We've all been there. Imagine your unit suddenly turning into a battlefield. Many bad things are happening at once. There is a crashing patient coming out of the OR or ED. An acute bed crunch is taking place and nurses are being pressured to transfer patients elsewhere in order to make room for sicker ones. Patients are climbing out of bed everywhere. The tele alarms won't stop going off. Phones are ringing off the hook and the secretary, as usual, is nowhere to be seen. It's 5pm and all the managers have left for the day. Now someone falls, then maybe a rapid response or code occurs. The entire pace of the unit has shifted dramatically. The small talk has stopped and people are shouting commands across the unit. Everything is amped up for the next two hours, and the environment is no longer therapeutic for you or for the patients.
For some of us, depending on where we work, this sort of shift in the pace of the unit happens seldom. For others, it happens every other day. It all depends on what type of unit we work in and the shift. However, regardless of those factors, most of us have experienced it on at least a few occasions and by the end of the day, we feel pretty run down.
The purpose of this thread is to discuss how you deal with these situations. What do you do when people are shouting at you and pressuring you to move patients. Do you tune those people out and keep doing what you're doing in order to maintain focus? Do you inadvertently start rushing tasks that require deft hands, patience, and focus? Does it cause you to make mistakes?
One of the things I will do when the unit picks up and people start going crazy, people are shouting, and tele alarms and bed alarms are going off non stop is to take my break, if I didn't do it already. I'll find the least busy person I can and tell them I have to go do something and will be off the floor for fifteen minutes, and can they please watch my patients. Then I use that time to sit down and gather myself and prepare for the rest of the day. I find that that kind of "pause" helps me function enormously better for the rest of the shift and makes me far more productive and able to contribute to my coworkers better. In really acute situations, like a code, I'll go to the bathroom and wait there for a bit so that the initial dust can settle. In those situations, people are shoving each other around the bedside, carts and furniture are being flung, linens are flying, and people are charging down the hall to do compressions and that kind of situation is just not therapeutic for me. So during those times I tend to go to the bathroom until the situation has calmed down a bit. Then after things are under better control I'll help with compressions, transferring, and so forth.
Use this thread to discuss the challenges you personally have faced in these scenarios and your strategies for making the situation more therapeutic for you.
I'm not an experienced nurse at all, so take what I say with a gain of salt... Sounds like you're very overwhelmed. Don't under estimate the power of taking a cleansing deep breath and get yourself pumped up to jump in a be "super-nurse"... Some of my favorite times working in the ER (as a tech/emt) where in these moments of chaos, it's where you find what you are made of :) Try to keep positive and thank you for sharing. And before jumping into an Emergency situation check your pulse first is something my favorite ER doc would say, it's okay if you need to take a step back and take a couple breaths before getting back in it. Physiologically we can't think as clearly or function as well if our pulse is too high that we ourselves are in the fight or flight zone.
It is very unusual for a man to have a BPD diagnosis. In my knowledge and experience anyways. In any event, as most of us know, part of this process is attention seeking.
You can't medicate a personality, so for people who have BPD, it takes a tremendous amount of time and work to function.
Many turn to drugs and alcohol to just be numb.
In emergent or emergency situations, depending on a level of function, most will walk away. They have no sense of how to respond.
I do believe that BPD is a level of post traumatic stress. A trauma reaction. Goes to the heart of my mantra of "you can be as _______(screwed) up as you wanna be, but don't involve kids." Because then those kids become adults, and some even nurses.
Now onto the OP's original stuff--there is a leader at every code. They have the ability to say "you do this, you do that, and you all leave". You have a charge nurse. That I am sure at the end of the day realizes things are ramped up a bit. OP, you need to focus on your patients, and take direction. To leave the unit is not conducive to safe patient care. So when you are seeing your counselor, I would think about exploring that. How you can successfully function under increased stress.
I have heard of units that employ a team nursing concept, where each nurse is involved in the strongest part of their practice. With that being said, this was a long time ago. So OP either you seek this situation out, or think about changing specialties. A critical care unit is all high acuity all the time. And with your BPD this may be your internal "comfortable" (what you are used to) place, but you need to work on the appropriate reaction part.
Specializes in Infusion Nursing, Home Health Infusion.
When all hell is breaking loose I actually get more focused,determined and organized to get the job at hand accomplished. I go right in with a plan an attack the problem. I have trained myself to stay calm and focused. You couldn't pull me away if you tried and I can't go on a break until I get to a point where the workload is less and things have been accomplished. It concerns me that your instinct is to run and hide especially when you are paid to jump in and accomplish!
heron, ASN, RN
4,661 Posts
All very therapeutic, or so the leatherfolk say.