Leaving work at work

jo272wv · Dec 6, 2006

I have been a RN since May and have the same problem. I was hoping it eases up a bit as time served goes on. Guess not always.

rn/writer, RN · Dec 6, 2006

Here's something I do that helps.

I am barely qualified to say that I can knit, but I do know how to cast on and cast off.

I look at the beginning of the night as casting on. I work postpartum and have a detailed cheat sheet that I fill out with all the usual stuff. A while back, I added a grid at the bottom of one of the sheets for baby feeds, weights, second set of v/s, and hep B shots.

As I go through the night, I cross off the things I got done, fill in the baby grid, and cross of info as I chart it. Anything that pops up along the way gets written on the sheet as well (or I'll remember there's something I need to take care of but won't necessarily recall what. That drives me bonkers.)

As the end of the shift draws near, more and more things get done and charted. In my mind's eye, I use the image of casting off. Baby A had his last feed and it's now charted. All the babies' weights are done. Baby C got her hep B and that's charted.

Eventually, the activity and the charting on each mom/baby couplet is finished, and I think of them as a completed project. Of course, that is always subject to last minute requests and unplanned emergencies.

I write down every cotton-picking thing I need to do or remember and that has saved my hide many times. Then, throughout those last hours, I begin the process of wrapping up the night. I think that's the key--that it's not just flipping a switch, but more like setting out on a journey, reaching the farthest point, then turning around and heading home. On that homeward leg, your mindset is different. You're winding down and entering a different phase.

I used to be in high gear from start to finish and felt what you guys are describing. The change when I left was too abrupt. Doing it this other way allows you to look at things just a little differently, even if you don't alter what you're doing.

Let yourself envision putting your work away as you complete your tasks. Start this a couple of hours before the end of your shift and then by the time you punch out, your really should feel much more able to leave it all behind.

That is not to say that I haven't ever called the next shift and told them something I forgot, but whatever information I had to pass on at least stood out. When I did things the other way, it was all a big muddle and I had trouble sleeping and letting go.

I hope this isn't too simplistic to be of some help. All I can say is that, even though it was only a change in my thinking, it made a big improvement in my ability to walk away and leave the job behind.

Valanda · Dec 6, 2006

Something I do that seems to help even in non-work situations. If i have something running through my head that I can't shake and it is keeping me from sleeping. I write it down. Especially when i am angry at someone. I write down everything I am thinking, then I burn it in a candle flame. I'm always careful to burn it completely so there is no evidence. This was suggested to me by a therapist when i was in my teens and it still works.

miko014 · Dec 6, 2006

I do something similar to rn/writer. When I'm at work, I have a piece of blank paper that is divided into sections for each pt. Mine isn't as detailed though. I write down room number, med times, VS, IV solution and rate, with a blanks for counts (that makes me remember to clear pumps and chart I/O), and then I just make notes of everything else that comes up. If they ask me for tissues, I write "tissues" in their box...then, then next time I look at the paper, I see it and take the tissues in. It saves them getting upset with me because I forgot, and it saves me getting frustraed for the same reason. I cross off things as I do them. Then, at the end of the night, I check all my charts and look at my paper. If all the charts are done and everything on my paper is crossed off, then I fel really "done".

I have called in a couple of times to tell them something I forgot to do, and I do think about my shifts sometimes after I'm at home. But I just tell myself that I did what I could do and that it's a 24 hour job. That helps too. I don't know why I feel responsible to do everything - that's ridiculous. I just have to remind myself of that and then I'm okay.

Plus, I work with a few RNs who are so stressed, it's a wonder that their heads are still attached to their bodies. They worry about every little thing! Like, "gosh, I hope the tech on nights rememebrs to fill water pitchers!". Lets face it, some things are out of our control! I guess being around people like that helps me to see that I don't want to be stressed like that all the time! It keeps me mellow or something, lol!

Elvish, BSN, DNP, RN, NP · Dec 6, 2006

I have struggled with the same thing throughout my nursing career (5yrs) although not so much recently as when I first started.

I would suggest you do much of what has already been suggested such as writing things down, realizing what you do and don't have any control over. I would also suggest some other things:

1) positive self-talk. I know it sounds nutty but it really does help me to think to myself over and over (or say out loud, whatever works) "I did the best I could." or "I will be able to take good care of whatever patient assignment I get tonight." or whatever phrase you find works for you. If I am having trouble getting to sleep, I think over and over the phrase from Psalm 23 that says "he makes me lie down beside still waters. He restores my soul." That works a lot.

2) Go see your doc in order to rule out issues like depression/anxiety or other mental health stuff that may be exacerbated by your work stress. I learned that the hard way after going for several months with untreated depression. The difference a little Zoloft made for me was incredible. It didn't take away the crap that was happening at work but I was able to cope better.

I hope you find something helpful here and I sincerely wish you the best as you continue your nursing career.

augigi, CNS · Dec 6, 2006

I'll be interested to see the replies - I graduated 10 years ago and never managed to find a good way to leave work at work!

Marie_LPN, RN, LPN, RN · Dec 6, 2006

I put the cell phone on hands-free in the car, and talk to my husband on the way home from work and talk about my day.

When i'm finally home, the work talk isn't allowed from either of us.

ICRN2008, BSN, RN · Dec 6, 2006

My husband just brought up this topic the other day. I have a hard time letting things go when I have a bad day. I would like to work in an office and come home in a relatively good mood every day. Unfortunately in healthcare we are dealing with some pretty heavy stuff, and the drive home is not always enough time to process everything. Often there is no one to vent to except one's spouse. I am hoping that it will get better as time goes on...

SharonH, RN · Dec 6, 2006

Your problem is very common; I have over 15 years in the biz and I still have to consciously work on leaving work at work and I am no longer working at the bedside. One of the things I do is to mentally picture the day in a box and then I close the box and throw it away. I have to do this more than once sometimes. Then I actively practice relaxation techniques, deep breathing and muscle relaxation are two of the most succesful for me. Good luck on working this out, it's important that you do because it will help prevent burnout.

Dalzac, LPN, LVN, RN · Dec 7, 2006

When I came hom after work I would swill down a bottle of wine or something of that nature. That got me familiar with AA. The next solution worked better, I would watch cartoons for about an hour. My husband, ever the intellectual, looked at me and wonder why his beautiful brilliant wife would lower herself to mindless fodder on the tube. I told him exactly what a day in a large metro ICU_CCU was like and every thing I did. He let's me watch cartoons whenever I want now

Seriously though, It takes a while to learn how to walk out of a facility and shake it off. I got to the point of going over everything I did while driving home and would pull into the garage take off my uniform and imagine all the dirt on that thing was being washed clean throw it in the washer and go into the house and have a great day with kids and hubby.

Valanda · Dec 7, 2006

I know this would only work for a few ppl, but I used to work with a nurse who lived in the country and had a 30 minute drive home from work through a relatively secluded area. She said she would roll her car windows down and scream at the top of her lungs while driving home to release the stress of the shift! It seemed to work well for her, but I wouldn't dare try that in town.