Stress related near breakdown

[inthesouthrn]

I've been and RN for 16 years. After graduation, I worked on a med/surg floor for 1 year then went into home health. That is where I stayed until 3 years ago when I went back into hospital nursing, med/surg. I did pretty well getting back into the swing of hospital nursing, however, I do find it very stressful and physically as well as mentally challenging. I have been handling it well for the most part however. I am in my late 40s.

However, the last several months, on those very stressful days, (you know what I'm talking about, when you have admissions, discharges, pt procedures, pt's going bad and being transferred, and those kinds of things happening all at once), I've noticed that the stress is almost unbearable. I feel like I am going to explode on the inside at times (I'm not talking about an outward outburst, I just feel a horrible turmoil on the inside). On the days so much is going on, I feel very inadequate as a nurse because I feel there is too much going on that I can't keep a handle on it. I am actually, a good nurse.

Our patient ratio ranges anywhere from 5 to 7, rarely 8 to one nurse. Our patients are such high acuity sometimes and we do have many unruly patients at times.

I have, at times, gone to our assistant unit manager telling her of my stress level being very high during the times it has been, and she has always been understanding telling me to take a break. However, the other day, I had a horrible stress filled day with SO much going on, I felt I may crumple up in a corner somewhere and start crying or screaming or something. I just felt so overwhelmed all day long. However, I always manage to take care of my pts, get everything done, and manage to leave somewhat on time. I still don't feel good about my days work. Anyway, I talked with my husband about it on this horrible day and I told him I don't think I can go on working like this that the stress level is so high I don't think I can bear it anymore. He was very understanding and said whatever I have to do, we will do.

The next day on the way to work, I felt as if my body and mind had been in some kind of war or something. I took report, but didn't feel right. I saw a couple of patients, until my manager came in and I told her how I felt. She told me that I needed to see a doctor, which I did. She took me out of work for a week, put me on an antidepressant, and made an appt for me to see a psychologist. I told my unit manager this and she was very understanding and I got the papers for a medical leave. My appt with the psych is in a few days.

Right now I feel better, but that is knowing that I don't have to go back to work for several days. The med has me feeling a little jittery and restless, but at least I don't have depressing thoughts. Now I'm here at home trying to figure out where I want to go from here. I don't know whether or not to try the hospital again after my rest, new meds, and appt to the psch, or try to find something else. Something else in this economy will be hard to find, and even so, I don't know where else I would want to work. I got really sick of home health care nursing....so I don't want to go back to that. MD offices are also horribly stressful I would think.

Our finances are good, we have most of our bills payed for, one child married, but one child in college which we have to pay 12 K a year for (she had a partial scholarship). If we really had to, we can afford for me to not work for awhile. But during that time, I would lose my experience, and you have to actually work as a nurse to keep your license up. So I am left pondering some deep questions. Can I really take this anymore? And if I can't, what now? I hate to lose what I have worked so hard for, but I want to live also and not have some mental breakdown, which is what came so very near to happening. I have not adequatley described the horrible way I have been feeling and my anxiety level. But suffice it to say, it was unbearable. I have thoughts of this world being horrible, nothing good in it and all kinds of things.

I can tell everyone I worked with is stressed too, so it's not just me, but I'm the only one that it has affected in this way

Words of wisdom from anyone? I'm kind of tender right now, so please be gentle. :)

[BradleyRN]

These high patient ratios are ridiculous, and likely fully to blame for what you are going though. For people getting burned out, i always recommend one thing: go PRN. That way you can work one, two or three days in a week, and take the whole next one off if youd like. I have been PRN for years and it has always been such a beautiful thing. It has always seemed to me that the full time people get railroaded all the time while PRN people have the red carpet rolled out for them, because hey, they didnt even have to come in. Work one day a week. Take a month off. There is no limit to the relaxation that comes from being PRN! And you get paid more which offsets working less days. And you only have to work one holiday. I could go on all day.

[mwinstea]

I have walked in those moccasins you are wearing and realized that I was perimenopausal which is life changing, physically, emotionally and mentally. The best thing for me was to attend a few seminars on the topic, read and follow what is recommended. For me, I cut back my hours, increased my exercise, found out the right rituals to do at night to ensure a good REM sleep and I feel much, much better! Hope this helps.

