Coping skills for dealing with trauma

  1. I'm in my 10th month as a Burn ICU nurse. Lately we've been dealing with a lot of high-acuity situations (sick patients, victims of violent crime, child abuse) and family member distress. I feel as though I'm on my toes all the time, even when I come home. I wake up in the morning thinking of code situations from the last time I worked. It doesn't help that a lot of these incidents have captured the attention of the news media. I can't even watch TV without seeing funerals of those I cared for. Usually my work doesn't affect me like this. But I can't seem to shake this "emotional tense-ness" feeling, even doing all of my usual stress-relieving activities. What do you guys do when this happens? I like my job and I don't understand where this is coming from.

    ~ Thanks ~
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  2. 13 Comments

  3. by   LMonty911
    Last time it happened to me- and I can relate to almost the exact feelings you've described, but from a different department- I got hold of the EAP counselor. Saved me from some serious burnout, by dealing with it promptly.
    I'd strongly suggest that for anyone in the same circumstances. Its a good place to start.
  4. by   aquaphoneRN
    It sounds like work is really getting to you, much more than it should. You should talk to someone about it.

    I hear that burn nursing is not for everyone. I'm not saying that is the case with you, just that I hear many nurses find it unlimately too emotionally difficult and haunting.

    Please don't get mad at me for giving my opinion, it is only an opinion, but I think you really sound like you're in bad shape, and you should discuss this problem with someone. Be it you manager, or a co-worker that you really trust, or a counselor. The key is, I think, it has to be someone you know you can trust because you don't you personal and private thoughts and feelings spread all over work, which could easily happen if you talk to the wrong person.

    If your job offers crisis counseling, I would start there. What you are describing is no joke and should be taken seriously.

    Good luck.
  5. by   weetziebat
    I am always so impressed that there are nurses who can work in burn nursing. That is one area (the other would be PICU) that I simply could not handle.

    With all that you see and do every day at work it would be amazing if you did not take it to heart, causing stress and eventual burnout.

    I'm so sorry for what you are going through, and strongly urge you to contact the EAP counselor as soon as possible. You need the support that they can give you.

    Good luck, and let us know how you're doing, O.K? :icon_hug:
  6. by   VivaRN
    Thanks for your helpful advice and care. I ended up talking with my best friend and some of my (more trusted) co-workers. Funny, though, how burnout can sneak up on you and you don't even know it! Many of them had gone through similar periods in their careers. We realized that part of the problem was a lack of good staffing (esp. for pt. acuity) during this period. Add the press trying to get in, crashing pts, family members everywhere... We were all going crazy!

    As far as burn nursing goes, I'm sure trauma nurses must experience the same kinds of feelings... or any nurse, really, when you have prolonged periods of work-intensity or a pt/family you get to know. Burns can be difficult because it's never a natural occurrence; there is always some incident or trauma that caused it. As nurses, it gives us the privilege of walking with the pt/family through that journey. Though there is such a thing (as I have discovered) as too much at once! More like running with the pt/family :chuckle... or sprinting with multiple pt/families... I need a water break!

    Has anyone out there ever experienced burnout? What led you back (if you came back)? Any advice for new ICU nurses in this area? I think we are more prone than those with more experience, simply because of our lack of experience!

    Thoughts?
  7. by   augigi
    I was getting fed up with the grind - much overtime, very sick patients etc (I mean more than usual ICU, since we were a specialised facility). I left for a corporate position (clinical educator to start with). I actually find the M-F 9-5 more stressful hours than 12hr nights after several years!

    Also, it's just as stressful, but a different kind of stress. I frequently work 8-5, then come home and do another 3-4hrs work, since I'm the only person with certain skills in the company.

    I'm planning to go back to nursing soon, as I miss the clinical hands-on and patient contact SO much. Plus, you get looked at very negatively working for a device company - going to the "dark side", as my ex-colleagues said!

    To avoid burnout, use your work counselling resources, have group debriefings after terrible patient situations, find a more experienced mentor and ask them what THEY do to cope with it, make sure you leave it at work and have a good lifestyle outside nursing. Too often, nursing is not what we do, but what we ARE - and sometimes, you have to learn to treat it like any other job.
  8. by   weetziebat
    Regarding dealing with burnout. I'm sorry to say, and believe I am in the minority, but once I get burned out, nothing will help it but changing jobs.

