Nursing & Depression

sphinx, BSN, RN · Oct 22, 2002

A check in from the pit.....back to work this week, fro whatever reason, I've been blessed with my patients either not being home/needing to reschedule, whatever, so it has not been too busy. But still long hours related to our new charting software, we are talking hours and hours, bugs, problems, questions, phone calls , etc. I cry in frustration, and ironically, I am supposedly one who is doing "well" using the system! In another thread I'd asked what other job options there might be out there for me, and a few mentioned agency.....I've thought about it, but fact is, it scares me. I mean, I have only 6 years expereince, 3 years on a post-op vascular surgery, 1 1/2 postpartum, and 1 1/2 doing homecare, doing mostly OB, a few regular adult pateints when my census is low. I don't know if I have what it takes to just be put any old place. Plus, because I was fired from my first job (related to missing work r/t my depression), they are like 1/2 of the health care industry, and won't hire me....my question is, can an agency place me with with them? I don't want to have to reveal that I was fired to the agency.

Forget it, I'm not thinking straight. I am very tired. I have been up late doing paperwork the past 2 nights. I feel numba dn depressed, but don't know what else to do. I have been expereincing confusion. I normally have very poor memory (real bad), but the other day I thought-honestly, truly-that it was mid-September. I don't know what to do anymore......I've seen my internest, who has done a full work up, labs, etc. I've seen my psychitrist, who has changed my meds and now it is just wait and see (he also wants me to decrease my stress level-yeah right). My GI doc found gastritis, so I'm on meds, diet, go back in 2 months. What else is there to do? My hours at work are so long, I couldn't get to therapy even if I had a good therapist right now, and I don't. I try and distract myself. Yesterday I bought myself a beanie baby to keep me company in the car. I'm sick of all my CD's. Its cold out and rainy and depressing. I'm too lazy to get out my light box, but we are working on getting full spectrum bulbs.

I'm rambling again. I'm sorry. You're probably all about sick of me, so maybe I'll be silent for a few days. Hope you are are faring better than I......enjoy your fall!

sanakruz, ADN · Oct 22, 2002

Spinx- my advice would be stay put for now. Agency work is very stressful.Unless you are in like flint they will do a bait and switch thing- "that shift is taken, how about nights?" Then they call you off and you lose pay you were counting on. This is my experience.The fact that you keep coming back here for support is a positive sign that all hope has not been lost. I would like to ask you something-Are you still taking zyprexa? If so how much? I have been in psych for the last 10 years solid. Good things are happening with meds, but zyprexa is not usually a treatment for depression. Just wondering if this is causing you unneeded sedation

Youda · Oct 22, 2002

{{{{{{{sphinx}}}}}}}}

>>

That couldn't be farther from the truth! Those of us who are or know of depression, have formed instant heart strings and caring for those who also suffer and understand. As long as you are willing to share your struggle with us, we will be here, and honored that you would allow us to share with you.

:kiss:kiss:kiss:kiss:kiss:kiss

sphinx, BSN, RN · Oct 23, 2002

Psychnurse, I have been off zyprexa for quite some time........maybe nearly a year (now don't ask why I still have a bottle, I'm doing better, I used to keep ALL my bottles full of discontinued meds "just in case", till I had a good day and tossed them all....that was a whole year ago). My psychiatrist had put me on it to augment my antidepressant, and it *did* help for a short while. It helped me sleep, but didn't overly sedate me, it did poop out though. At one point they tried Risperidone, and that was horrid, we're talking ZOMBIE. I have been on many meds, and many combos. If you are interested in the boring details, let me know, and I'll give ya the scoop. They either work and stop after time, don't work at all, or have side effects I can't tolerate. I've tried ECT, DBT classes, and many types of therapies (individual, group, with many different therapists, et al). All I can see is a sea of "nothing left to try". I mean seriously, what's left? As for work, staying put or not, I need an alternate option.....I am way too stressed out as it is.......I am working waaaaay too many hours, I feel like it is sucking the life out of me. I don't know what else to do, where else to go! I can't do "nothing", and I hate to leave nursing behind, but truly, what is there honestly?

*sigh*......youda, keep up being so sweet and I might have to cry and come snivel of your shoulder or something. I just finished my paperwork, my back aches, and i am trying not to cry.

Youda · Oct 23, 2002

I just thought of something.

