How do you "leave it at work?"

  1. 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?
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    Joined: Jun '12; Posts: 62; Likes: 70


  3. by   jadelpn
    This is all new, and with anything new, and with your mind going a mile a minute at clinical, it is sometimes hard to wind down. It will get better as you are fine tuning your new skills as opposed to trying to take it all in.
    Make a routine as soon as you get home--a hot shower, a cup of tea, a good book, a mindless game on the computer....whatever makes you happy. And if those thoughts creep in, perhaps a phone call to a friend "Geez, I am perseverating. Tell me what's new with you" and before you know it, you are gladly going about her latest fashion score or jerky date. Another thought is to visualize a big STOP sign in your head. If it is something that you are wondering about, a question you have, write it down, put the pen down visualize stop and move on. You can bring your notebook to clinical and ask whatever you were thinking about.
    It will get better!!
  4. by   SoCalGalRN
    Wow. I can't give you any advice because I have never had a problem yet leaving work at work. I very rarely think if patients outside of work unless I am trying to relay a story on purpose. I'm sorry you are struggling though. That sounds really tough.
  5. by   akulahawkRN
    Personally, I key on specific events... When I take my uniform off, I put "work" in it's little box and put it away. I generally leave all the "stuff" behind and get on with being "at home." Likewise, when I put the uniform on, I put "home" in it's box and put that away and open the "work" box. That results in me not talking much about work at home and about home while at work...
  6. by   BlueDevil,DNP
    My partner and I have a rule, we do not discuss our work places/events/careers in our home. We have to do it someplace else. That helps a lot! We have had that rule for 30 years, it has worked well. Our home is our sanctuary, and work is not permitted to invade our special space. We don't take work related calls at home (other than when I'm on-call, which cannot be helped-but we don't answer other office calls for instance, they have to speak to us at the office only) and we don't have work peers over to our home or host work functions in our home. We socialize a little with some of each of our work friends, but we don't have them to our home, we meet them out.

    Likewise, I have never been one to share much about my personal like at work. People I work with know little to nothing about my family, hobbies, interests. Other than the fact that I am blonde, left handed and vegetarian, I suspect they would be hard pressed to tell you much of interest about me at all. I bet even after working with me for almost 4 years now, they could not tell you one personal fact about me. For instance, I am certain no one other than my boss could tell you my spouse's name or occupation because I am deliberately vague about it (it is somewhat high profile and we would both rather avoid the fuss). Since we have an unusually large number of children that fact is well known, but I don't think anyone I work with knows their genders and I am certain not a single person in my office could tell you any of their names, ages, occupations/schools, etc.

    I suggest you do something similar. Designate a time/place to consider your clinical concerns, and stick to it. At no other time can it be discussed or contemplated. Make this a habit, and before you know it you will have effectively compartmentalized!
  7. by   macawake
    Two things jumped out at me when I read your post. You are showing signs of depression or burnout and you put one single word in bold.

    Do you have a preceptor or clinical instructor that you trust? Is it possible to explain to him or her what you are experiencing and ask for suggestions about coping strategies?
    Personally I find that exercise is a great stress reliever. If I've had a bad shift I usually go to the gym or go for a run. I don't know if that'll work for you?
    If a negative image from work pops up in my mind during my off time I usually acknowledge it. Yes, this patients plight pains me and I feel for them. Then I firmly set the thought aside and replace it with another more positive one. You say that you love the moments when you helped a patient. Held their hands and smiled at them, and have them smile back at you. Focus on that! Make that the image in your head. You already had plenty of moments and will have many more in the future where you make a difference in a persons life. Use those moments for mental sustenance. You won't be able to fix everything that's wrong and unfair in the world but believe me, your professional knowledge and your caring attitude will make a difference in a lot of patients lives.

    I knew early on during school that the typical med-surg floor or any kind of long-term care was not for me. I dread it for so many reasons. One of them is that I don't want to form long relationships with my patients. If I do, they will inevitably (for me at least) spill over in my private time in a way that I don't find beneficial. I found my happiness to some extent in the emergency department but even more so in the pacu and snooze side of an operating room. I love the chance of for a couple of hours focusing on one patient at the time (well, two in the pacu) and making a huge difference in their lives. Also I have a huge interest and fascination with physiology and pharmacology and my chosen path stimulate/challenge me in those areas.

    I think that's the charm of the nursing profession. There are so many different type of jobs within the profession that I believe that there is a match for almost every type of personality. Perhaps some of the angst your experiencing right know will resolve when you gain experience in your new profession. Nursing is a high-stress job that often demands a lot from you. I think that you need to find the niche that offers you fulfillment instead of anxiety.