[Keepstanding, ASN, RN]

sweetie, you need a break. you need to give the medication time to "kick in". if your finances are good, then take the time. i wish you all of the best. saying a little prayer for you too :heartbeat

praiser :heartbeat

[inthesouthrn]

MWISTEA, I forgot to mention, I'm menopausal too.....am on hormone replacement therapy....you know estrogen, prempro...thanks.

[NurseLoveJoy88, ASN, RN]

Why don't you try school nursing ?

[HouTx, BSN, MSN, EdD]

First of all ((((((((hugs:heartbeat)))))))))) to you - what a horrible experience.

Just wanted to let you know that stress-related illness is legitimate grounds for (workers comp) disability leave in my state - it probably is in yours. Based on personal knowledge - once a hospital gets hit with a few of these claims, they tend to take concrete action to reduce the workload and stress because due to the negative effect it has on the ol' financial bottom line.

Going PRN or strict Part-Time (no coming in extra, even if they wheedle) is a great option if you can. Bless your DH for putting you first - he knows that the most important thing to save for retirement is your sanity.

[oramar]

Never, never feel guilty for taking care of yourself. Good luck and God bless.

[victoriahall]

Hi inthesouthrn, first off, it seems to me your reaction to your stressful working environment makes perfect sense…you don’t sound crazy at all! There is a reason there is a nursing shortage, and you are a good example of why. Many nurses (and paramedics, police, etc.) are so tough, yet are walking around with PTSD! True.

You have already gotten some great suggestions here—going PRN, trying school nursing…there are so many choices! Too often we stay at a place that is just not a good fit for us. Have you considered a future role in education or administration? The important thing is, don’t leave nursing! You are obviously caring and committed, and we need nurses like that.

It also makes sense that you feel like your body and mind have been in some kind of war because they are! As you demonstrate, chronic stress leads to illness eventually…of body, mind, and spirit. As nurses we often put others ahead of ourselves, so be sure you take some time putting YOU first. The first thing I’d do is run not walk to get a good massage! You will have so much negative energy housed in your muscles, so don’t be surprised if you are quite sore for a day or two, but then should feel much better. Get another one in 10 days if you can…and consider going regularly.

Also someone mentioned the importance of exercise and I couldn’t agree more! Even “just” walking is a major stress-buster, and you will feel better on all levels. Do something you like to do…that is even fun. You might like yoga or Tai Chi. Sometimes we try to “think” our way out of problems, which can only make things worse. Try to put negative thoughts out of your mind as you walk (or whatever), and make this time just for you. This should help your sleeping also which, as mentioned, is so important. Be sure you are getting sunlight (or a light box) everyday, and are taking vitamins, especially Vit D. And then of course, eat right! White sugar and flour in particular may make you feel worse.

Finally, you might find it helpful to do some volunteering—it is a wonderful way to give, and in a way that you will really be appreciated. What you put out there comes back to you many fold. Wake up and go to sleep with a grateful heart--even if you have trouble coming up with something to be grateful for in the beginning, it will come naturally over time. For one thing, it sounds like you have a loving and supportive spouse, which is of course, priceless.

I think it so good that you are reaching out…I hope you will come back to this discussion board and let us know how you are doing. You are not alone and people care! Victoria.

[kellykelly]

I too have been per diem (PRN) for years and I love it. I usually work at least 32 hours a week so it's like I'm a regular employee, but if I need a week off, I have it. No more wasted weekends or holidays! It does wonders for the mind and soul! Though I can't say they ever roll out the red carpet for me. I've been there too long. :)

It sounds like you could swing it financially. Join a gym and start working out every day, even if you're in good physical shape, because there is nothing better for your mind than exercise. That's my opinion but it's never failed me yet. Limit your work to once a week at first, more if you feel like it. And let your manager know that the workload is just too much. Good luck to you!

[jjensen]

That is why I work casual... If you are financially able to go casual... I can pick the hours I work and if I need a week off, I take one... This way I can balance being a mom, wife and nurse... Take care of you, or you are worthless to everyone else honey...

[steelcityrn, RN]

Your the only one putting pressure on yourself. If you can afford it for a while, take time off. Your license will not expire with some time off. You have years of experience, I would not worry about missing anything .When your ready to go back to work, make sure its where you want to be. But if its not, try another job. We are only on this earth for a blink, don't let a job ruin your life.