Hi everyone! I'm a new nurse and I had a really bad day a bit ago with a patient who I had to call our rapid response team for and he ended up in the ICU (I have no idea other than that, HIPAA and all) and a small part of me wants to know how he is doing. He was young and I felt helpless when I couldn't fix the oxygenation issue that was going on at that time (O2 sats dropping despite increasing oxygen to 6 liters-the only method we have on our floor is nasal cannula unless respiratory brings it). I hugged his mother as they left the floor and that's the last I heard about him.
I've done everything I can think of to leave it at work but it still nags at me occasionally that I want to know how he's doing. Logically, I know that it's honestly none of my business, I'm there for my shift to take care of my patients and go home and return on my next scheduled shift to do the same. I have no desire to call and find out or do any of the creepy things I've read/heard about nurses doing (showing up to the room to check in on my days off, calling, sending flowers, etc.). I honestly just have a curiosity that I know can't ever be satisfied and I think it's because he was the first patient who left the floor on my shift to go to a higher level of care. I've had fleeting thoughts of other patients, too, who have touched me in some way, whether it be how sweet they were to me or how kind their family was.
I just need to know: what kind of methods do you use to leave it at work? I know this is one of the (I'm sure many) places I need to improve.
Dranger, I'm sorry that there seems to have been a pile-on with you. I think the snipes directed at you are an example of bullying. I know you can probably handle it yourself, but I think this needed to be said.
I agree-Dranger, you have been calm and rational in your replies to these non-nurses and nurses who got their shiny new license 10 seconds ago, and who are barely out of fetus hood.
I was tempted to direct some posts to these people, but then I remembered-I make it a policy not to argue with children. Especially children who have been told all their lives that they are Special Snowflakes who know everything about everything.
Now, the OP of the original thread (and I'm sorry, but I'm terrible at names and have totally forgotten hers) had a valid question, one which most of us seasoned nurses wrestled with at some point. I think she is going to be a very good nurse-she actually knows how to carry on a conversation, and has been very gracious, whether she actually plans to utilize any of the suggestions thrown out here or not.
We need more nurses coming into the profession like her-the self righteous, sanctimonious, spoiled entitlement Snowflakes should take their cue from her instead of screaming NETY!! and "You're a bully!!" It gets old.
OP, just one final remark. I still stand by the notion that nursing is "just a job", however it is a job where you witness humanity at it's highs/lows and can influence others around you more than you know. Nurses are the nexus of the care team and you will have a hand in saving many lives and witnessing others pass away. It happens, so do what you have been trained to do and everything will be fine. Keep your vigilance knowledge sharp and you will do great things.
A healthy distance/disconnect is not a bad thing, it will make you do your job better and keep your mental health intact.
Specializes in Mental Health, Gerontology, Palliative.
.... but I can't help but feel like I missed something, some clue that his condition would change.
Cut yourself some slack. Sometimes this stuff does litterally up and present out of no where
I arrived on shift last week to find one of my patients had a temp of 38.8degrees C. Got the after hours doc out to them who diagnosed a chest infection and started ABs. Roll forward five hours, the person had two doses of the ABs, had taken approx 1000mls fluid and was looking a load better.
I happened to notice that the colour of the urine in this persons catheter bag was fairly dodgy looking. Took a sample from the bag and it tested positive for protein, leukocytes and hb was in the process of clamping their catheter to get a sample direct from the bladder. The patient had a massive power chuck and bought up 1000mls vomitus and spiked a fever again.
Ended up sending the patient into hospital, ended up with a diagnosis aspiration puemonia and urosepsis. I did the whole "now why didnt I end up dip sticking this persons urine five hours ago" and the answer was 'they were presenting with the signs of a chest infection they werent presenting with the signs of a UTI and the chest infection appeared to be responding to antibiotics as evidenced by a reduction of the fever and improvement in the patients mood.
It can be hard not to beat yourself up over this stuff. For me its about doing a self evaluation of the care i provided and asking myself "did I do everything I could within my power for this patient" and then moving on.
Please dont be too hard on yourself, it sounds like you did every thing right
After 20 years of bedside nursing, I too have learned to separate my feelings from my work. I just feel you can't approach every shift on an emotional see-saw.
As a new nurse you will learn that as much as you put your heart into your care, some patients will take advantage of your kind sincerity, and run you into the ground.
