Advice needed regarding hurting patients - Long

[lifeisgood2024]

Hi! This is my first post here so I will try and provide as much info as possible without writing a novel. 

I've been an LPN for approximately 12 years. I've worked in LTC, SNF, Hospice, Med Surg and ER. I was led to be a nurse. I couldn't imagine doing anything else until recently. 

My father passed away May of 2023. We didn't have a great relationship. My Mom and I don't have the greatest relationship. It brought up a lot and I was out of work a lot including on medical leave. Prior to being out on medical leave, I would be in a patients room and just zone out/disassociate - I had to have my (wonderful amazing) coworkers come and take care of things while I got my head back in the game. These were basic things that I have done a gabillion times and just zoned out. 

I do have a history of depression, anxiety and PTSD. I have had extensive EMDR and cognitive behavioral therapy. While out on medical leave, I was able to find a new EMDR therapist (I just moved to a new city late 2022) and get started on a new med. When I went back to work, 3 days in I made a ridiculous med scan mistake - I gave a patient 10 mg of Oxy instead of 7.5 - I immediately noticed it and contacted the MD - no harm was incurred with the patient - but it was a ridiculous mistake on my part - and because I had been written up for excessive absences (after my Dad passed I was taking care of my Mom a lot) I lost my job over it. I take ownership of that - all of it - I was absent a lot regardless of the reason and I was spacey and making errors. I'm not refuting it.  Because of that, I'm currently without meds or therapy.

I am doing Shipt daily and sometimes Door dash. I have set up with 2 nursing agencies, but I have only gone to a total of 4 jobs because of anxiety. I've cancelled or they've cancelled. I'm truly scared that I'm going to zone out while I'm at a nursing home and hurt a patient - just by overlooking something or getting shaky. 

I truly feel like I lost my job and it was the universes way of telling me that I'm not supposed to be a nurse. I've tried all the things. Taking one job. Taking day shift. Taking night shift. Taking an 8 hour shift. Taking a 12 hour shift. Taking a job close to me/far away from me. Taking a job the same day. Nothing is helping my anxiety/deep rooted fear that I am going to hurt a patient. Even when I was on meds regularly after I got fired I felt this way. I do agree I need to be on meds. I do live in a larger city and am aware of the resources available to me. I'm also just having enough energy to keep my head above water. 

I don't have a lot of day to day support in real life. I've tried all the things. I've tried the Calm app breathing exercises, I've tried distraction, I've tried music, I've tried looking at positive quotes on Pintrest, I've tried everything I used to try and I cannot shake this! I am so afraid I'm going to hurt someone beyond repair and never be able to come back from it. My previous therapist I was with before I moved out here (I was with her for approximately 3-4 years off and on doing EMDR/talk therapy) always had me break things down into their smallest part. And with this - the smallest part is I'm afraid I'm going to hurt someone - and they are going to die. So even that tool iisn't working. 

This is so humiliating. I'm a grown woman. I just can't shake this. Thank you for hearing me. I'm usually a pretty resourceful person and I just don't have it in me anymore to figure this out. I am open to suggestions/constructive criticism/whatever you've got. 

Thanks. 

 

[mtmkjr, BSN]

I'm sorry about your struggles, and I understand The vicious cycle you are in where you need help but you don't have the insurance to get the help and you can't get insurance without getting a job. 

Have you considered leaving the bedside if even for a time? With your experience are there might be something you could do outside of patient care to reduce your anxiety.

[lifeisgood2024]

Thank you for your response. I have considered it, but financially it is just me and I'm not sure what else I could do that would cover bills. I've looked at medical billing, and even into phlebotomy, but it would barely cover rent/car/car insurance. I can't keep doing Shipt/Door dash - it's not sustainable - but me having this fear isn't either. I just feel really stuck and ashamed that I can't pull out of this even to do one job a week. I used to be stronger than this. Take good care. 

[mtmkjr, BSN]

lifeisgood2024 said:

Thank you for your response. I have considered it, but financially it is just me and I'm not sure what else I could do that would cover bills. I've looked at medical billing, and even into phlebotomy, but it would barely cover rent/car/car insurance. I can't keep doing Shipt/Door dash - it's not sustainable - but me having this fear isn't either. I just feel really stuck and ashamed that I can't pull out of this even to do one job a week. I used to be stronger than this. Take good care. 

Well I didn't mean non-nursing, I was thinking about non-bed side, more relaxed environments (okay so maybe not all of the following are more relaxed, many are but just differently paced):

Infection prevention

Occupational health

Clinic nursing

Nurse educator

Telemedicine 

Health coaching

Health informatics

Hospice nurse

School Nurse

Nurse writer

Wound Care

Diabetes Educator

Risk Management

Occupational health nursing

Utilization review

Case Management

School nurse/college clinic nurse

Community health nursing 

Prison nurse

Clinical documentation integrity specialist

Nurse recruitment

Medical device/Pharmaceutical sales

[lifeisgood2024]

Thank you for this. I appreciate it. I feel like my biggest issue is hurting a patient - and I don't know how to get past that no matter what nursing field I go into.  I don't know how to get my trust and confidence back.  I don't know how to shake this. I appreciate your time and hearing me.  Take good care. 

[neenie109, ASN]

I can understand what you're saying because I think I felt this all throughout my nursing career. I've been out of nursing for two years now and doubt I will go back but read these message boards every so often because sometimes I think I miss it. Anyway, if you can swing a bit less money I would say try something healthcare-adjacent for a year and let yourself breathe and get stronger mentally. I went into the school system as a paraprofessional (very big drop in salary but it's my favorite job ever) working in a classroom with multiple medical/developmental disabilities. You still get to work in a helping role but don't have that feeling of overwhelming responsibility that I got with nursing. My second best job in terms of low stress was home health, opening cases and supervising HHA's in the field, it was a lot of driving and paperwork but very little patient care, and I got to spend time talking to the clients and figuring out what they needed to live safely at home. Third best was (believe it or not) working in a jail, because it was mostly healthy people with a few chronic illnesses and some mental health stuff peppered in. It was actually a fun work environment a lot of the time and I learned a lot there. I hope you can figure out what a comfortable next step will be for you, and realize that it can just be a temporary one for a year or so until you are in a better place mentally.

[FolksBtrippin, BSN, RN]

Your employer traumatized you. Firing someone for excessive absences is really low when their parents are sick and dying. I feel like you are internalizing their maltreatment of you. The med error was not a big deal. No one was harmed. I don't know why you think it's ridiculous. You're a human being and made a med error. It happens. I think you really need to forgive yourself for this and also maybe get angry at your POS employer.