Breakdown at work

Nurses General Nursing

Published

I'm not asking for any medical advice. I just can't hold this all in to myself. Im having a breakdown at work and can't stop crying. I've been dealing with depression and anxiety that seems to be getting worse. I've been hanging on by a thread, and now feel like I can't hang on anymore...except that I feel like I have no other choice. I can't take off work. I work private duty on a case that the family are not trained to care for the pt. They refuse to. Even though they are on the 485 as trained caregivers probably so the company can get away with accepting the case. There are only 2 of us day nurses trained for him. I can't financially afford the repercussions of taking time off.

I've already been just pushing through this and don't know what to do bc i feel like i can't push anymore. I'm not having any si. I just feel like i can't face the world...at least work anyway. I hate hate hate this case so very very much. Been here 1.5 years, but anxiety paralyzes me and keeps me from being able to do another case. I am screaming in my head for my pt to shut up, hearing his nasty secretions in his mouth bc refuses robinul. but I promise THIS IS NOT ME!!!! This is not who I am! I am caring. I am kind. I am helpful. I'm not an *** who is bothered by patients, but i am cringing inside and hating to my core being here, but this is not who I am. I'd be horrified hearing another nurse say that about their patient. I am frozen with anxiety as to finding a different case. I feel completely hopeless.

Specializes in Community health.
On 2/8/2020 at 11:50 AM, Orion81RN said:

Thank you. My case is very easy, actually. I tell myself all the time I need another case...and I've tried. I backed out of the other cases when I tried. Had a full blown panic attack on my way to another case and called in. My severe anxiety is what keeps me from trying another case. As far as counseling, I don't currently have insurance. It will kick in next month though.

My old psychologist was great, but it honestly didn't help me and majorly stressed me out squeezing it into my schedule. I quit counseling. I saw her off and on for 2 years. I felt like she was pushing me too hard. I was trying to just keep my head above water. Keep my job and not quit and move back in with my MIL and completely escape from the world. Meanwhile she was pushing me to take on more and more. Like here I am trying to not just quit my job and she wants me to pursue another degree. I just hide my depression way too well. Even from her.

I stopped taking my antidepressants over a year ago. I tried starting it up again, but it was doing absolutely nothing, so I stopped again. I need to try something else.

In this temporary period when you don’t have any professional help, good self-help can be incredibly effective. Have you read “Help and Hope for Your Nerves” by Claire Weekes? It’s probably at your library. Or, if you’re not a reader, I highly recommend the free podcast “Not Another Anxiety Show”. Start from Episode 1. The host is a nurse and she was where you are now. She has amazing, grounded advice. There is hope for you. I promise. This season will not last forever.

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Specializes in Hospice.

Do you have any grounding techniques that have worked for you in the past?

Sometimes it's really easy to forget things that have worked in the past when you are experiencing acute anxiety symptoms. Reviewing what helps when you're not having anxiety is a great way to refresh your "toolbox".

If you're not familiar with grounding techniques, it might be helpful to google that term. There are so many different ones and many that can be done without anyone noticing you are doing them?

Best of luck to you!

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Your concern for this pt and their dysfunctional family is going to come to naught if you implode at work.You are right there. Your employer will then take appropriate action, against you, and probably your license too. Then where you be? At the very least, it is obvious you need a medical leave of absence. Go to a doctor and start the process. Now. Yesterday. What more can you expect strangers on the internet to do.for you? Go to a doctor!

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Specializes in Psych (25 years), Medical (15 years).

There's a line from a Hank Williams song that exemplifies feelings I've had at overwhelming times like this, Orion81RN:

"God, why must (we) know pain with every breath?"

In order to get through these dark times, we sometimes have to live, not a day, nor an hour, but a moment at a time.

My heart goes out to you, Orion81RN, and the information and support from your virtual community is outstandingly noteworthy. By all means, take from here what you can use and persevere.

