Injured nurse returning to work

Ruby Vee, BSN · Aug 2, 2016

Hello all! I am a new-ish (3 years experience) nurse in a CVICU. Long story short, I have been away from the bedside for six months due to an ankle injury/surgery/complicated rehab. I return to the bedside in a couple of weeks and I am honestly terrified. I requested to have a couple of orientation shifts to ease back into things but I was denied because we are short staffed. I do have GAD but I think it is legit to be concerned since our census is boom or bust and I still can't stand for more than an hour straight without excruciating pain. Plus, I worry that my nursing skills are rusty. Has anyone else been away from the bedside and returned to ICU with minor hiccups?

I had nearly thirty years of experience when I injured my back (to the point where my right leg had no sensation and I couldn't control it's movement). I was off for a day less than six months, and came back to work on Christmas Day. (My choice, another subject.) Of course there was no opportunity for an orientation shift or two at that time of year!

From the moment I learned that I was cleared to go back to work, I worried whether I'd be able to keep up with the workflow, remember how to do things, handle the stress after nearly six months of not working. I had issues with pain, with balance, with strength and of course I was reconditioned.

Here are the things that helped me:

First, I asked my physician for a note clearing me to work eight hour shifts (instead of my 12s) and no more than three a week for the first month. Nursing doesn't have "light duty", but this helped me ease my way back into the job. Working over the holidays (when no one schedules an elective surgery) meant the unit wasn't as busy. My colleagues had more time to help me, there was more "down time" and I wasn't as stressed trying to put it all back together on the fly. (I'm talking workflow, time management, organization here.). My boss wasn't thrilled with the restriction, but having me back was better than not having me back, and four weeks (or a month) goes by quickly. At the end of that time, I felt ready for the 12 hour shifts.

Second, I learned how to "work smarter." I couldn't squat down to read the volume on the chest tube canisters (different issue) and I couldn't bend, so I learned to lift them up to read the volume, hang them on the bed rather than sit them on the floor or sit on a little wheeled stool which I could roll around as needed when I needed to empty Foley bags, read chest tube canisters and fiddle with stuff near or on the floor. I sat down at every opportunity -- even during rounds. All but one attending understood, and it seems that he "misunderstood" because his own orthopedic issues led him to snatching the nurse's chair whenever possible. Even during codes, you don't have to actually stand the whole time. Someone has to chart, and although it seems to be the thing to chart standing up, there's no reason you HAVE to. I had wonderful colleagues who protected me in every way possible. They'd step away from the computer and slide me a chair when I came to a code.

Ambulating patients was my biggest problem, and I was lucky enough to have colleagues who planned to help me out with that. I sat with their Houdini patient, fed their little old lady, hung their PCA or did whatever I could to help THEM out while they were ambulating MY patient. It helps to have good colleagues. Great colleagues, actually. When you first come back, people will be asking what they can do to help you out. Think it through in advance and take them up on it. Just make sure it's a trade, not you dumping on them.

I was incredibly fatigued after my first few 8 hour shifts. I'd come home and sleep until time to get up for work the next day. Plan for it. It doesn't seem as t bough eight hours should wear you out that much, but it does.

Congratulations on your imminent recovery and best wishes with your return to work.

Here.I.Stand, BSN, RN · Aug 10, 2016

When my 3 yrs old was born, I'd been off of orientation and whopping 6 weeks, and then I took a 12 week leave. Before coming back I had a momentary freak out, thinking I wouldn't remember how to do my job.

I then had a talk with myself: "Self, you know how to keep VS in range, you remember what we do for high ICPs, and you know those basic nursing things that prevent complications (pressure ulcers, VAP, CAUTI, etc). The rest will come back."

Also my first few days back, while I didn't get any orientation, they did give me the stable/ready-to-transfer-out patients. That helped me ease back into my work flow.

And yes, it all came back.

luckynurse_1234 · Aug 17, 2016

Thanks for both of your advice and kind words. I met with my scheduling manager about my concerns, and unfortunately only doing 8 hour shifts won't be an option but they did say for my upcoming 4 shifts in a row (3 12's plus 1 8) maybe I could be on call if the census permits. I was able to squeeze in a couple of unofficial (more along the lines of helping out here and there) shifts and it went ok. I'm still nervous about starting back officially tomorrow but I agree that I think I can manage the big stuff like keeping vital signs stable and when to call the doc.