Quo Vadis?

For those who know little of Latin, the phrase means "Where are you going?" An aging nurse stands at a crossroads in both her career and her life, agonizing over the choices before her and wondering which direction she should take. Should she fight for what was once the best job she's ever had, or start looking for another? Even more critical, should she try harder, knowing that she's already given it her all.....or accept the truth that it's over? Nurses Announcements Archive Article

Life, as my grandmother used to say is a very odd little duck......you live through five or six decades, fashioning an existence that (hopefully) reflects your values, and learning to be at peace with who you are and where you're going. Then suddenly "stuff" gets real, and you find yourself standing at a crossroads where you're given a list of choices as to where you want to go next; the only option you don't have is staying where you are.

I just arrived at that intersection yesterday. And I already hate it here.

For some time now, I've been battling a personal issue that I've realized---too late---really does affect my work, no matter how much I wish it weren't so or how often I've denied it. Now it's developed a new wrinkle that is likely going to cost me my job in the short run, and perhaps my career as well: I've developed work-related anxiety attacks.

I don't mean just a little nervousness, or the stray "Omigosh, I can't do this anymore!" I'm talking about a primal fear that floods my entire body with stress hormones that I can literally feel---my heart flutters wildly, my stomach turns to stone and drops into my pelvic floor, my throat closes up, and my hands shake like leaves in a brisk wind.....all because I can no longer perform consistently at the level of intensity my job demands.

Naturally, I was the last person to figure this out. I've been clinging desperately to life at work since the disastrous state survey in which my department was scourged ferociously for multiple documentation issues. Six months later, we still have not succeeded in passing. And I have it on good authority that if we don't pass the next re-survey, the top three managers will be replaced.

I'm number two. In more ways than I'd prefer to count.

Look, I get it. I've been in this business long enough to know more than I ever wanted to about the 'business end' of things. I myself have fired people for poor performance; it doesn't take a Donald Trump to figure out who their problem children are and get rid of them before they can cause even more trouble.

None of that mattered one bit to a certain MD I see pretty frequently, who promptly took note of how stressed-out I am and wrote an order taking me out of work for a minimum of ten days. This is not to say I had no choice in the matter; unfortunately, the options were limited to either taking time off---NOW---or going inpatient.

I chose the timeout.

Now my boss is upset, and the rumors are spreading among the staff like wildfire. My condition is not the world's best-kept secret, but until now I never thought of it as a career-killer. Maybe it doesn't have to be.....but I do know that I'm done at my current position. Oh, I'll still be employed for a bit longer while the TPTB figure out how to dump me without running afoul of the Americans with Disabilities Act, but eventually they will. I know it as well as I know my own name.

That said, I've never worked with better people. My boss, my co-workers, my subordinates, and most of my residents are simply awesome. (I could do without the families, but that's a whole 'nother subject.) I hate the idea that I will soon be leaving them, even if I do manage to get my department through this next survey. Bottom line, I can't take the pressure anymore, and it's time for me to own up to that.

It's often said that God never gives us more than we can handle. But as a dear friend of mine says, He sometimes does hand us a burden that we cannot bear, so He also gives us wisdom to know when something is no longer ours to handle.

I am not there yet. Someday in the not-too-distant future I will be, but I have this crossroads to navigate before I can be on my way........and oh, so much more to learn.

Your posts have inspired me for a few years now. You have such kindness in your heart. You are a good person and deserve to be happy going into work everyday. Something better is out there for you. You can not watch every single person in your facility every second to make sure that they do not make a mistake when State is in surveying your facility, I am sure you did the best you could. Keep your chin up Viva!!!!!!!!!!!!

Thank you for sharing this!

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
VivaLasViejas said:
You know what's funny.......during my grilling session with the surveyors, I was joking around a little and told them I'd almost gone over to the "dark side" a few years back. They grinned and one person said in all seriousness, "Hey you could still come over to the dark side, we have openings." I can think of worse fates. :sneaky:

State or JACHO? Doesn't matter.....I have to secretly share...it's not a bad gig....:up:

Specializes in Hospice.