That being said, when I worked on the general medical unit, I did occasionally call the unit I sent my patients to, just to see what their outcomes were. That is not a break of Hipa, since you did take care of the patient. It's also a good way to learn what could been done differently. As an ICU nurse now, I really don't mind catching the floor RN up, as long as they call during a down time.
its good to be idealistic about nursing when you first start out. There will be plenty of days later when you will hate it!
I am a victim of true bullying, thanks, who seriously considered suicide briefly as a young teenager. I took plenty of verbal BS and it sucked, but the day I was surrounded by a group of boys and physically beaten in an open quad during break with no response from any authority figure is the day I'll never forget.
I stand by every word I said, because I actually DO know what I'm talking about.
That sucks and I'm really sorry. REALLY. I'm not pitying you, because I know you are strong and resilient and are walking the walk for your kids.
I don't think it's a contest, though. I do think words can hurt. Often those that are beat have both physical and verbal/emotional.
I DON'T think there as any bullying in this thread, just a lot of drama and pointed fingers at a scapegoat.
I am a Relief Charge/Staff Nurse and I can tell you that you are not alone with your problem. Nursing is an intense field and in order to be an effective nurse emotional bonds will be formed and broken. The rush and trauma of a rapid response or code may lesson with time, frequency and exposure but the first effects leave a mark on anybody. I am sad to the fact that you refer to nurses trying to deal with their issues as "creepy" but I guess it's just an opinion.
In my hospital it is standard that the Nursing Supervisor is called for both crisis. After each we also do a critique of the rapid response/code and condition of patient upon transfer. As Charge Nurse I always made sure we would get a follow up report by the end of the shift on the patient status.
In addition if a patient was important enough to anyone( me or my colleagues ) we would make a point of going to visit the patient during a break or after work. Families seemed to really appreciate that we showed our support by visiting.
As far as going home..
On days that I need time to wind down I drive to the gym and go to the steam room/pool/jacuzzi/shower (no talking to anybody) and let my mind drift.
So by the time I get home I usually feel a lot more relaxed
You will always remember your firsts. It is only human to care and it is probably what makes us better nurses. As a new nurse, you want to learn from each experience. When you have a situation where a pt goes bad, you may want to get with your charge nurse after and go over everything and he/she can lead you to see if there is anything you would have or could done different. I'm sure your ICU nurse would not have minded if you called a few hours later just to see if your pt stabilized. (If that helps you sleep better at night) Another thing which is important is to review policy and procedures of your hospital. i never did anything without reviewing P&P. in an emergency situation where you sent a pt to ICU, you also want to review the P&P on transferring pt to ICU just to make sure you filled out all of the correct paperwork & everything else pertinent in your hospitals policy. If anything ever happens to a pt and they sue, the hospital will not back up the nurse if they did not follow policy. I'm probably giving more information than you need but I love giving advice to new nurses so I hope you don't mind if I'm telling you stuff you already know.
As far as leaving it at work, it gets easier as you become more confident in your nursing career, knowing that you are doing everything in your training and per policy to take care of your patients.
Good morning, group :) I have this very awkward situation where I have very lovely private messages in my "in box" that I am unable to reply to because I have not yet met the minimum posting requirements to return their messages. I believe I need to have 15 posts, which I do not. Thank you for the private messages. I am sorry I cannot reply back privately at this moment. I did write quite a bit only to have it lost somewhere where only the most advanced techies would know, and maybe even unknown to them.
At the risk of sounding old and motherly, I want to say the same things that I say to my own children when I know they are capable of a much higher level than they are performing, or maybe even know sometimes. When you have the charisma and the power of being a leader, you also have the responsibility of leadership. Leadership is noble, it is also hard work. It is also something that we truly need in the profession of nursing. Leaders will get put on the hot seat sometimes, and that is normal. It is to be expected. Good leaders will not take it personally, they will realize that it means they are, indeed, doing what they are called to do.
Not everyone is going to appreciate or understand what I'm saying, and I realize that. But, some will, and those are who I am directing these words to. When you have leadership skills and a leadership gift, people will watch you, people will follow you, people will want to please you, people will want to protect you, and sadly, some people will want to target you. Leadership can get lonely, but it is also an amazing role in the many professions, definitely nursing. Leaders create the culture, leaders guide the attitudes, leaders heal.
