Has anyone been stress and dont think?

[tampaflrn6]

Anyone been stressed when your patient deterioates and can't figure out the source when you have all the red flags? Twice, I had that happen. I get so stress and worried about my deteriorating patient that things don't click when I have everything right there in front of me. I do have a BSN. I know something is wrong with them... like the abnormal VS & labs and s/s that they are presenting ... I guess under stress I can't realize what's going on with my patient after another expert ICU nurse explains to me what's wrong with my patient... for example sepsis shock or GI bleed.

[Keepstanding, ASN, RN]

Are you a new nurse ? Just hang in there friend. RELAX ! BREATHE !!

Good Luck !

Praiser :heartbeat

[tampaflrn6]

Yes.. I am A new Nurse since March.

[clee1]

Yes.. I am A new Nurse since March.

Relax, nurse. You WILL get it; but it does take time to develop "the knack".

[HouTx, BSN, MSN, EdD]

Stress is natural under the circumstances and it's a universal response. But I don't think you are giving yourself enough credit. You are recognizing the fact that your patient has a problem. Maybe you can't consciously determine exactly what is causing it but recognizing it and summoning appropriate help is the most important thing at this stage in your career.

This is why Rapid Response Teams exist - so bedside nurses can 'raise the alarm' and get help immediately rather than try to take time and figure out what's going on by themselves.

Suggestion from an educator - because we know that experience by itself does not result in greater expertise. After this sort of situation occurs, take the time to reflect on it and put the pieces together; make sense of what happened. Why did it happen? What were the early symptoms? Talk it over with a more expert colleague if you can. This type of self-reflection and "effortful thinking" turn the experience into learning & develop your expertise.

[aeauooo]

The other day I was talking to one of my colleagues who told me he's great working a code when it's someone else's patient, but he's useless when his patient codes.

I've known that about myself for a long time!

I enjoy a good code - it's an adrenalin rush, as long as it's not my patient.

There is no shame in acknowledging that you don't know what's going on and asking for help. What is shameful is to realize that something is wrong and pretend that you have the situation under control - people die that way.

[classicdame, MSN, EdD]

That is why we have rapid response teams - so several smart people can put their heads together and decide on an action that benefits the patient. Also, seems to help us all learn from one another.

[hikernurse]

Yep, that darn tunnel vision stress brings. I often ask more experienced nurses for their opinions when I know something isn't right, but can't tell what. I don't have enough perspective and experience to know what is wrong, but at least I can tell something isn't right and that's a good start, right?

It's not a fun position to be in, but you are recognizing the danger signs and that is the important part :).

[aeauooo]

I don't have enough perspective and experience to know what is wrong

I'm not sure that experience makes one less likely to rely on one's coworkers for advice and insight. I think just talking through something can help. An extra set of eyes usually helps.

A classic book on nursing and experience that is required reading for at least some BSN programs is "From novice to expert" by Patricia Benner. I read it when I was a new nurse and realized how far I had to go. I read it again over a decade later when I was working on my BSN and realized how far I had come.

[Bonnie Nurse]

I've read valid comments here about asking colleagues to look at your patient in these situations. Experienced fellow nurses are wonderful, but what I don't see addressed here is how asking "too many questions" and asking for "too much help" is viewed negatively by more experienced nurses, with the end result being a perception that you are somehow not up to the job. I've heard things such as, "I can't believe she....didn't know how to do that......didn't know what a ------- was....had never done that....... She's always.......overwhelmed......really slow....not confident.....blah blah blah It makes you really think about asking a question because of the judgement that follows when your back is turned. I got my license in 2006, and I have felt this way. I can only imagine how a recent graduate feels.

[jjjoy, LPN]

Yes, I have to wonder if the OP's colleagues either explicitly or implicitly suggested that the OP *should've* been able to "figure it out" on her own. So I ask the OP to review how her colleagues expressed themselves during and after the cases where she felt that things weren't "clicking" to see how much pressure she feels may be coming from colleagues and how much from herself.

Sometimes this negativity is explicit "you don't know that?" "that was obvious!" "what did they teach you in school?" or it could be more subtle... a barely visible eye roll, a tone of voice that expresses displeasure, etc. I know it can be confusing when an experienced nurse keeps harping on a newbie for this and that issue and then at the end of the day says "You're doing fine. It takes time to get this down." Is that one quick comment supposed to allay all of the fears of incompetence that the whole day's worth of negative feedback may have brought up? With such seemingly contradictory feedback, it can be quite unclear if one's performance is acceptable or not for their level of experience.

If your colleagues are pressuring you or making you feel like you should be farther along in your progress, you'll probably want to find a way to deal with that. Maybe find a supportive mentor on your unit and tune out the negativity of others. Or come here to get a different perspective and be able to put their criticism in perspective instead of accepting it heart and soul (soul-crushing). It could be that they don't appreciate what it means to be new and how much support you could still use. It could be that their expectations aren't realistic for you (eg if their school experience was different than yours). It could be that they are stressed and angry to have to "train" and "watch out" for a newbie. Sure, it would be better for them to be nice to a newbie, but they might be thinking it would be better for the hospital to offer better pay and hire on someone experienced and they unfairly take their frustration at having to work with a newbie out on you. It could be that a nurse is curt in the midst of work, but may be better able to express supportiveness only when they have a chance to relax and reflect. Maybe they aren't all that negative but speak bluntly and don't give much positive feedback, pointing out what you DID get right (like noticing that something was wrong and asking for help). This site and/or a very supportive mentor could help provide that sometimes lacking positive feedback.

[aeauooo]

I've heard things such as, "I can't believe she....didn't know how to do that......didn't know what a ------- was....had never done that....... She's always.......overwhelmed......really slow....not confident.....blah blah blah It makes you really think about asking a question because of the judgement that follows when your back is turned.

Personally, I think that says a lot more about the people you are working with than it does about the person asking for help and/or information.

I've worked with very good people, and I've worked in some very toxic environments. Nurses are our own worst enemies for precisely that reason.

EVERYONE has flaws, and everyone's s*** stinks. The nurses passing judgement on other nurses are, IMO, the WORST thing about nursing.