Feeler-Doer-Thinker: Got Balance, Nurse?

My mother likes to use three descriptors when referring to people. To her, you are either a “feeler,” a “doer,” or a “thinker.” These are not terms of her creation, to be certain. They are well-known components of the study of axiological psychology, and make up what is commonly referred to as an FDT Profile (Feeler-Doer-Thinker Profile).

According to my mother, and to the insanely complex community that studies axiological values and psychology, we all function as one of these three, or a blend. My family hasn’t taken tests to quantify our tendencies, but my mother says that my father is definitely a doer, she’s a thinker, and I fall somewhere in the middle – I’ve definitely got a doer’s drive, but lately, the thinker in me seems to want more space and time. But yesterday, while I was telling a friend about a recent bedside shift, I started to wonder whether a feeler bone exists in my body.

The patient that I had cared for was very young, fairly sick, and had suffered a pretty traumatic experience that landed him in his hospital bed. After hearing the basic story, my friend asked me if I had great emotions about his care, or if I faced the weight of the situation with deep feeling. I was tired at this moment, from a long day, but as I looked back at its contents, I realized that I could only shake my head no.

I had not connected emotionally with my patient at all. His story was a sad one, yes, but my years of experience gauged it as hopeful on the scale of recovery. Yeah, he looked pretty darn sick with the tubes, wires and lines, but my instinct somehow communicated above it all – based on years of similar patients – that he’d come out okay. I couldn’t talk with him because of sedation, I didn’t see much of his family, and the work of his care – the management of his process – kept me busy, so much so that as I explained this phenomenon to my friend, I realized: He had literally just been a series of tasks.

I’ve written frequently on the importance of seeing your patients as humans. To look past a person’s diagnosis into their life, not only gives you insights into how to best care for them as people with lives and wishes and stories and fears, but it also gives them hope for returning to the life you ask about. This practice dates all the way back to Florence; in Notes on Nursing, she states:

“Means of giving pleasure to the sick: A sick person also intensely enjoys hearing of any material good, any positive or practical success of the right. He has so much of books and fiction, of principles, and precepts, and theories; do, instead of advising him with advice he has heard at least fifty times before, tell him of one benevolent act which has really succeeded practically,—it is like a day’s health to him.”

Patients spend hours recounting the details of their illnesses without a single peek into the outside world. Their apartments lay vacant, their bills unpaid, their pets lonely – how often we forget this, blaming their foul moods on personality flaws. People love to tell their stories, and questions like, “Where do you live?” and “How did you meet your spouse?” demolish the wall of medicine between nurse and patient, exposing our mutual humanity.

When I reviewed this practice and need for its place in all of my care, my thinker-self kicked in and said, “Gee, Amanda. You really checked out emotionally on that patient yesterday. What’s up with you?” Shortly after, my doer-self piped up: “Knock it off, man. She was working hard! No time to chat.” Leaving my feeler, last of all, to say, “Did it ever occur to you guys that sometimes I just need the day off?”

Maybe it’s okay to just give the tasks of care sometimes. While I don’t understand it even close to completely, I think this axiological psychology stuff shows that we all have each element within us, taking turns to form inner balance. If we felt and wept and got involved in every patient’s life during every shift, we might not have room for our own. And if we worked and performed and ran and raced, we’d be tired all the time. We cannot be everything, as much as everyone wants us to be – we must let the balance of our feeling, doing and thinking guide us through our care.

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