[WanaBdun]

At least you recognize what it is that is bothering you. You are devloping that black humor that nurses have and you are no longer naive to what is done to people when they are ill and want everything done.

Give yourself time, and more time. If you are particularly affected by something that happens, take time off to deal with it. I know you dont have months on end, but take a day or two to face yourself and your issues. You will prevent the slow burn from taking over if you deal with it. If you shove it and pretend nothing is wrong, you will end up burnt for sure.

It does get worse. I could tell horror... HORROR... stories about things I have seen, and yet that will not make it any better. Use your experiences as chances talk about end of life issues with the living.

And there is nothing wrong with feeling this way. You probably identified something that many have a hard time dealing with because they don't know what it is they are feeling.

[bollweevil]

Originally Posted by sweetsmiles2007

just wondering if any of you other ICU RN's feel like you walk around with blood on your hands all the time? Been in the SICU almost a year now--night shift. Don't get me wrong, i love my job--love doing all the cares for my patients, love having an amazing team of MDs and other RNs around me, thrive on the challenge of constantly learning new things, and a billion more tiny things that make my job wonderful. but, seeing something as violent as CPR and ACLS, watching people younger than myself dying with questions still in their eyes--it haunts me. it's like a shadow constantly on my shoulder, like the alarm bells that i dream about at night. I've got friends on the tele and medsurg floors that i try to explain it to, but they just don't seem understand me. I love my job! i relish it! but i just don't know how long i can do it--like the violence of it all is wearing me down. I don't know if it's just cause i'm naive, and this is growing up, or if this is me starting to get burnt out or what. I don't want to get burnt out. I just wish i could forget some of the things that i've seen, that i've done to try to help someone. I want to forget the cries of the wife of the man we just coded three times after we finally called it at 1548. I want to forget to way a pt's anus gapped open from the FMS. I want to forget about the pt with a black right foot due to a clot that happened in a different hospital from a perfed bowel. I want to forget the mom (who happened to be my age) and the fear in her eyes as 4 MDs tried to decide how they could/should fix her aneurysm, while her baby... but i can't. maybe that's just an ICU nurse's burden. but it's a ******* heavy one.

I'm on vacation right now. trying to get away from the shadow that i can't seem to get away from. You know the phrase--do unto others as you would have them do unto you? well--the last thing in the world i want is to be a pt in an ICU, even my own. I know i would get compassionate RNs and MDs, and the best medical and nursing care available, but given the choice, i would much rather just be dead. I think part of my problem is that i feel guilty. Guilty for condemning anyone to something I wouldn't be able to deal with. Guilty for knowing that the definition of 'torture' is too similar to the definition of the ICU (taking away dignity, restraining, no sleep, pain, no ability to speak, ect.). and angry at friends for not understanding why i want them to make their parents in the hospital DNR/DNI. angry at my MD dad and sis for not understanding the burden i carry, despite their understanding of my medical terminology. angry at the public for not seeing what we do, and not discussing things like codes and ventilators and such--for hiding from it. and angry at myself for not being able to grieve for the patients i've lost--for burying it with laughter and jokes and pretending like i'm strong enough to carry them all.

am i the only one who feels like this?

Ah, my dear new friend, I wish I could be with you right now. I'd give you a hug, I'd hand you a drink of your choice, and we would sit together on the porch swing, overlooking the tranquil garden. We'd watch the butterflies and the birds, we'd admire the brook and the newly flowering trees. And we would talk of life.

We would watch the children play and know that this life is not of our choosing. Our hearts would nearly burst with joy as we stroked the wonderful fur of the kitty cats asleep on our laps. We would strengthen each other by coming to realize that all of this beauty, this sun-filled perfect day, the passing clouds, all of this is meant to be enjoyed and stored away in our hearts so we can call on it for sustenance when things are not so pretty - when people pass over to the next phase of their lives, when we have to do painful things to patients, when we must try to comfort the newly widowed, the suddenly motherless.

I believe your feelings are so normal because I know of no nurse or doctor I've ever worked with who hasn't experienced them. We all want to help our patients and their loved ones, none of us want to EVER be in ICU or a nursing home. Who in their right mind would choose to be so sick, so helpless, dependent? No one.

There are just some things in life that we cannot know. It is not given for us to avoid all pain or to have all the answers. For me, it is enough that God is in control. He has given me tears to cry when I'm sad and I do let them flow. I used to journal and that helped me to get my feelings expressed. I used to go with coworkers for coffee or a drink after work and we'd let our hair down and get out all our frustrations, helping each other to cope with the suffering we'd seen that day. I hope you have those outlets. You have this forum.

When I was younger, I tried to get answers, just as you are doing. When I finally realized there just aren't always explanations, I was angry with God. Gradually, that phase passed, too. And I came to accept that "I don't know" is so often the answer with which we must be content. Often, words are not the best thing. Sometimes, we just have to give people time to be horrified and in shock. We have to let them cry, scream, throw things, hit the wall. As they calm down, we can offer them the Kleenex and a hug and get the Chaplain or a volunteer to sit with them if we just can't stay. We can go to funerals of patients of whom we were particularly fond or send sympathy cards to their survivors. And we can always pray. My prayers are not eloquent. They are usually "God, help!" or, "God, why?" or "God, please comfort whoever it is." Quickly, I turn to praising and thanking God.

