Dealing with stress, guilt, and emotions

zmansc, ASN, RN · Mar 4, 2014

I don't have a solution for you, that's something that only you can come up with. For my wife and I, we like to debrief with each other, it helps us to decompress a bit after a shift. We also try to identify patients that we felt like we helped their situation get better, thinking about the positive outcomes instead of dwelling on the negative ones or the ones that could have gone better helps us to realize that we are doing much more good than we realize. Remember, that it's easy to forget all the cases you had in a shift that went well, those don't stick in your mind, it's the ones that went bad that you remember and dwell on. Anything you can do to change that cycle is helpful (IMHO).

Like I said, I don't know your personal situation, who you can talk to, how you prefer to go about recharging your batteries, etc. I have a co worker, he goes fishing. I personally would slit my wrists if I had to go fishing. So, that part, who to talk to, how to redirect your focus and energies, I can't help with, but it does sound like some time to do something non work would be helpful.

dsherman · Mar 4, 2014

I find just going to the chapel or prayer to help but as I am religious im sorry for all your issues.

1fastRN · Mar 4, 2014

Thanks for the feedback thus far, just wanted to see how you guys deal. :) Nothing I can't bounce back from, just a tough string of shifts lately!

Esme12, ASN, BSN, RN · Mar 4, 2014

We all go through times like this. ((HUGS))

Everyone finds their own way. For me I watch old slapstick comedies with Katherine Hepburn and Cary grant. I will also indulge in my secret indulgence and watch reruns of Ghost hunters or other of those paranormal shows...they amuse me! I watch them for the pure non educational nonsense. It soothes me. I fire up the TV (it's in my master) and fill up the jacuzzi tub with bubbles and a glass of wine...or I call the Captain and diet Pepsi and I soak. Undisturbed. I let it go. Into the universe.

I hug my kids. I snuggle with them and listen to their problems

Know this...this too shall pass.

emtb2rn, BSN, RN, EMT-B · Mar 4, 2014

Working out helps. I'm in chainsaw & maul mode currently getting next year's wood set to dry. It may be a guy thing but there is something inherently relaxing about bucking & splitting wood for a couple of hours.

Sun0408, ASN, RN · Mar 4, 2014

Hugs to ya OP, it is tough sometimes. Had one of those emotional shifts last night. Tears were shed by all evolved even myself and other co-worker. It helps to lean on those we can trust.. I love a hot bath and music!! Gonna amerce myself in one tonight.

1fastRN · Mar 5, 2014

Feeling the love! :cat: ER nurses tend to be a little stoic so it's nice to be able to share my woes anonymously. I love my co-workers but with everyone being as equally overworked, I don't think they'd care to hear it. Don't get me wrong, when that med room door shuts, the ranting of nurses begins! LOL misery loves company

After a workout, a nice MEAL for once, and now that I'm about to go see some friends, I'm feeling much better! Cheers :)

Anna Flaxis, BSN, RN · Mar 5, 2014

Self care means different things to different people. For me, self care means getting enough sleep that I feel rested, drinking enough water, eating fresh, whole foods, being physically active, like doing yoga or getting outside. I like to keep my house tidy and work on my land. It can be really hard to find the time to do those things when you work a lot. I work per diem, but I work 12 hour shifts, often back to back, and I have a long commute, so during those times, everything I just said above is very hard to do! But then I'll have stretches of time where I don't work, and so doing those things is a lot easier.

I also find that having things outside of work that I enjoy can be really helpful. I like to do crafty type things like crocheting, making silver jewelry and natural body care products using essential oils, and things like hiking and photography. None of those things may sound even remotely interesting to you. But I'll bet there is something that does!

Maybe you've always wanted to take up scuba diving or take riding lessons. Maybe you used to play an instrument and would like to pick it up again. Maybe you're more social and joining a club of some sort or taking ballroom dancing lessons is more your cup of tea (or not). It doesn't really matter what it is you do, but having something outside of work that you can look forward to, something that takes your mind off of work related issues, can be very beneficial.

I think the reason I like creative projects like crocheting is that it taps into a different part of my brain than the part I use when I'm working. I get to sort of shut off my brain and just be intuitive and let the project flow however it's going to flow. I don't have to be so in control, logical, or precise. Nobody is going to die if I drop a stitch.

Even so, as long as you are working in an understaffed and busy ED, you will have this work stress. Whether it's worth the price of admission to you is a highly personal choice. For me, it wasn't worth it, and I took a much lower stress job outside of the hospital. But I got bored, and now I'm back in the ED, only I am per diem in a small community hospital that sees a much different type of patient population, and I am much happier. Sometimes I do miss the adrenaline of the big regional trauma center, but the great work environment that I enjoy now more than makes up for it. And, I do get to take care of really sick people sometimes, because they do come in through the lobby when by all stretches of the imagination, they should have called 911. People are just weird that way.

Anyway, best of luck to you as you try to figure this all out for yourself.

saraCOS · Mar 6, 2014

I just had a conversation today about how susceptible emergency medical folks are to secondary trauma from dealing with mayhem all day, and how we are kind of forgotten about when it comes to support. Cops get it, shrinks do too. I guess we have to care for ourselves and each other until the industry catches up. I'm one that tends to spin for days once wound up with stress. I have no idea what "relaxing" is, and can't figure out how people just sit. My best solutions have been doing things that require all of my focus, not the 101 directions I'm pulled in in my work and personal life. A day skiing, or a spin on my fast road bike, or a trailrun helps. I sew, which requires full attention so you don't sew through your fingers.

I'm sorry you had a rough week, and I'm glad you seem to be smiling again:)

1fastRN · Mar 7, 2014

I want to follow up by saying thanks for the support! I followed up on my little old lady. After bilateral PEs, sepsis, 3 presssors, TPA, and multiple antibiotics I sent to her to the ICU. Things were not looking good. No blood pressure. Terrible color. Intubated, old, multiple comorbities.... her last words as she crashed were, "can you please pass the ketchup?" (I lol in retrospect!)

She was in the ICU a few days and extubated herself. Now she is alert and is chillin on a tele unit. Can't believe it! I guess it's a good thing I didn't "pass the ketchup!"

I was so full of guilt thinking I dropped the ball or should have seen it coming. But seeing her outcome made me so relieved and recharged me. Most of these pts don't do well following such a sequence of events, but guess she's a fighter. Hopefully she's discharged before I go back to work next week but I'd love to visit her! Definitely happy I was able to intervene and things took a turn for the better. Just a great reminder of why I love what I do!

annie.rn · Mar 7, 2014

She was in the ICU a few days and extubated herself. Now she is alert and is chillin on a tele unit. Can't believe it! I guess it's a good thing I didn't "pass the ketchup!"
Definitely happy I was able to intervene and things took a turn for the better.

So awesome! I'm glad you are feeling better and realize that your interventions are what helped to save her. Laughed out loud at the "good thing I didn't 'pass the ketchup'"! You've obviously got sense of humor in your orificenal of coping skills :-)