Can't stop the nightmares- please help

HillaryC, RN, CRNA · Jun 20, 2005

I've been a Pediatric ICU nurse for 3yrs now, and I've seen it all. GSW on 4 yr olds, deglovings, MVA, ped vs. car, abuse- I was able to deal with all of that. But when I was in work on Friday I saw something that no human should ever see. I can't get the picture out of my head, everytime I think about it I start crying. I have no plan to quit my job or anything like that over this, and it hasn't affected my love of my job, but I am just so fixated on what happened. I was hoping if there were any paramedics, ED peep's, or just RN's who had experianced something way beyond the realm of reality- something truly horrific they could pass on how they dealt with it. Will the images fade? Will the tears dry up? I can't stand it right now. Please help.

I haven't experienced anything like that (so far); I just wanted to offer you my sympathy. It sounds like you may be suffering from PTSD. Are there coworkers you can talk to about this, or possibly a counselor or therapist? It sounds like what you saw was very traumatic.

Hugs,

Hillary

Katnip, RN · Jun 20, 2005

Hugs, to you, Caren.

Does your department have a psychologist on board? Do they do debriefings when truly horrific events occur? Do you have someone in an employee assistance program you can go to?

Most hospitals have all that. Find out and make sure you take advantage as soon as possible. Take care of yourself.

Audreyfay · Jun 20, 2005

EAP definitely. They will help you learn how to cope with disturbing things you experience. Please call them tomorrow. Don't wait. I wouldn't recommend talking with anyone except a professional.

Stitchie · Jun 20, 2005

Perhaps the hospital has an employee assistance program that you can call right now, or a crisis line run by the county if you feel you need to talk to someone right now.

I have always thought that those of us who work in high-stress areas (ER, ICU's, pysch) should have therapy just to de-compress. We see so much that no one else can see or understand.

If you feel that you can wait, and that's up to you, but you can always phone your doc's office for a referral to some counseling if you don't want to go through your own hospital's program. Get the doctor on call.

There is no reason why you should tolerate one more minute of the distress you are in.

You are brave to come forward.

**canoehead, BSN, RN** · Jun 20, 2005

I did about 4 months of PICU at one point. I didn't make it through the orientation, it was so stressful. I had dreams about my cats intubated and sedated, fragile, and not being able to help them. Pathetic, I know, but it goes to show that the most benign PICU has some horrific sights that most people never have to deal with.

I quit because of stress, nightmares, and not being able to organize myself well enough to get to a movie at the right time. Employee Assistance was a great help to me, just to be able to tell someone who would sympathize and not think you are losing your mind. Call them and just tell your story- if you aren't comfortable you don't have to go into any more depth than that.

Remember that is what they are there for, and you need to let other people give you a hand once in a while if you are going to survive. If you need vacation time you are more than entitled to it. Good luck.

Mystery5 · Jun 20, 2005

Yes, I've had stress inducing events that have haunted me. I think it's good to talk, talk, talk. Every once in a while, I'll just get overwhelmed with something and have a little mini-nervous breakdown, and need help, by seeking emotional support from others.

I had a pt die last night, in fact, 3 hours after admit from septic shock. It was the fastest I've ever seen anyone go down the tubes. She was only 44, and her loving husband was devastated. It was awful.

suzanne4, RN · Jun 20, 2005

If this incident is bothering you, then it certainly is bothering others in your dept and anyone else that came into contact with this child.

A debriefing should be scheduled immediately. If you feel that you need to speak to someone tonight, ask to speak to the social worker on call at your facility and they can arrange something for you. You should not need to suffer thru this alone.

Surgical Hrt RN · Jun 20, 2005

I've been a Pediatric ICU nurse for 3yrs now, and I've seen it all. GSW on 4 yr olds, deglovings, MVA, ped vs. car, abuse- I was able to deal with all of that. But when I was in work on Friday I saw something that no human should ever see. I can't get the picture out of my head, everytime I think about it I start crying. I have no plan to quit my job or anything like that over this, and it hasn't affected my love of my job, but I am just so fixated on what happened. I was hoping if there were any paramedics, ED peep's, or just RN's who had experianced something way beyond the realm of reality- something truly horrific they could pass on how they dealt with it. Will the images fade? Will the tears dry up? I can't stand it right now. Please help.

When I first got out of nursing school I went straight into the ICU. I knew that this was the area and specialty for me. I have always prided myself on my tender heart and caring nature; it was one of the main reasons I chose to become a nurse.

I had been working in the trauma surgical ICU for 6 months when my whole career changed for good. I had a 16 year old patient. He as an honor student and only child. He was gifted and on his way to a great life and an Ivy League school. He was standing on a busy street corner, waiting for his school bus, when a drunk driver hit him and drug him 30 feet. He was a complete mess. He had a multitude of internal injuries and had undergone several surgeries. He was intubated and wide awake. He was a very handsome young man and he was scared to death.

