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- by erhnurse Feb 19, '12I started my career as an RN 9 months ago and discovered that it was more stressful than I could've ever imagined. I assumed that the worries and second-guesses would diminish over time but I am finding that they are only getting worse. I constantly lie in bed at night wondering if I have charted sufficiently or if I remembered to tell the doc that pt A had developed a cough. I recently had my first "code blue" and stayed awake for hours that night replaying the situation in my mind thinking of things I would've done differently (despite the fact that the patient was stabilized). I frequently receive encouragement from co-workers, doctors, and patients that I am doing my job well, but I can't seem to relax 'behind the curtains' thinking that I had forgotten something that would cost me my license, or worse, someone's life. How do I learn to leave work at work and enjoy my life?
- Feb 19, '12 by efiebkeThis is a GREAT question to ask. It seems universal that newer nurses tend to take their work "home" with them when they leave the building. I remember asking THE very same question about a year into my nursing. At that time, I worked on a Heme-Onc floor. Needless to say, a lot of people didn't survive their cancer or didn't survive the treatments. It got to me.
So. . . there was this one nurse who was ALWAYS compassionate towards her patients, and had an air of positivity which I desperately sought. I knew that she had a background in Hospice work. So, I approached her one day and asked that very question that you present to this forum, "Who do you keep such a warm smile on your face? How do you keep such a positive and even hopeful attitude??"
Her answer was wonderfully simple and exceedingly profound. She said, "Ted. I give these patient's the BEST eight hours of my time that I could possibly give them. Then, when I go home, I go home and leave work behind."
It wasn't so much the precise words that she spoke, it was more her facial expression as she said them. She had a sincere look of "Peace" when she said, ". . . when I go home, I go home. . . " I wish I could share you that look to you so that you could receive the same benefit as I did back then. It took a while for me to fully appreciate her answer to me (body language and all), but it's one that I practice faithfully . . . well, as best as I can.
Balancing work life and home life seems to be an art. I love what I do as a nurse but I also cherish my home life. My wife and I work hard to make sure we have time for each other. I also have very important hobbies. I'm a firm believer that there is more to life than work. We are more than just nurses. We are spouses, we are parents, we are musicians, we are vacationers, we are "part-time employee for some other job". Attempt to tap into that concept.
In reading your post, I have no doubt that you will work hard to give your patient's the best 8 (or 12) hours of your time to them. I see this because you express concern about how well things went during a code and wonder how you can do things better. Hopefully such concern will never stop. But, believe it or not, there is more to life than those 8 (or 12) important and worthwhile hours that you spend at your health-care facility. I would wager to bet that you have other interests worthy of your time and attention. If not, work to find those interests. They're important! Enjoy your relationships with your significant other or your friends or your whoever is important to you. It's my opinion that without such balance in life, that path toward burn out is what lies ahead. It doesn't take much to see who's burnt out. I've been there myself and it ain't pretty.
That balance in life is important. Now that you know that it is truly o.k. to leave work at work, do it! Live that life outside of work. . . and, as I type all of this to you, I WISH I could give you that look which was given to me by a WONDERFUL nurse many years ago.
- Feb 19, '12 by VerbatimMy response to this is: education! If you do not have ACLS, get the certification. It doesn't matter that your unit does not require it. Study for CCRN. It doesn't matter that you are not in the ICU. No, I'm not suggesting that you take the test. Just study! You will be much more confident in your ability to care for people. Take a telemetry course. It doesn't matter that your unit does not use monitors. If your hospital does grand rounds: attend!
I certainly recall being a new nurse. I began in telemetry, then ICU. I recall that the majority of my anxiety was secondary to (2/2) a lack of knowledge. The more I filled in the knowledge gaps, I rendered better care, I understood why, and subsequently, I slept better.
