Verge of nervous breakdown

Nurses Stress 101

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Specializes in Operating Room, CNOR.

Hello all.

Been a nurse for 7 years. Mostly OR but recently I am on my 8th month of Med Surg. I am really, REALLY struggling. Feel on the verge of a nervous breakdown... well I had a mini-one at work yesterday. The stress just got to me and usually I go cry in the bathroom for a minute then get back to work. This time I was on the verge and/or crying, had 8+ co-workers ask if I was ok, what's wrong... which just made me cry again. I really feel like I need to get out of this job but, you know, bills, job hopper resume, etc etc....

A little background: I have bipolar II, anxiety. Since nursing school I have been thinking I possibly made the wrong career choice. I have hated 90% of the work I do. I have been driven to the point of some Nurse Jackie moments and could easily have lost my license many times over. I went to meetings, got help, got it under control. I feel like I cut so many corners just to get through the day. I see a psych nurse and have to take drugs just to get through my days; legal, prescription drugs but still. If I were not so extremely anxious and full of adrenaline, they might make me drowsy, but all they do is bring me to a state of LESS anxiety so that I can function enough to do my job. I literally have to drug myself in order to tolerate my job. Usually it works okay, but yesterday I still melted down even with my meds onboard.

My patients love me. My co-workers love me, I just had a great review from my boss. I fake it well but I feel like I am slowly being crushed and dying inside, and am mere moments away from snapping.

I found a per-diem job doing post-op at a surgery center. Less pay, WAY less stress, definitely tolerable for now. I am there 2 days a week at the moment

I am considering leaving the hospital job altogether to go full time at the surgery center. But that would require me to work 5 days a week, which has been a problem in the past with my mood disorder. I need more days off to do self care. The drawbacks of the surgery center are no breaks (yes it's illegal, but they have a culture of not getting people their breaks, and I don't think I am going to be the one to swoop in and change all that. I already brought it up and they pretended to try for a day). $6/hour lower pay. I don't think going full time there is the answer; I will get fed-up with no breaks, or bored, and quit.

My other idea is to take a medical or personal leave (which one would that be for nervous breakdown related to job stress?) at the hospital job while continuing per-diem at surgery center, just to have some time to think. Can you take leave at one job while working another?

I am at my whit's end. I am not cut out for high-stress jobs; I have tried therapy, books, meditation, bla bla bla. I probably need to change professions altogether but don't know how else to make this kind of money.

Should I quit hospital job immediately? Ask for leave while working per-diem at lower stress place? I was going to try to make it to my one-year mark in med-surg. But that's 24 more shifts til May (I work 2x12 hour shifts a week) and I just don't think I can force myself to do it. Help?? Thanks in advance

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I am so sorry to hear you are going through this. I can relate in MANY ways. I don't have advice, just a lending ear. Well, one piece of advice. If you decide to quit this job, don't do it impulsively. For those of us with anxiety and mood disorders, that can be extra tough. Make the decision when you are not emotional. Write a letter of resignation. Give at least 2 weeks. I know, BELIEVE me, I know how hard that is.

Good luck. Keep us posted.

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Specializes in ER.

Yes, you sound temperamentally unsuited for your job.

Personally, I think the rise and all these anxiety disorders is a direct result of our crazy society and modern culture.

Recognize that you are very sane and having a natural response to an insane world. Money isn't everything, I think you should find a less stressful job that you are suited for.

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Specializes in Operating Room, CNOR.

Emergent, I so agree!! Our society is very sick indeed... I need to find a way to be in the world where I can cope. I don't want to shut down; probably couldn't even if I tried. So I need a job that is less in direct contact with the way society is making all my fellow humans ill. I need to help in a more indirect way. Thank you for your input and I agree I need to quit... And yes Orion I will give notice, but how bad is it to call out sick those 2 weeks? :D rhetorical question...

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Specializes in Nephrology, Cardiology, ER, ICU.

I'm so sorry you are going thru this. Please talk to your psych NP and see if there is a different combo of meds that might help you deal with the stress.

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Can you go back to school for something else?

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Specializes in Operating Room, CNOR.

My meds seem to work great when I am not at work. I feel like I have tried everything under the sun and finally found a combo that works... on my days off I feel mostly great, except for the days right after work when I am still recovering. What i am trying to say is, I don't think there are enough drugs in the world to help me tolerate this job... unless they could somehow completely knock me out while allowing me to completely function :D

I have thought about going back to school but don't know what I would do... I am so burned out I don't have any hopes and dreams about what sounds tolerable for work, let alone enjoyable... I will ponder though

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Specializes in Travel, Home Health, Med-Surg.

