when you cant let it go (long vent after a crappy day)

[Sugarcoma]

Why is it that whenever a pt. goes bad I automatically think what did i do wrong? Why is it that I feel guilty when a pt. has a complication that I clearly had nothing to do with. Why do I keep going over and disecting every little thing I did for and with said pt, developing insane hypothesis that could never have happened?

Today I had an extremely pleasant, a&o 4, perfectly stable pt. admitted for observation following a fall with a arm fx. Pt. was fine ALL DAY. Vitals stable,a little brady (mid to high 50's) but taking several cardiac meds and a hx of MI. Only med received from me was Pepcid. Handed off pt. at 1530 and on my way out stopped to chat for a minute with pt. about what they were going to order for lunch. Again perfectly stable pt.

Apparently within minutes of my leaving the unit this pt. crashed. (I know this because a coworker called to inform me) So here I am blaming myself, wondering what I did wrong, thinking I am going to walk in tomorrow and be fired immeditely, lashed with a wet noodle, license revoked and perhaps a small blurb written up about me into the latest editions of all the nursing textbooks as an example of poor nursing. I envision myself walking the hall of my unit as my coworkers slowly turn their backs to me as I pass (I think I saw that in a movie once).

Is it because I am a mother and used to the fact that everything is my fault? Is it because I am mentally ill? I seriously concocted the following scenario in my head: The vial of pepcid could have been something else......nope I always check my vial. Maybe I grabbed a vial of something else mistakenly....the only other iv push med I gave today was dilaudid and I ALWAYS check my vials when I draw up meds.....Maybe we have a rogue pharmacist secretly switching pepcid vials with some other insidious conconction or perhaps someone at the pharmaceutical company accidentally substituted a batch of Pepcid with some other drug......Do you get where I am going here?

Why can't I just let it go????????

While this is a tad bit exaggerated, I really am having a hard time letting go of my pts. I automatically think it is my fault when things go wrong even if I had that pt. a week ago, (maybe I did something, what did I miss, etc.). It doesn't help that certain coworkers can be a tad bit accusatory and love to sit around disecting the nursing care of others (and apparently have time during crisis situations to call the offgoing RN to ask them for information easily accessible in the pt. chart).

Can anyone share some coping skills? Mine aren't working!

[tencat]

First off, I'm sorry that you feel so badly. That's bound to make your job more difficult. It might be a good idea to explore your fears with a counselor.

Now: I would set some limits for yourself. It is TOTALLY unacceptable for that nurse to call you at home to give you the 'scoop' on a patient. It smacks of harassment to me. What's the point of calling you? To nit-pick what you did wrong? To throw your insecurities back into your face? I would let that nurse know in no uncertain terms that you are NOT to be called after your shift is over for ANY reason short of the apocalypse. And you have to be willing to set aside your work when you get home. Find a hobby, spend some time with loved ones, go for a walk...anything to get your mind out of work mode.

You have to accept that you do the best you can for your 12 hours, but your time off work is YOURS. And you need to find a way to let go of work worries. As one poster said, people are going to die and you can't change that. If you could, you'd be a God....

[j621d]

My take on what you have described is a bit different from the others. It doesn't sound as if the nurse had a vendetta against you, rather it sounded as if there may have been a "connection" you had with the patient. It could simply be that she thought you might want to know, not that she was finger pointing (you didn't indicate this in your description).

As others have said, things can change quickly. If you were vigilant in your assessments and had no reason to believe something might happen, then there is nothing you can do. Your report probably reflected the assessment that everything was fine (and it probably was), and the oncoming nurse just happened to be the one where the patient crashed. We don't have crystal balls to tell us what will happen in the future. Just be confident in your assessments and skills.

[jjnmrsmom]

I think a lot of this is in the co-workers. If you don't feel supported and like they're going to talk about you of course it makes you anxious about every little thing.

I couldn't agree more!!

OP: I could have written your post myself! I have only been a nurse 1 1/2 years now and I worry about everything too. Part of it is inexperience and self doubt which will resolve with time. But a big part of it is my co-workers! Mine are a lot like yours, they love to point the finger and seem to get pleasure from other peoples troubles.

It sounds to me like you did nothing wrong. Patients die suddenly sometimes... can happen to any nurse on any unit. When I was a month into nursing I gave a patient a suppository and 5 minutes later he was gone! To this day I feel a little guilty even though it's highly unlikely I hastened his death. One of my co-workers tried to make me feel as though I did.

Don't let your co-workers drive you crazy like mine did me. Let their comments and attitudes roll off your back. They are obviously focusing on you because they are insecure themselves. Some nurses need to make others look bad to feel better about themselves. Sad for them not you.

[sasha2lady]

1. it was inappropriate of that nurse to call you at home about that. You had nothing to do with anything that happened AFTER your shift. You are only responsible for what you do when you are there. She was probably just trying to be a PIA because she had to do a lil extra work.

2. Prior poster is right...people die, they get old, they get sick..they perish. its a fate we all will face eventually. Some things arent predictable no matter what you do or dont do.

What I do when I have a bad day is vent on my journal at home. I have a file on my computer that I just go to town on every time I have a day I dont care to remember but cant afford to forget. Anything questionable or wrong is on my file. It helps relieve some stress and keeps me sane most of the time when I have no one to vent to. I like it because I can say anything I want to about anybody and anything and not have to worry about it leaking out. The only one who reads it is me at home in my own privacy.

I recently had a nurse from day shift call and try to argue with me over a weekend lab that wasnt done by a different nurse, I had been off for 4 nights and I let her know right off that I wasnt there nor was I responsible for what someone else didnt do! She had full intentions of ******* me off. When that didnt work, she tried to say I had a narc missing, which again wasnt true...I checked myself when I went back to work and what had happened was she overlooked what she was looking for to start with!

This same nurse also thought she'd be smart and write on my report sheet in giant letters for me not to get urines at a certain time...whatever. She can get them herself for all I care.

Point is, try not to overstress because it will eat you alive...trust me I myself am a worrier nonstop and all its done is give me headaches and heartburn and more frustration than its worth.