    Best wishes to you OP!
  8. by   BrandonLPN
    The key is keeping work and life separate.

    This might sound sexist, but I've noticed women have a much harder time separating the two. Everything just seems to.... blend together for women. The women I work with talk way more about their families than the men I work with. And most women I've met love to talk about their job to anyone who'll listen. Talking endlessly about who's lazy, who's sleeping with who, who's a total b****, etc. Men just keep it separate better.

    I like blue devil's "no work talk at home" rule. I don't care what anybody says, listening to somebody gossip about their job is excruciatingly boring.

    As for the sadness/depressing aspect of patient care..... well, I look at it like this: I work in a nursing home with no shortage of pathos and depressing scenes. Elderly and crippled people abandoned by families and society. But these places and these situations existed long before I became a nurse. They'll exist long after I'm dead. They would still exist if I quit nursing or moved to a different field. Me sitting at home and feeling sad about it doesn't help them. Or me. If you did your job completely and competently, well, at least you know you accomplished that much, even if the pt is still stuck in a hopeless situation. Do your best at work and just putmit out of your mind the second you walk out the door.
  9. by   anotherone
    you either think about it or you don't. even if op doesn't talk about it she might still think about it . it is all doom and gloom and tyat is they way life is . i just accept it and try to move on. try to wipe it from my mind. doesn't always work and i guess it can make you feel like a robot and that the pts are just tasks (i dont mind that but someone people do not like feeling that way). i strongly disagree on mentioning these feelings to anyone in "real life" who has anything to do with school or work no matter how friendly or trustworthy they seem.
  10. by   macawake
    Quote from anotherone
    you either think about it or you don't. even if op doesn't talk about it she might still think about it . it is all doom and gloom and tyat is they way life is . i just accept it and try to move on. try to wipe it from my mind. doesn't always work and i guess it can make you feel like a robot and that the pts are just tasks (i dont mind that but someone people do not like feeling that way). i strongly disagree on mentioning these feelings to anyone in "real life" who has anything to do with school or work no matter how friendly or trustworthy they seem.

    Perhaps you have a good and sound reason for advising OP not to reach out to an instructor/preceptor. I don't know what you and others have experienced so it's difficult for me to judge and I certainly wouldn't want to put OP in a situation resulting in negative fallout. I will however say that I find it profoundly sad if nurses who take care of others aren't extending the same care to their present and future colleagues. To me school is about giving the student all the tools required to successfully carry out their future duties. Theoretical skills, practical skills as well as the abilty to cope with whatever feelings the many human encounters may evoke.

    In my school we used to meet in groups with our clinical instructor halfway through and at the end of each clinical period and informally "debrief". Whatever was on the students mind was discussed and the discussion often gravitated towards ethical dilemmas. According to the anonymous feedback each student gave at the end of the clinical period these discussions were very much appreciated. I think that dealing with your emotions is a part of the growth process and is beneficial. A little trivia, my class was 68 % female and 32% male (the usual male percentage at my school is 15-20%, so this one had a comparatively large number of male students).

    Substance abuse is quite common in the nursing and medical professions. Perhaps just wiping stuff out of ones mind doesn't work for everyone?

    For me personally, the day my patients become merely tasks is the day I quit nursing.
  11. by   Tait
    I learned that no matter what was going on with my patients, I often felt that in some small way I was making a difficult life situation a little easier by being compassionate, attentive, and helpful. Managing pain, talking to docs for them, advocating, these are all ways I feel I make a difference in my patient's lives. We can't fix everything, but we can take some of the pain and discomfort of the day away, even if just for 12 hours.
  12. by   salvadordolly
    You're new to all this. give yourself time to learn to cope with all of it! It will all calm down after the first year of being nurse. You are doing something new and your brain is just trying to find a way to integrate it. I found it took me a couple years in nursing to let it all roll when I left work. I just get in my car and crank the tunes really loud and sing obnoxiously, seems to let off the steam. By the time I"m home it's all gone. I have the same rule as Blue Devil - my home is my castle, no work allowed.
  13. by   Lennonninja
    Leaving work at work is a very important skill to learn. At my old job I lived about 7 minutes away from work, so I'd come home and still be stressed out for hours because I never had time to mentally change gears. Now I work 50 miles away from home, and on my drive home in the morning, I listen to podcasts that have absolutely nothing to do with nursing or anything medical, and that really gives my brain time to transition and by the time I get home from work, I'm fully out of work mode and can just relax and go to bed. Obviously this isn't going to work for everyone, but it has really made a huge difference for me.
  14. by   RNSavingHearts
    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 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... :-)