At 63 yo, I'm finding that sheer fatigue is really affecting my ability to do my job competently. While neither emotionally nor financially ready to retire, I've had to ask myself whether I want to end a 40+ year career by causing harm or getting fired. It kind of put it into perspective for me and by August I'll either be part time or resigned, depending on which way my DON jumps.

Here's a thought - maybe mgt would consider accepting a resignation then hiring you as a consultant to help your replacement get thru the next survey ... You get out from under and facility still gets the benefit of your expertise. And you wouldn't be leaving your coworkers and residents in the lurch.

Whatever ... The idea of a consulting gig or "going to the dark side" seem promising.

Am thinking the good thought for you!

I remember reading something Mother Theresa suppsedly said in response to the saying, "God only gives us as much as we can handle." Mother Teresa's reply, "How strong does he think I am?!" Fitting, I think. Best wishes.

God has reasons for everything , even the smallest thing He placed here on earth - He does it for a reason....

and .... even in the worst situation in our life ,there is wisdom that He wants you to understand. Trust Him with all your heart because He loves you...

Specializes in LTC, assisted living, med-surg, psych.

Thank you ALL for your support and kindness. Trust me, it's good to be validated, to know that I'm NOT crazy---that nursing really is stressful and one must practice good self-care in order to survive and thrive in it.

I met yesterday with my administrator and two of the corporate folks I know well, and the four of us had a productive and even friendly discussion. They are actually very concerned about me, and as much as they want me to stay on (nobody's talking about firing, in fact they were hoping I could help them out at a couple of our sister facilities until they learned of my illness) they don't want me to return until I'm 100% again. None of them thinks a week is enough, and reluctantly, I have to agree......all it takes to trigger the anxiety is hearing from my son about what's going on there.

Guess I need to tell him not to say anything about work, as curious as I am.....Lord bless him, he thinks he's doing me a favor by keeping me posted. Simply hearing about the residents and families who stress me out the worst makes my stomach start knotting up and my breathing shallow and raspy again---not good.

But, tomorrow is another day, and it's the day for my doctor-ordered trip to the coast, where I am to walk on the beach with my husband and watch the sun set. (I rather like his prescriptions---he also wants me to reward myself with a Hawaiian vacation when I reach my initial goal weight of 250 lbs. :)) The seashore is the place I love more than any other on earth......the soft breeze in my hair and sunlight on my face, the roar of the ocean, and even the screeching of seagulls bring peace to my soul and calm to my fevered brain.

It's exactly what I need right now; what's sad is I probably wouldn't have allowed myself this pleasure if my doctor hadn't told me to go, and then take pictures as proof that I've followed his orders. Guilt is a powerful de-motivator, and I've got it in spades! :(

Specializes in Wilderness Medicine, ICU, Adult Ed..

Viva, there is nothing wrong with taking a medical leave of absence while you seek treatment. You may have a treatable disorder (as was the case for me when I "hit the wall" several years ago). However, the beach holiday sounds like a great way to recalibrate your heart. It is O.K. to postpone decissions until you feel better and can think more clearly.

Best wishes Viva. Believe me, you are NOT alone. The only difference between you and many others is that you had the clarity, honesty, and courage to reveal this about yourself while most of us do not.

So glad to hear that you are staying on good terms with your employer. That is crucial. One of the most important things you can do is to make sure you take the time off you need to really get your symptoms under control, and be extremely diligent about really facing your symptoms head-on and repeatedly following up with your doctors to make sure your symptoms are really taken care of. Don't beat around the bush or try to deny this is a problem any longer- it will only make things worse.

Also, know that anxiety is a clinical problem with clinical treatments, even though life experiences can also aggravate it.

If I had a patient with mildly high blood pressure at baseline at home (say, averaging 140's/90's), and then the patient complained of headaches from work every day and she was found to be averaging blood pressure of 160-170's/100s at work every day, and then one really stressful day at work, she got dizzy and her head was pounding and she went to the ER with blood pressure of 180/110, what would you say needs to be done here? Probably you would say we need to get this patient on some anti-hypertensives! Or if she's already on antihypertensives, she needs some more! (and of course lifestyle choices and stress management are important, and the patient should engage in these healthy behaviors, but this patient's symptoms are affecting her job and her health- she needs more than just stress management techniques).