I came in that night and it was my turn to take care of him. He was doing better; it had been a long road to hoe for him. He had been in the unit for about 2 weeks and his parents kept vigil at his bedside. We had all grown close to the family and to the patient. Even though he was intubated, he would crack jokes, and smile. He was a real joy to take care of. Anyway, this night he started dropping his blood pressure. I called the resident he gave me some orders for a fluid bolus, and he responded to it well. About 2 hours later it started again. I called the resident again.....same order. About another 2 - 3 hours later I went in his room to give him his bath. There had been no significant changes in blood pressure, heart rate etc.... He was rock stable. I was gathering my supplies in the room and he started banging on the side rail. I walked over to him, took his hand, and tried to calm him.

He had the most petrified look on his face that I had ever seen. I called for help, and no sooner than I did that, he started spewing stool from around his ET tube. We called the code and the docs came, opened him up bedside and started taking clots out of his belly. His abdomen had perforated. During the code, this boy had periods of being conscious, it was the single most worst experience of my career to date. He died after nearly an hour of coding. Someone had called his parents in and I was devastated. I had never heard such wailing in all my life when he parents arrived. I was crying hysterically and they were trying to comfort me. I felt like everything was my fault, even though everyone said that there was nothing I could have done differently.

I took a week off work and talked to anyone who would listen. Do the tears dry up.......yes, but you will probably still shed some always. Can you get over it......yes. Will the nightmares go away......yes, but sometimes I still dream about him and it's been over 7 years. Take pride in the fact that you can feel. It is what makes you a great nurse. Seek help, talk, talk, talk, talk, and be prepared for it to happen again.

You will be fine, hold your head up, and take pride in you.

Genevieve RN · Jun 20, 2005

{{{{{{{{hugs}}}}}}}}}

You need to speak with a therapist right away. You might consider taking a leave of absence for a few months and just do fun happy things. It will help, trust me.

I also worked PICU for three years and had to leave due to unrelenting stress. I worked in a law firm form 10 months. I took 8 weeks off and went back to the hospital working General Pediatrics. I just had to work with kids who were walking/talking etc. I could not take the intubated, etc. patients anymore.

Working somewhere different and then taking time off just for me helped me feel so much better.

Best of luck to you

Trauma Columnist · Jun 20, 2005

I am so sorry for you. Critical Incident Stress Debriefings are now offered in hospitals for ER, ICU, pre-hospital personnel and anyone else who deals with stressful events. Please get some help - other posters have also given some good suggestions. Please know that many (even those with years of experience) need some help once in awhile. For me, it was a pediatric child abuse case that I still to this day (9 years later) think about. It is so strange because the paramedic that brought this child to the ER became one of our RN's years later and recently we were both talking about this incident and how it changed our lives. You have to take care of yourself before you can take care of others.

Gromit · Jun 20, 2005

Caren, I agree with my compadres on here. You need to talk to EAP. IF EAP doesn't help, talk to a psych or other professional. Don't let it eat at you until you dump the job eventually (you say you have no plans to do so right now, but let it eat on you for a while and you will change your tune -don't let it happen). I won't get into any story details, but back in the early '90s I was a paramedic/firefighter and loved what I did, but a series of back-to-back horror-stories caused me to get down to the end of my rope, and I sought the EAP -sadly, in my county, this was very poorly run, and of no assistance whatsoever (in fact, after telling my story to the psych-wannabe there, he told me that my problem wasn't work-related (gee, you think nightmares (night terrors), a sudden penchant for drinking -rarely ever touched a drop before) and having difficulty sleeping, and having to justify to myself why I had to go to work -all this started after years of perfect attendance and "normal" behavior- has nothing to do with the job?? Thank God I wasn't married or had children) and sent me on my way. I finally talked to my private doc, but not before I'd gone too far to stay in my chosen profession. I tanked that job, got out of medicine entirely, and went to driving rigs long-haul (needed a drastic change and time to think). I truly missed medicine, and eventually went back and became an RN. I let my 'medics license lapse and never looked back. My doc was very helpful and I'm firmly convinced he is the reason I'm still breathing today.

I was always one of those 'tough as nails' kind of bikers who thought nothing would truly bother me -but we all have breaking points. I love my new career as an RN, and I intend to take care of my mental well-being. I won't lie and say that the ghosts never visit anymore -sometimes (rarely) they do, but I have a good group of friends and a good wife who let me talk to them when this happens, and we get on with life.

Because of my experiences, I do avoid certain parts of the field (I guess to minimize the odds of something similar? )but I love critical care, (though right now I work in a "sub-critical" department, we still get plenty of unstables or marginally stables) and I do enjoy my job.

I guess my point is, nobody has to be 'superman' -what good is a career that makes you unable to enjoy life? don't let it get that far.