- Feb 19, '12 by ShantheRNI have this exact problem!!! I'm 6 months in and like the OP, I feel like it's getting worse. I think it's because my assignments have gotten harder so there's a lot more potential for error. Last week I had my first MRT (you may know them as RRT - basically deteriorating status but not quite code worthy) and it happened fast. In less than an hour my pt went from sitting up, talking, and eating with his mom.....to sats in the 80s and lethargic. All day his sats kept fluctuating, and I kept switching from cannula to masks while titrating his oxygen to keep him stable. I kept calling the resident and fellow to keep them updated on his status. He was admitted the previous day in sickle cell crisis and they suspected acute chest. He ended up going to PICU.
I charted all of this as it happened, and the medical team was up to date on everything. The MRT and PICU transfer went smoothly. The pt survived and a code was never called. My charge nurse told me I did an awesome job of documenting all day. Yet.....after my 13 hour shift (I stayed through the MRT and transfer, then charted), I couldn't sleep for hours because my mind kept going "what did I do wrong/what could I do differently/what did I forget to chart?" It really annoyed me, because I know the disease process. I did everything I could, and logically I knew that. Sometimes you have to tell your brain to shut up already.
I know nurses that can flip off the work part of their brain as soon as they clock out. I'm not one of them. I've rediscovered yoga and it's done wonders! I do some poses before bed and I'll be joining a class soon. Reading.....cooking a wonderful dinner....exercise...anything that has zero to do with nursing. I like the education suggestion above but for me, I really need hobbies from the other parts of my life if I really want to relax.
I hope you find something that works for you! Losing sleep over work stress is a vicious cycle.
- Feb 19, '12 by colleennurseHave you tried finding a co-worker that you can talk to? Sometimes just talking about your day with someone who understands can do wonders. Especially when something like a code happens. You have to get your feelings out. Plus I find that when you do talk to others, it helps you to realize that you are not alone. You are still a new nurse, time will make you feel more confident/comfortable in your nursing practice. I have been a nurse for 6 years and I still question myself (which keeps you on your toes Good luck!
- Feb 19, '12 by bds165Excellent topic.
I too am about 9 months into my nursing career and luckily I've had two previous stressful occupations that taught me some hard-learned lessons. I try to evaluate each shift by asking myself these questions as I head home:
-Did I make my decisions with integrity?
-Did I keep my patients' well-being and best interest in the forefront of that decision making process?
-When in doubt, did I bounce my thought process off a trusted, competent coworker and asked for advice?
I usually am able to leave things at work. It's not always easy...
We new grads are taught to be sponges during our first couple of years. Most of the time we are not reminded to wring it out.
- Feb 19, '12 by griffinchetIn the field of nursing, it's impossible to not take some of your work worries home with you. The best thing to do is build a support system between you & your colleagues so that if there is ever a point of questioning you can have a second opinion on your decisions. Your first Coding is always going to be difficult, but eventually you'll learn to trust your instincts knowing at the end of the day you've done all you can. You'll do well in this profession with the caring nature you have, as obvious by your OP.
- Feb 20, '12 by erhnursethank you all so much for your encouraging words! I actually am ACLS certified and after this code I repeated many of the exercises I used while studying for the initial exam. I use every day as a learning experience and ask questions whenever I possibly can, please believe this. I will consider talking to some of my co-workers, but as we all know, nurses eat their young. I am more of a "closet neurotic" and prefer that my co-workers not know that I have such issues as I don't want them to think I am weak. I read every night before falling asleep to try and clear my head but I suppose I need to find another outlet.
- Feb 20, '12 by griffinchetQuote from erhnurseThat's a great tool, reading. But, if you feel as though you are in an environment where pride out weighs team work, that's definitely not the best for a new graduate. You should have someone who is willing to assist you along the way. Best of luck!-Griffinthank you all so much for your encouraging words! I actually am ACLS certified and after this code I repeated many of the exercises I used while studying for the initial exam. I use every day as a learning experience and ask questions whenever I possibly can, please believe this. I will consider talking to some of my co-workers, but as we all know, nurses eat their young. I am more of a "closet neurotic" and prefer that my co-workers not know that I have such issues as I don't want them to think I am weak. I read every night before falling asleep to try and clear my head but I suppose I need to find another outlet.