Stress is not anxiety. Stress is not hypertension. Stress IS a trigger- it will aggravate existing anxiety, it will aggravate existing hypertension.

So now if I say there is this patient with mild anxiety symptoms at baseline, but her anxiety symptoms are worse at work and the other day she had a super-stressful day at work and things really came to a head- what would you say we need to do? Treat the underlying anxiety.

If you don't treat the anxiety, you can end up with unhealthy coping skills and maladaptive behaviors -things you turn to just to help you get through it all, that may not be very healthy for you. Also, while you notice how your anxiety is affecting your job, chances are it is affecting other aspects of your life and your loved ones too. So take care of yourself- mentally, physically, and emotionally- so you can stick around to really enjoy life with the people you love.

Specializes in LTC, assisted living, med-surg, psych.

See, it's so much easier when I'm advising someone ELSE on how to take care of her/himself. ;) I'm not a very good patient, but I am taking everyone's words to heart.

Yes, I'm seriously considering staying out another week. Today I followed my doctor's orders to the letter and went to the seashore with my husband; we had an absolutely WONDERFUL day walking on the beach, exploring tidepools, poking through the funky little shops, and people-watching. All of my anxiety and stress literally were 75 miles away, and it may as well have been 75 million miles....the ocean is where I never fail to find solace and draw my strength. Unfortunately, I don't go anywhere near often enough, but that is going to change---we did the whole day on less than $100, and that included a full meal and gas for the trip.

But I also realized that I am not yet ready to go back to work. This is the first day I've been able to detach myself completely, and there are only five days left until my original return date; I performed an honest self-assessment this evening and can't come up with a single reason (except money) to risk relapsing by going back too soon. How ironic that my underlying bipolar illness is relatively stable, while the anxiety superimposed on it still isn't under control. I hope it will be soon!

Specializes in Med-Surg.

Viva, I'm going to hop on the 'go to the darkside' train. I just hope you treat me nice if you ever end up where I work!!

Or how about teaching? Mentoring? You do such a fantastic job of it on here, why not try to do it professionally?

Or you could start working on that book we have been wanting from you! I am sure the AN community would gladly help market for you!

Get some rest. Don't make any final decisions until you have taken your ordered vacation. I mean, patients, family members, the big-kahoonas (sp?), they are enough to push any nurse into anxiety attacks. But for someone with underlying issues, that are still relatively newly under control? You are a very strong woman, and it does not make you any less of a person or a nurse to need a break to recoup.

Specializes in Correctional, QA, Geriatrics.

You know sometimes being very strong is actually our greatest weakness. We become so determined, so focused on doing, being, fixing, controlling that we don't listen to the subtle hints our bodies and minds send our way. As a result those hints have to become loud or even shout at us so that we heed them and stop, review, refresh and accept that our strength is no longer an assest but harming us. We have to let the universe reach inside us and show us all the possibilites that we haven't acknowledged before and accept the new realities that we must embrace in order to move forward in a truly functional, intergrated fashion.

I have some physical health issues that have forced me to realize that the coping and lifestyle patterns of my past no longer and will never again work for me. It was a bitter pill to swallow but once I did I found my center of calm again. Please understand I verbalized my understanding and acceptance of the changes my health issues required but deep inside my strong woman core I secretly said I can still do it the way I have always done it if I want to. It wasn't until I really acknowledged that the changes are real, are permanent and there is no going back that different pathways opened for me and, most importantly, I found that inner core of calm, that gooey center of divine love again.

So here is wishing you a re-connect with your inner gooey center of divine love and calm again. Remember we at AN are always here to walk with you a bit whenever you need a buddy on this new journey, to help you when you stumble and to listen whenever your heart needs to cry or fret or just needs some reassurance that you are not alone.