Countertransference is Real

Since I became aware of the prerequisites of a professional nurse-client relationship, I kept myself delivering nursing care with empathy but consciously avoiding countertransference. It is a phenomenon when health care providers show and exhibit more feelings than expected to their patients. Theoretically and empirically speaking, it is a response to transference when patients develop dependency feelings towards their caretakers. With regards to this, never did I imagine that I myself experience countertransference, most especially this period of me changing work place or nursing home. How did this happen and how I plan to address this are the focus of this blogpost.

It so happen that six months ago I needed to make a bold decision of choosing one work place or nursing home for me to focus on. I made a pretty good decision as I selected a closed psychiatry department with the city's most challenging patients to handle in terms of mood swings, workload and attention needs. Previously, I have already worked in that place but no more than an average of 20 hours per month such that I did not develop an emotional attachment to any of the patients. I even hardly get to be fully-acquainted of the routines and the patient behaviors not until I continuously worked in a single place within 6 months, almost five to six times a week.

Though it is quite impossible to know whether patients developed transference due to their mental and psychological states, I can say gradually I developed affection towards my patients gradually. Now, as I realize that I would no longer see and take care of those individuals due to immigration rules restrictions, I felt longing like I was deprived to see and take care of a close friend or family member. From helping them to bath, feeding them, being with them to addressing their fears and anxieties; I fell to trap of countertransference. My thoughts revolved around how would those dependent patients be after I would no longer work there. Though I know they will be many who will give them attention, but in my heart I worry so much in their behalf.

It would not be appropriate to elaborate on what causes that worry but those patients are quite dependent. Some of them are physically strong but they need constant and seemingly uniform level of care. In connection this, I would hope they will be more health care providers who would work there more often to learn them better the way I got to. Within six months, I saw changes in them and in me. I became more patient and responsive to their needs. They were some of them who I got to help almost everyday because only few of us can deal with them. Now, I am leaving it meant a deduction of the number of people who are even willing to be with them and courageous enough to address their behavioral problems and attention needs.

I remember one of them suddenly stop eating and drinking. I was too concerned that within three weeks, I could say I was the most engaged in waiting for that patient's anxiety to subside before starting feeding. Just few weeks before I left the work place, that patient is doing well as if nothing bad happened. There is another 120-kilo man who is quite confused that makes literally morning and evening care challenging. Though I know that person needs to trim weight down but I realized there is no sense of doing that when that person even plays with food like a child and is only concerned with simple and repetitive things. What that person  deserves is a good life in the remaining days of life. Sitting next to that patient made me realize a lot of things on myself and the life that I have. Because of that, I got attached to almost all of them and felt extra responsible for them. Thus, the impetus for countertransference has been laid.

The experience of working on that area was tough, but I guess realizing that it may take long time before I may get the chance to work there again is tougher. Worse, when that even time comes, I may not even certain if all of them would still live and behave the same they used to the time worked there. I honestly do not know just like the feeling when I left my family and carreer in my homeland for Norway. The only difference is that I know my family in the Philippines still have the emotional support from each other, while some of my patients get to be visited only once a month, worse once a year. The most fortunate of them gets almost daily visit, but that does not happen to most of them. In fact, only about one-third gets visit more often than once a week. The mere thought of it makes countertransference worse. I am feeling guilty for changing workplace but I do have no choice I got a better and more stable work offer, which is either both beneficial for myself and for my family.

Now, I am coping. I am writing this blogpost as a sort of self-awareness and reflection. This way I could also release my thoughts for me to convince myself that I do not need to feel guilty. Yes, it is natural to worry for them but there will still be at least few care providers who will be there for them. Perhaps, I just worked so often that it resulted for me to gradually felt more obligated to do more for them. Thus, life is indeed a journey. We see people past by but it is the learning that stays matters. Those patients are part of a chapter of my life. They were not just patients. They were human beings who made me more aware of me being human.