How do you "leave it at work?"

Nurses General Nursing

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Hello everyone, I'm currently a nursing student and am seriously reconsidering my choice to be a nurse because I just can't seem to "leave it at work", as they say. Well, leave it at clinicals is more like it.

Every time that I've come home from a clinical day I've felt unhappy and thought about some of the patients that I'd worked with for days. I feel badly for them, to be in such a dependent state and suffering, with no light at the end of the tunnel. They'll pop into my mind suddenly, usually when I'm trying to do something that I enjoy, and I'll feel a pull down from the sadness.

Before starting nursing school I had no problem managing my emotions. I was happy and in good spirits 99% of the time and laughed more easily than anything. Now I feel like a bomb ready to blow, and it can go either to crying due to sadness or crying due to frustration. Things that never bothered me before in my everyday life now have the potential to set me off with no real warning. My feelings just spill from the hospital into every other part of my life.

I don't feel like it is the schooling itself. Academically I do very well and while I study a fair amount, the material isn't daunting to me, just time consuming. I'm very lucky in that I still have enough time to work 30 hours and not feel as thought my grades will suffer.

I've come to dread my clinical days. The day beforehand I get feelings of anxiety and I am NOT an anxious person. It is strange because I enjoy them while I am there and like to try new skills, plus I just love when I am able to help a patient out or just hold their hand and smile and have them smiling back. I just have accidently conditioned myself to dread them based on the feelings after I leave the hospital.

Does anyone have any coping mechanisms that could help me? Or should I hang up the stethoscope before I dive off the deep end?

I must be very cold hearted.. because I have gotten very good about "disconnecting" myself from the people that I care for. I am there to do my job...and don't get me wrong, I care for my patient, I'm compassionate and caring...but at the end of the day I clock out (physically AND mentally) and return back to MY life. Ok....let me not fool anyone, because I still leave stressed out if I have had a horrible day from time to time...BUT I have gotten much better about it...you have to turn it off somehow. If I have had a REALLY bad day...I talk with my husband about it for about 5 minutes (just to vent) and then LET IT GO. This is just how I deal with things... :-)

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Specializes in NICU, ICU, PICU, Academia.

I purposely do not work at the hospital closest to my home- my commute is how I keep 'home' at home and 'work' at work. And on my drive- I talk to myself about all the things that are bothering me - sometimes praying, sometimes rehearsing things I need to say or write to people. But sometimes, when the weather is just right- I roll down the windows, crank up my 70s music and SING all the way home. Very cathartic.

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Specializes in Cardiology.

The only patients I generally ever "bring home" with me are the ones that frustrate/annoy me. I have a long ride home, so I try to get my mind off of work listening to books or talk radio. If I still can't get something off my mind, I vent to my husband (no identifying details) and then the patients are back in their hospital beds where they belong. I did tell him that I truly had the most awesome patient ever, too.

If you are depressed about your patients' conditions, I'd think about two things: 1. Maybe you just haven't found he right type of nursing yet. I work cardiac tele, and most of my pts are short-terms stays with excellent prognoses- hardly anything for even the most emotional person to get depressed about. Sub-acute rehab might suit you as people aren't acutely ill and work every day toward a goal of greater Health/independence. 2. Even if you work in the most depressing place ever (for me personally, that would be LTC) you can be the ray of sunshine and hope in your pts' lives. You do that by giving them compassionate, respectful care and by educating them about how to make the best of their health. You can be the change....

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Specializes in ICU, Emergency Department.

I like marycarney's reply. My commute is about 35 miles, and I usually listen to an audio book if I'm really tired because it helps keep me awake, or blast some "90s Pop Radio" on Pandora (I'm a 90s child.. born in '87). It helps me disconnect from work, singing along with the radio IS very cathartic, and usually by the time I'm home I'm able to let it all go.

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Thank you all for your replies, support, and advice. I really appreciate it! I'm most definitely going to talk with one or two of my professors to gain their insight, thank you for reminding me that they are an excellent resource outside of academics alone. I tend to forget that.

I think that I'm going to be able to handle it. It is very new to me, but I think that I'll find my niche somewhere and strike a good balance between work and my life. I've been a restaurant server for years and there used to be things that would really get to me here and there but as the time passed I've noticed that nothing really bothers me for more than a couple of minutes, if at all anymore. I really can't even remember the last time that I had a bad day. In fact, I worked all day today and couldn't tell you a darn thing about it, lol. It is amazing how a little experience, maturity, and the passage of time can change things.