Do I feel bad that I hijacked this thread once again? lol ... maybe a little. Sorry to the OP. I wish I could have just used the PM, but sometimes, like The Rolling Stones say "You can't always get what you want, but if you try sometimes, you just might find, you get what you need." .. and such is life.
It saddens me some of the things I read in this thread. My heart goes out to some people who I can see are struggling. There was a time in my life and career that I had some pretty intense struggles and someone handed me this small, easy to read book called "The Four Agreements". I took the book and angrily assumed the person was just dismissing my pain and anguish with some self-help book. I was a professional, I expected professional answers to my questions. How dare this person, who I thought respected me, give me this self-help book that had nothing to do with science or my profession at all? lol ... ah, to be that young again ... such a beautiful and intense time of life. I ignored the book until one day I was packing for a long flight and these were the days before smart phones and what have you, so books were pretty much the only option. It was a small book so I just threw it in my bag. Pretty sure I rolled my eyes when I did it. I rolled my eyes a lot back then.
It's a beautiful book with a profound message, so I will share it here since it really does address the OP in some ways in terms of coping with the unknown in nursing ... it also addresses some of the issues discussed in the thread. It's truly profound and if anyone picks it up and reads it, I will not be surprised if the person has many "aha!" moments.
"The Four Agreements"
1. Be Impeccable with your Word
a. Speak with integrity
b. Say only what you mean
c. Avoid using the Word to speak against yourself or to gossip about others
d. Use the power of your Word in the direction of truth and love
2. Don't take anything personally
a. Nothing others do is because of you
b. What others say and do is a projection of their own reality, their own dream
c. When you are immune to the opinions and actions of others, you won't be the victim of needless suffering
3. Don't make assumptions
a. Find the courage to ask questions and to express what you really want
b. Communicate with others as clearly as you can to avoid misunderstandings, sadness and drama
c. With just this one agreement, you can completely transform your life
4. Always do your best
a. Your best is going to change from moment to moment; it will be different when you are healthy as opposed to sick.
b. Under any circumstance, simply do your best, and you will avoid self-judgment, self-abuse, and regret
Thank you, anyone who took the time to read this. Good luck to you in your career. The leaders I am speaking to, and you know who you are, good luck. You shine, keep shining. The profession needs you, your peers need you, your team needs you, your patients need you. Yes, you are a leader. Yes, that's a lot of responsibility. You can handle it. :)
Alright, enough out of me, I'm tired of hearing myself write. My kids, when they were younger, would be saying "mommmmm, enough already, we got it, we got it" ..... lol ... such is life.
Take care and good luck everyone with your careers. Fight the good fight and take care of each other and yourselves.
i have been a nurse for over 40 years and I still think about my patients when I leave work especially when unusual things happen. As a former nurse educator, I believe that every situation is a learning opportunity. You are correct in questioning the outcome of your patient as well as what was done clinically to the patient after he left your care. I would talk to you manager and engage her help in finding out what lessons could be learned from this experience. You are right in being concerned about HIPPA and express those concerns to your manager. Nursing is an art and a science and the art is in caring for those we care for. Because of that caring it is sometimes hard to leave work at work.
Izzydame, I understand that you love yourself a bunch and have a powerful need to show off your writing skills, but would you please start your own posts and stop hijacking this one? I feel that you are a distraction to the topic at hand and I think we would all appreciate you more if you were showcased in a more appropriate venue.
Jensmom7, BSN, RN
1,907 Posts
I agree-Dranger, you have been calm and rational in your replies to these non-nurses and nurses who got their shiny new license 10 seconds ago, and who are barely out of fetus hood.
I was tempted to direct some posts to these people, but then I remembered-I make it a policy not to argue with children. Especially children who have been told all their lives that they are Special Snowflakes who know everything about everything.
Now, the OP of the original thread (and I'm sorry, but I'm terrible at names and have totally forgotten hers) had a valid question, one which most of us seasoned nurses wrestled with at some point. I think she is going to be a very good nurse-she actually knows how to carry on a conversation, and has been very gracious, whether she actually plans to utilize any of the suggestions thrown out here or not.
We need more nurses coming into the profession like her-the self righteous, sanctimonious, spoiled entitlement Snowflakes should take their cue from her instead of screaming NETY!! and "You're a bully!!" It gets old.