dealing with stress response

[guest1074638]

I think I am dealing with a possible stress reaction to my last job, in home hospice. I don't want to use the term PTSD because that's very strong. But I've noticed that I have some concerning behaviors. For the last year-ish, I've been teaching ESL and avoiding working as an RN.

My last job, which was over a year ago, was full of manipulative staff. Examples:

-support staff calling 4-5 times "to talk about a patient", wanting to have 20 minute conversations to report that the patient is normal/to complain about patient's idiosyncracies. I would advise REPEATEDLY that we do not need phone report (lasting 15-20 minutes) for this, written report as normal is appropriate. Staff called management to report that I "refused to help with patients".

-other nurses and CNAs flooding my phone with calls at 8:30-9am daily to say good morning. When I do not respond, staff request that we have a mandatory conference "good morning" call each morning. I state that this is not productive as we need this time to make patient calls. People are offended. We do this time-wasting good morning conference call for about 3 weeks and then people lose interest.

-staff calling me during hours I was not scheduled on call to ask about patients. I would report that I was not on call and provide telephone number for on call nurse. Again staff complained to management that I refused to help with patients.

-staff calling to report (for example) we are using a different type of briefs this week as our supplier did not have our usual type. I did not call back for this as it did not require a response. I was reported to management as "not answering phone calls". (I was busy calling patients/families).

-management calling intermittently during the day to ask what I am doing right now in a suspicious tone, as if they do not believe I am working. Clearly I am working. When I report that I am working, they wish to have a conversation about how I am doing "emotionally". I report "doing fine and able to perform my job" and they do not like this.

-management calling me into the office for meetings weekly to complain about my interactions with staff. I was written up for "poor communication with staff" because I stated repeatedly that I do not like to talk about my personal life at work and refused to have conversations about my personal life. I was told by my supervisor that I need to talk to other staff "about normal things, like your family, how things are going at home. You don't visit with anyone." I refused to sign the write-up because "poor communication" implies communication about WORK RELATED matters. I was told that if I didn't spend some time sitting around the office visiting each day after my workload was completed that I would probably be written up again.

-management calling patients' families to solicit complaints when the service was satisfactory. One patient's wife told me "they keep calling and trying to get me to complain about something, but I'm happy with you". One supervisor went so far as to call and tell a family that maybe the patient should be taken to the ER because I missed something on my assessment (the patient was asymptomatic, and I had not missed anything. The family was extremely alarmed by this.)

-even after I quit this job (when I finally went to the office to give notice, I almost cried during the meeting because I was so frustrated and sick of this job) people from the company continued to call me, hanging up instead of leaving a message. I had to block people's phone numbers (obviously I could see who was calling, are these people idiots?)

So for the last year-ish, I've been having this thing where I avoid interactions with people. I avoid my phone like the plague, and when my phone rings I become really agitated and sometimes yell "who the f is calling me!" When people ask me how I am doing emotionally I become very defensive because I feel they are trying to find something to hold against me. I resent receiving calls and texts, because I'm afraid it's going to be someone trying to pick a fight. It's worse in the morning, when I typically had more problems at work. Has anyone experienced this?

[Katillac, RN]

I can't say whether this is a stress reaction, PTSD or something else. But here's the psych speak for what happened to you; those in authority over you repeatedly refused to allow you to set appropriate professional and personal boundaries. In fact, you were punished and shamed for your attempts. From an outsiders view, the repeated violations caused emotional trauma which is now presenting as avoidance behaviors.

Setting boundaries is a cornerstone of maintaining your mental health as a nurse, especially in hospice. You've recognized a correlation between ways you were mistreated and problematic responses to current events. That's a great start. Some people could work through this sort of thing on their own. Others, myself included, would need some professional help.

I found that having a space to tell my story led to exploring ways in which the toxic work culture connected me with older emotional traumas. The next steps were to rebuild my confidence in my ability to take care of myself in the present, and letting go of the pain and resulting hyper-vigilance of both the recent and long past traumas. If that sounds like PTSD treatment, it's because it was.

Side note: For the life of me I can't understand how a hospice whose staff spend this much time focused on each other instead of patients can be successful. Case loads and management are hard enough without spending hours in a day in these staff-focused activities. I assume this is a small agency?

[Kyla RN, BSN]

Wow, I am so sorry you had those terrible experiences at that job and are currently dealing with the aftermath as well. Whether or not someone calls it PTSD or stress reaction, I encourage you to talk with a professional about it all.

[HandsOffMySteth]

"...they wish to have a conversation about how I am doing "emotionally". I report "doing fine and able to perform my job" and they do not like this."

These people are obviously crazy, but not everyone is. I have had experiences like that , and so have many people. You did the right thing by getting out of there, but things like this take time to recover from. There is no shame in that. Sometimes getting an outside perspective is helpful. Sometimes a vacation is in order. How you cope with stress is just as important as what is causing it. I strongly encourage seeking out a counsellor because sometimes we can't fix these things on our own.

Be at peace...

[FolksBtrippin, BSN, RN]

Let me first validate that your manager was totally incompetent and mishandled the situation. What he or she should have done is given support staff firm boundaries on when and how they are allowed to contact you and forbidden them from wasting your time asking you inappropriate questions about your personal life. That would have nipped the problem in the bud. Instead, management encouraged the poor boundaries and created a real problem.

I left a toxic workplace too. Not exactly the same problems you had, but like you I was mistreated by support staff and my manager backed them instead of me. Like you, I got out after being written up for malarkey.

At my next job, I was at first hypersensitive to benign events. My boss was awesome, and said she wanted to help me feel comfortable. For me, it passed with time, as I gained confidence back in myself and developed good relationships at the new gig. I didn't need therapy, but I think therapy is great and would encourage anyone who is open to it to go ahead. It might have sped up my healing process, I don't know.

I'm 1 and a half years out of the toxic job and very solidly comfortable. I felt better after 3 months and very much better after 6 months. At the 1 year mark, it was just a memory. You will get your groove back too.

[guest1074638]

Thanks for the responses guys. Honestly I wasn't expecting so much sensitivity and support, I really appreciate it.

I think sometimes things like this can really hurt us when they bring up old traumas in which personal boundaries were violated...even though it seems like "ugh, it's just a crappy job" it pushes a lot of buttons for deeper things that might not be 100% resolved.

I think I do need some help dealing with this, at least to receive the validation that I'm not crazy for having this response. You guys have helped a lot by taking my situation seriously. I had a patient in nursing school who told me "sometimes when people are suffering, the best thing you can do is say I see what's happening to you" and that has stuck with me.

[Jedrnurse, BSN, RN]

I'm glad that you mentioned that labeling your feelings as PTSD was strong, as often people are very quick to throw that designation around which can dilute its meaning.

That being said, your former job did a real number on you and maybe having a sit-down with a counselor to decompress and get some feedback might be a good idea...

[CrunchRN, ADN, RN]

Your previous work situation was messed up. I could never tolerate that kind of intrusive and time wasting stuff. I am glad you left and I hope you find a better situation soon.