Is it all possible in their budget for you to hire an LPN assistant? Keep track of the hours you are putting in per day, and make a list of some things that an assistant could do to take some of the workload off. Surely there are some duties that you could "delegate" off! What do you think?

cargal · Oct 23, 2002

Originally posted by Youda
{{{{{{{sphinx}}}}}}}}

>>

That couldn't be farther from the truth! Those of us who are or know of depression, have formed instant heart strings and caring for those who also suffer and understand. As long as you are willing to share your struggle with us, we will be here, and honored that you would allow us to share with you.

:kiss:kiss:kiss:kiss:kiss:kiss

ditto me too me too! We're not sick of you, we care and want to know and want you to keep in touch with us. We are here, one day at a time.

sphinx, BSN, RN · Oct 23, 2002

thanks all around.....and youda, we do have "extra help", a couple LPNs, and even a per diem RN, 2 of these do OB, which are available to "help out". But they aren't always available, or they are assigned to other nurses, or if say I have 6 heavy patients, and need to give one off, they can't call in a per diem LPN for only 1 patient, so either someone else needs to require her services too, or someone else on our team may have an open slot, or most likely, I see all 6 heavy patients (ie an opening, a recert, a discharge and 3 revisits). A big part of the problem is paperwork, and our new documantation software is supposed to eventually make theat better, but as it is, the assessments are a lot longer, a LOT, more complicated, and the computers open everything in this program so slow. I spend nearly twice as long at a home than normal, then still have quite a bit to complete at home. This has improved over the past 3 weeks or so, but it still is more labor intensive than our old system. But even then I was stressed out, I don't know if I am too much of a perfectionist, too disorganized, or what......but it never fails, I always end up working way past the 8 hours, and for months now I sit there late into the evening, crying over my paperwork.

I feel as if I have no life.My husband does all the cooking, clean the kitchen, laundry.......and he has a pretty full schedule too! Some things I don't know how or when they will get done, he doesn't have time to do it all.......clean garage and fix opener so we can park in grage in the cold weather, get chimney cleaned and buy wood for our woodstove, mow lawn, rake (kids can help), we have to buy and carve pumpkins, which is tough cuz of mixed visitation between his son and my youngest son, we won't be able to all do it at once, and my youngest is not here on weekends, so that leaves me having to do it on a weeknight, which is way hard.......plud having to get the kids boots, also tough for my younghest cuz his dad has him weekends, it's hard for me to bring him in the eveings, and god forbid his dad actually buy them for him.......I could just go on.......like tomorrow, my youngest has therapy at 4, so I have to be done working around 3-ish, go pick him up, drive to therapy. I am second on call, so I'll be ok unless the first on call calls in sick, which with my luck would happen, in which case I'd be driving around all day AND all night, and NO time to do paperwork, OH JOY!

OK, vent, vent.......deep breaths........to bed I go, while the hour is still halfway decent. Night all!

sanakruz, ADN · Oct 23, 2002

Spinx- I am interested in the meds you have tried,it's not boring to me. I run a group officially titled "Medication Education". I call it "wellness". I truly believe that your Dr. will hit on the right combo for you, honest. Lets us help you with our collective experiences

Youda · Oct 23, 2002

A couple weeks of good days

makes it harder to deal with a bad one.

I'm so afraid that my meds, already, are starting to fail me. I know the signs, know them so very well. Sleeping to escape, heavy feeling in my heart, holding back tears all day, turning off the phone cuz I don't care to talk to anyone, keeping the shades pulled all day . . .

Please, dear God, let this just be one bad day instead of a slide back into the black pit . . .

sphinx, BSN, RN · Oct 23, 2002

psychnurse....well, you asked for it, haha........here's my list, I meant to group it in order of type of med, but I pasted it from an older list to save time, and added bits here and there, so they are all mixed up. Hope I don't bore you!

Nortryptiline: I have been on this twice, after the births of my children. Worked "fair", but side effects were awful, did not diisipate much over time.

Zoloft: I have been on this at least 3 times, at first on pretty low doses, later up to 200mg. Higher dose worked "fair", pooped out after several months and also caused pretty nasty bruxism.