It is important to remember that when we praise God, when we offer the sacrifice of praise when what we really want to do is be angry with God or circumstances, that is when He can move to comfort us.

Also, as our trust in Him grows, we become steadier, more stable. We learn to not look for answers beyond the simple fact that there are no real answers except that He is in charge and He is love. For me, He is Jesus. I know other people worship in other ways and that is what works for them. You probably will find gret help from your loving, good Higher Power, too.

I hope, dear one, that you have found some moments of peace and strength in our beautiful garden. Be at peace. Somehow, all is right with the world.

[CrazyPremed]

I think that it is interesting that people are addressing this from a "you will develop a tough skin" or "that is the reality of ICU nursing" approach.

There is nothing wrong with not wanting to see people in this environment. I even think that continuously working in this environment can - for some people - take away compassion and empathy. All in the name of getting a 'thick skin'.

I have been working on a tele floor for a little under a year (as an LPN) but I LOVE my clinicals and preceptorship in the ICU. I have considered taking an ICU position upon graduation, but I don't know if I can reach my ultimate goals in that environment. Yes, I'm ACLS certified, yes, I've worked codes, yes, I've seen patients die and suffer, and yes, I can handle autonomy and stress. I'm drawn to nursing for other reasons, and you may be, too.

Don't try to talk yourself into something you really don't want. It's OK to not want to be an ICU nurse.

Good luck on your journey.

CrazyPremed

[Honestnurses]

You know, I have done ICU (MICU, SICU, NICU and CCU) for the last four years. It has given me valuable insight regarding the health care business and the holistic approach of nursing care. I would not trade that experience for anything else in my nursing career. The only problem that I have with ICU is the suffering. In the beginning, I was scared and read everything about what I was required to do as a critical care RN. After 6 months, I was dreaming about what I saw in the unit as well. Then I got mad, nervouse, patient, etc. You see, ICU made me realize a number of things about myself.... not wanting to be a patient versus death. It made me realize that some things needed to change with the processes of nursing as well. You should have the support of you colleagues and seek your hospital's EAP (if there is one available). Otherwise, you may find yourself in a depressive state and that is not good for you or your patients. Try some exercises also. This will help relieve the tension and stresses that come with this type of nursing. I hope this helps...

Crys

[gradcare]

Some times you feel "dirty" because you are advocating for the patient knowing full well what that entails even if they don't (doing everything for the pt with GVH taking over their entire bodies, watching the disease process head towards the point of no return, knowing that their chances of survival reduce everyday), other times you wil feel dirty watching or assisting in painful procedures that may result in an improved chance of survival for the patient or that are necessary because of misshap or just bad luck. Sometimes you will feel bad because despite everything you do your patient is not comfortable, does not have a good outcome etc. What keeps me relativly sane is asking my self "have I done my best" if not then "what can I do to improve?" Finaly when all else fails I remind myself that everyone deserves the best chance we can give them to survive, thrive and hopefuly return to a state where they can again direct their lives. I guess the other thing to remember that you are not the cause for your patient being with you. You did not hit them, you did not inject dishwashing detergent into their arm, you did not ignore the wound that gradually ate away their arm. You were not the driver who ploughed into them, you did not suggest to them that they have their valves replaced. All you are doing is attempting to assist them to return to the best they can be. And if they are not going to survive then you are trying to provied the opportunty for their loved ones to say those things that need to be said but often cant be because time runs out.

cheers

[RNFELICITY]

Originally Posted by sweetsmiles2007

am i the only one who feels like this?

are you kidding me? I think we all go through this especially when there has been an exceptionally hard case to deal with. Does your hospital have a debriefing that they do routinely? If not, get it started. It is a nice way of talking, venting, yelling or crying out those emotions with others who completely understand what is going on in your heart.

As to a think skin, I don't think anyoine who is truly compassionate grows sucha thing. We learn to channel that emotion in different ways, but if you don't cry...something is wrong. I have cried on the way home in my mini-van with the windows open and it is a refreshing moment.

If the SICU is becoming too much, try a different style of ICU like an MICU or something. I usually hop specialties or environments about every 2 years to broaden my knowledge and to give myself a different change of pace.

good luck honey ((HUGS))

Originally Posted by Dinith88

But...the vibe i get from your post is that you're a very sensitive person...and these are simply growing pains. These experiences and feelings can either drive nurses away from the ICU...or...they are what gives us our hardened skin...and allow us to deal with this stuff every day. (or drives us to drink )
I hope these emotions you're dealing with dont drive you away.
If you were new to the ICU and indifferent or un-phased by the 'stuff' you may have other issues...or not have an authentic 'heart' for nursing.
Hang in there!

well said