I am sorry you are going through this! Working a staff job in a hospital is extremely stressful even if you don't have any disorders (many nurses acquire these after working nurse jobs as well) maybe it is best to find a less stressful position. You didn't say why you left OR, was it just as stressful for you, if not maybe you can go back to that. If that won't work then I would (at least) consider full time at the other position, even if you don't get breaks etc it still might be more suited for you. I don't know your financial situation but if you can afford the pay cut it might be worth it! Like others have stated I would not be hasty in any decision. Good luck to you!!

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Specializes in ER.

I suggest you take at least two weeks mental health leave from both jobs to get your feet under you. Don't make a decision about quitting until that time is up. Hopefully the solution will become clearer when you are away from the situation. I would NOT work one while on leave from the other, someone is bound to find out and take offense.

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Specializes in Operating Room, CNOR.

I love the 2 weeks mental health leave idea. I am very wary of taking leave from the surgery center job; I just started 3 weeks ago. Hm... I will have to think about that one...

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Specializes in LTC, assisted living, med-surg, psych.

If there's anything I've learned from years of living with bipolar disorder, it's this: if you don't have your mental health, you've got nothing.

I've also learned that we often lack insight into our condition and don't see clearly what we need to do to be healthy. You have insight, but even knowing that you need to stop what you're doing STAT, you are still trying to figure out a way to maneuver things so you don't have to take leave from both jobs. I hate to say it, but you are in bad shape and I don't think you should be taking care of patients right now. I totally understand; I had to retire and go on disability when my illness got so out of control that I was unsafe at any speed. Towards the end of my career, my anxiety was off the charts and I was either flying-off-the-walls manic (I have bipolar 1) or in the pit of despair; there was no middle ground.

I did the best I could, but I was unfocused, easily distracted, over-amped. I made several minor med errors and was erratic in my charting. One day, I came within a whisker of committing a serious med error that could have cost my patient his life, and when I walked out of the facility after my shift was over, I didn't go back. (Well, I did go in to do quality control work for management and admit patients for rehab, but I never worked on the floor as a nurse again.)

It shouldn't have been this way. I was getting excellent psychiatric care and taking five medications daily, but it wasn't enough. I had so much anxiety built up that I was afraid to continue in my much-loved career.

Don't let this go so far that you burn out like I did. You need time off to work on your mental health issues before you break down completely. Please get the ball rolling, and yes, take time off BOTH jobs. It's crucial to your well-being.

Wishing you the very best. Keep us posted as to how you're doing.

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Specializes in Med-surg, telemetry, oncology, rehab, LTC, ALF.

I am not bipolar (or at least, I don't have that dx yet), but I have struggled w/anxiety & depression for some time now. My anxiety levels reached their peak during my 4th month of Med-Surg nursing. My doc had just put me on a trial of anti-depressants, which sent me into a nasty spiral. I ended up having a panic attack in front of a coworker & then quit w/o notice the day after. I was told by my manager that because I didn't give a notice, I would not be able to work for that hospital system for at least two years. I was devastated & facing $32,000 in student loans, two sick parents, and a host of other issues.

I ended up taking a 1.5 year break from nursing after that. I kept my license active but I did other things instead. I was lucky in that I had saved a lot of the money I had made. I could still pay my bills & pay for my medications. I worked on my self-confident & applied to other nursing jobs. I finally landed a job that was better suited to my personality nearly two years after I left my first nursing job. I have been at that job nearly 6 months. I haven't have a panic attack yet (though I did have angry tears one day, but my supervisor told me she was surprised I hadn't done that yet, considering the string of stressful shifts we were all experiencing). I don't dread going to work every day.

Is it perfect? No. Some of my skills are slipping, and I would eventually like to go back to acute care, maybe in the ED, but this much I've learned: life is a marathon and not a race. If I push myself before I'm ready, I'm only going to fail. I still have more learning to do, more lessons to learn & more improvements to make in my mental health before I jump back into the insanity of acute care. But I will get there.

If I were you, I would seriously consider taking a break from your current work. Maybe not a long break, like I did, but I would NOT make any serious, impactful decisions while you're feeling this overwhelmed. You don't want to damage your resume like I did. It took a LONG time to find 1 employer that would take a chance on me after that. You don't want that to happen to you.

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