional burnout. (Read it here: http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/vol132008/No1Jan08/ArticlePreviousTopic/WhyEmotionsMatterAgeAgitationandBurnoutAmongRegisteredNurses.html.)

In the study that prompted the article, researchers noted that half of nurses polled in the study left work every day “exhausted and discouraged.” Half! The article goes on to dissect nurses’ “emotional exhaustion,” a painful state from which many nurses and other workers with similar demands suffer. Read it if you have time. It’s telling.

And it’s making me tired just thinking about it.

OVER THE LAST few months, I’ve given how to AVOID emotional exhaustion some thought. I’m idealistic, still, and think I could never burn out as a nurse. Ha. Ha. Ha. Right. Sure I could.

But I don’t have to — not if I learn from my own experience working as a doula. See, I’ve been doing doula work for some six years, and while I’ve had a few exhausting moments where I swore I would never again go to a 27-hour labor, take one more new client or squeeze one more set of hips for 10 hours, I haven’t burned out yet.

And here is why:

1. I keep clear boundaries. My doula clients are that — clients. While many go on to become friends, I simply don’t see them that way while they’re paying me for doula services. Sometimes it’s tricky — because I do have some clients I consider friends — but I work at it keeping the lines clear.

2. I get my own emotional needs met elsewhere. While I enjoy my work with clients and relish the time we have together and am glad to have a job that is, most times, emotionally fulfilling, I do not depend on my clients to meet my needs. I’m there to meet theirs. That means I have other ways, other people, who meet my needs — for me, that’s my husband and the few friends, relationships and other activities I have.

3. I make sure I and my clients understand the objective(s) and the parameters of our relationship. As their doula, for example, I list out what they “get” from me and on what terms. We talk about the relationship before we embark on it, making sure we’re both clear on what our expectations are. We try to objectify things as much as possible — leaves less room for troubles. Turns out, this principle is fundamental in nursing care, I’m learning in the classroom and on the hospital units.

4. I reserve the right to distance myself from or grow closer to clients as it seems appropriate. For example, there are some clients I offer a little more of my personal life to. For others, however, just the opposite is effective. If I’ve had an experience very similar to a client’s, for example, I am often compelled to share more — so long as I believe it will be helpful to do so.

5. And that is the bottom line and my No. 5: I keep the main thing the main thing. And the main thing is WHAT IS BEST FOR THE CLIENT. In most service work, it is imperative to remove one’s self and think, mostly, about what will actually HELP the client achieve the goal of your relationship with him or her. In doula work and nurses’ work, quite often, the goal is to help the client become more self-sufficient, believe it or not. Sometimes, then, a more “aloof” or seemingly “sterile” relationship is very necessary.

Goshen News columnist Stephanie Price is a wife, mother, teacher, childbirth educator, doula, midwife’s assistant and student nurse pursuing a minor in complementary and alternative medicine from Elkhart. Contact her at wholefamily@goshennews.com, 269-641-7249 or on Facebook at the page “Whole Family Column by Steph Price.”