In my darkest times, I have relied upon spiritual readings, meditation, prayers, deep breathing, focusing techniques, exercise (sometimes to the point of exhaustion), art and humor. I have immersed myself in whatever eased the pain to the point of experiencing something akin to an out of body experience.

All of these techniques need to be worked as a program, every day, all the time, and not just when I'm feeling bad. If I don't practise these techniques, work my very own program every day, I can, and most likely will, fall back into the abyss.

My very best to you Orion81RN.

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Specializes in Psychiatry, Community, Nurse Manager, hospice.

It really seems to me that you are heading toward a mental health crisis.

I don't think you are in a place where counseling alone will help, because you are having panic attacks. The panic attacks need a medication to start. Once you get some control back, then you can learn to stave them off with therapy.

I'm not sure what kind of antidepressant you were taking, but if it's an SSRI please take it even if you feel like it isn't helping right now and then get to a doctor or NP.

Go to a federally funded clinic until your insurance kicks in. Get some treatment, and a note excusing you from work for a couple of weeks. If a doc says you can't work, then you can't work.

I know it seems like you can't afford that, but I think you are in a place where you can't afford not to. Hit up the food bank, let your credit card bills go unpaid for now, whatever you need to do. If you don't take a rest you will hit a wall that will force a rest.

Apply for temporary disability. You will get through this, but you need to take care of yourself.

Also, try not to blame your husband for not understanding. You need whatever support you can get right now. And husbands don't live in our heads. Just tell him doc said you can't work right now. Because you can't.

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I thought I would update you all, and thank you all again for your support. Even just being heard helped tremendously. I was able to look back and remember some coping techniques for when I'm in the middle of a panick attack. After just an hour, I was able to begin to turn my mood around. My patient and I ended up having a good rest of the day. It means the world to me when my pt smiles. I'm much happier when I know I'm making a difference.

I've been able to talk to my old psychologist over the phone. HUGE breakthrough in that we discussed that yes! My "disgust" for the sounds my patient makes is my misophonia. I still have to tell myself a lot that it isn't my fault that my mind reacts this way to certain noises, bc I feel very guilty for feeling a sense of disgust. She was also able to point out that I handle these situations very well in the moment. That I can be at my absolute wits end and still put a smile on my face and be professional when the time calls for it. No one would have a clue by looking at me. Her point was just that no, I am not weak, despite feeling that way. I am strong for hanging in there when needed, and strong for reaching out for help when needed.

My insurance finally kicked in, and soon I will start antidepressants. I am also talking to other schedulers about different cases. Thank you all again so very much. I am glad I made the decision to post something so private despite fear over being judged by my reaction to my patient's secretions. I am working on letting the guilty feeling go.

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

Good to hear! I'm glad you've found a way to handle your anxiety and depression. I've been through a few breakdowns of my own and I sympathize with you. Sounds like you're back on track and doing the right things to get and stay healthy. Just remember, you can always come to us when you need to vent; while we are no substitute for your therapist, sometimes you just need to talk to other nurses. You are brave for coming out with your emotional/mental health struggles. I would definitely not discuss it with your supervisors though, because there still is a lot of stigma in the medical and nursing communities and people can be VERY judgmental. But you've got a support system in place, and that alone puts you ahead of a lot of other folks. Wishing you the best in all you do. Viva

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Specializes in cardiac/education.
On 2/8/2020 at 8:42 AM, Orion81RN said:

I'm trying to text my husband and he said

"Tons of ppl hate their job or are miserable in their job dear. You're not alone. We just need you to try and be strong and find a way to get thru the day. Quitting CANT be an option."

I snapped saying I didn't say anything about quitting!!!

And THAT'S my support system.

And hubby probably has an 8-5 desk job. ? (sorry, couldn't resist!)

I'm so sorry you are going through such a tough time. It's so hard, I know. What do you usually do to cope? What has saved you before when you've hit hard times?

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