Prozac: I have been on this maybe 2-3 times. It has worked well for me, at doses of 60mg.....always poops out. At one point, I was taking a different antidepressant for everyday, and took 20mg Prozac for 2 weeks premenstrually. Worked great, stopped when I a)went on lupron b)went off lupron and on continous bcp's c)went off those and had a hyst. Oh, had minimal side effects with prozac. Some bruxism when on 60mg for long period of time.

Trazadone: take for sleep, works wonders

Paxil: didn't seem to help, chose not to increase dosage due to side effects (sleepiness)

Remeron: didn't seem to work , decided not to go with increased dosage due to side effects (hunger, weight gain, excessive sleepiness-ie zombie)

Buspar: no effect -none at all, on anxiety

Wellbutrin: 1996, then again 2000-have been on ever since then.; works well, but I can not take it alone, I always need something else to augment (this has pretty much been the case with all antidepressants, for years)

Cylert: seemed to work somewhat-=former Pychiatric nurse practitioner thought "maybe" I had ADD, both kids have it, *I* was never formally tested

Lithium: never really worked. Gave me hand tremor, and my affect was "off". I felt very strange on Lithium. Not normal. Edema despite watching diet, weight gain above and beyond edema.

Neurontin: seemed it may have worked for a while as augment to andtidepressant, helped with the anxiety. Gained 50lbs while on it.

Ambien: on and off, for sleep. Works well. 10mg.

Effexor: worked fairly well for a while at max dose, than pooped out

Celexa: some effect, didn't last long-was on max dose

Serzone: had a weird doc at the time, kept taking me off, and later putting me on. It never helped at all, even at max dose.

Risperidone: have been on twice as "augment" to antidepressants; seemed to help somewhat, but it made me very, very tired, (ZOMBIE)and that effect never really went away.

Zyprexa: used to "augment" antidepressant, did ok for several months, then I pooped out. MD chose not to increase dose.

Depakote: was on briefly, after Zyprexa stopped helping.....was hungry 24/7, even below blood level, I did not want to increase, for fear of gaining weight (I am already 40-50lbs overweight)

Topamax: I am currently on this to augment the Wellbutrin, now at 200mg (recent increase from 150mg). was doing great, but as you see, what I am taking now is not effective for whatever reason.

At one point I was on Xanax, used sparingly for anxiety, was good about it, till one night I swallowed a handful and some other stuff and went inpatient, and since then, no more benzos for me (although I do take librax for my GI probs, but I'd hardly swallow a bottle of that, I'd live through it, and be terribly constirpated for ages)

One doc wanted to try Provigil, but since it is quite off label, and only starting to be tested for depression (at least at that time)my insurance would not cover any penny of it, and it is quite pricey!

I have for the past several years taken combos of antidepressant, usually with either a different type of antidepressant, or with another type of med, as you see the different types listed above. My current psychiatrist tends to think Wellbutrin is the best choice for me (I take the max dose), and he likes to mess with the alternate meds used in combo. My former docs would fiddle and fiddle a lot. I feel like I have been on the big med merry go round (I hope I didn't forget any).

Well, I need to go, my kids are acting like monsters, I have work to do, (paperwork of course), and I'm having pain below my right rib cage (hmmmmmm, got a call today re the ressults of last weeks HIDA scan, but too late for me to return her call, I'm curious what the results were????)

Thanks so much.....

sphinx, BSN, RN · Oct 23, 2002

Youda

Sorry about your rotton day. It really *could* be just that. I hope so, you've been sounding so good lately. Keep us posted.

((hugs))

Heather

mattsmom81 · Oct 24, 2002

Sphinx, I think agency is a viable option you might consider to gain more control of your life...as you can work 1-2 shifts per week and make more money than FT staff, you have more free time. Some love it...some hate it...but it never hurts to give it a try.

I know many nurses who would do nothing else but agency. If you are the independent, flexible type who likes to go in, do your job and leave, you may enjoy it. We expect to get the patients the staff doesn't want, and focus on doing a great job while we're there. The great thing about agency is we stay out of politics. We also never have to go back to a hellhole if we don't want to :)

I did agency for many years and it was good for me...trouble is sometimes there are 'dry spells' and for that reason I stayed on staff somewhere PRN so I could plug in there when needed..

If you don't need benes, PRN is a great way to control your workload too...and make your own hours. :)

I hope you can afford to take a long vacation soon..or cut your hours....and rest up...so you can feel better. :)

Nursing & Depression

Nurses and Depression/Anxiety