    I've tried all kinds of advice but I just never get back the enthusiasm or joy at working there, and then start feeling cynical and not caring. Oops! time to leave.

    Depending on the job, I've lasted anywhere from a year to seven years. Maybe you can turn it around with counseling. Good luck
  9. by   Mags4711
    I'm glad you are feeling better about things, I was going to agree with the folks above me and suggest you speak with a nurse counselor. They have a different take on things, having been a nurse themselves.

    I worked a Level I Trauma and Burn ICU for five years and I LOVED it. I actually preferred the burns, I think it is true, everyone is different and reacts differently to things they experience. It is a special breed who is a Burn nurse, just as it is a special breed who is a Geriatric nurse, or a NICU nurse or an ED nurse, etc. We all have our "niches" and that difference is what makes the world go 'round.

    Best wishes to you and welcome to the wonderful world of nursing!
  10. by   Newfoundland Nurse
    I recently started training for the Intensive Care and Emergency Units at my local hospital. I am a new grad and was very hesitant about enrolling for this program because of my lack of experience. However, now that i am enrolled, i find it very interesting and i am learning more than i ever thought possible. I am proud of the way i am adapting to this new way of nursing, but am still green in a lot of areas. Yesterday i experienced my first code situation and am struggling to deal with the events. I seem to have gone into a slump where i am spacing out and getting very emotional b/c i cannot seem to get the images and sounds out of my head. I tried to talk to my husband about it, but since he is not a nurse, he has no idea what it is like to perform CPR on a real person and fail to succeed. He didn't want to hear me "whine" about the hard day i had. Today we actually got into a huge fight b/c i am so emotional.

    To get to my point of this posting....for starters i guess i just need to know if my reaction is normal for a first experience. I would also greatly appreciate some advice on how to deal with this experience. I don't want to become cold and unfeeling in these situations, but i do need some advice on how to keep my emotions in check. Anyone else out there ever experience the same feelings?
  11. by   VivaRN
    I guess I can reply because that's exactly how I felt. Isn't it so strange, how you can be cool in the moment and then go home & be like, Whoa! Somebody died! I have found the most comfort in comparing experiences with fellow nurse friends. Other people have a hard time understanding. And it takes so long to explain the terminology. I think that "first" experiences are always the most difficult. But after you've done it once you know what to expect, what it looks like, & how to be prepared as a nurse, with the result being that you're more prepared emotionally. After awhile a code is just a code. It's not unfeeling. I began to think of it as, "We did the best we could, but it was his time." Accepting it instead of dwelling on it. That "tense" feeling goes away gradually. I know in my unit, there's an ebb and a flow. A few quiet nights at work... and I was back to normal. Write about your experience, or talk to another nurse-friend. Let us know how you are! Probably the best advice anyone ever gave me:

    1) It is what it is.
    2) Just do the best you can.

    That's how I survive!
  12. by   DizzyLizard
    I haven't experienced burnout as a LPN (I just started) but I did experience it when I worked as an EMT. Over the course of two weeks or so we had a lot of "bad" calls" that left me shaken. One call in particular haunted me. Every time I closed my eyes I relived the situation, I didn't eat, I didn't sleep, I was anxious, I started calling off, I stopped leaving the house, etc. After 4 weeks of misery I started working with a CISD counselor (critical incident stress debriefing) for about 6 weeks and took some time off of work to re-group. I made a lot of changes in my life and learned how to effectively manage my stress and the crazy world of EMS. I was skeptical but counseling was the best thing that came out of the situation. I'll keep you my thoughts and prayers. Good luck!

  13. by   blueheaven
    That seems to be the case with me also. My non nursing friends and husband do not understand the full extent of my occupation. Thank God for other nurses, these boards, and my momma (she is a retired nurse) to get through those times.
  14. by   LadyNASDAQ
    You need to float out of there for a month. This is trauma for you otherwise you'll leave your job eventually due to exhaustion. Trust me, you need a break. I would ask for a few days off anyway and take a mini vacation. You're taking a lot of this in.

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