Like many of you, I think that a little distraction right after the hospital will be a great benefit. With a relaxing routine and the right brain training, it should be possible for me to strike that balance that I'm so happy to hear most of you have.

Thank you all again!

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Specializes in geriatrics.

It's 24 hour care and we cannot solve the world's problems, no matter how much we might want to.

I reflect on my day and leave the rest at work. I can't do anything from home. Exercise and a healthy diet keeps me centred. Sometimes I will discuss situations with other nurse friends to de-stress, and this helps too.

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It can really be tough thing to do, one needs to learn to adjust with work. I still have the habit of talking about work when I go home, however, I also train myself not to do it often.

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One poster suggested the word depression. This may be accurate or not. Certainly overwhelmed is common and can lead to a narrower focus. In some cases it would be clinicals. In others it might be re-reading insignificant parts of the anatomy book so you know every bone rather than much about bone breakage. Our minds are not always linear.

People have given good suggestions. One I heard when I was young in nursing was "When you take off your cap put your shift in it". I preferred to review the shift on my ride home and think of all the things I did right. I learned early we can beat ourselves up for not being perfect. This kept me from burnout and happy in my chosen career.

After discussing this with a trusted person keep an eye on your moods. make sure you are taking good care of yourself. Food, fluids, exercise and rest. All things students put aside to make it in school. Your body will rebel without care. You cannot care for others if you do not care for yourself.

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It's 24 hour care and we cannot solve the world's problems, no matter how much we might want to.

I reflect on my day and leave the rest at work. I can't do anything from home. Exercise and a healthy diet keeps me centred. Sometimes I will discuss situations with other nurse friends to de-stress, and this helps too.

I have similar issues in my personal life - I want to save everybody and everything. I've seen a therapist (maybe something the OP should consider as well) and I have a new mantra: It's not my problem.

@OP:

It sounds cold-hearted, but when I leave work, work issues are not my problem anymore. Nothing I can do about it from home, no need to worry about it. It's easier said than done of course, but with practice, and nursing experience, it will get better.

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Specializes in ICU, telemetry, LTAC.

When I was in school, the focus was on pass clinicals, get good grades. Period. So for some reason I do remember some things about my patients from clinicals, but I couldn't tell you their names and they don't produce much of an emotional reaction for me now. (I graduated in 2005.) My very first bed bath patient had rheumatoid arthritis, now I find that to be interesting as it seems to be chewing on my joints now, and I am glad I treated him with respect and did a good job. I didn't have a lot of "room" for getting attached to the patients while I was in school, really I was too anxious about not messing up and flunking out.

So as a new nurse, things kinda hit hard. I remember my first code, my first deaths, the first time I had an "aha" moment with an end stage COPD'er and realized he was having an MI, like right there, right then. (And he was. And he died very soon thereafter.) I didn't want to forget their names. I had the urge to treasure the things they taught me and especially for the deceased ones, to allow them to live on. Problem is, of course that I'm human and I have this life, and it really doesn't have room for me to mourn extensively for everyone I meet who's elderly and sick. That's a LOT of people.

Stress brought me shingles, recurrent, took six months to get it under control, several back injuries were not helped by stress at all, high blood pressure (mediated by my lipid profile and genetics), kidney stones, and now some form of inflammatory arthritis. I am actively the last two years making strides, finally, in leaving people at work. I try to treat them well, but I can not possibly remember them all and I can not carry them all around with me. I'll allow maybe one a year, I'm thinking, to stay with me awhile. And there will be people who teach me things; I can remember what is learned but everyone needs sanctuary, especially the nurses. We just have to keep telling ourselves that, and practice compartmentalization, and take care of ourselves, if we want to live good lives. Work is not life.

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There is a 4 step process of thinking in yoga called RAIN. It allows you to accept your feelings without being consumed by them. It also teaches you comfort yourself. Check it out!

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I found clinicals to be a different kind of stress than actually working on the floor. You have to stress over different things. I used to take it home in school (which I believe can be a good thing if you are a student) but in the field, I close the door on the way out and everything just stays in the building. Guess I just learned there is nothing to be gained by taking it home.

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