Leaving Work at Work

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Specializes in Pediatrics, Step-Down.

I am a new grad and really do love my job, but maybe a little bit too much. I have been working for a little over 4 months and it is getting harder and harder for me to leave work at work. I work on a highly acute pediatric floor and on my days off, I find I am wondering how my patients are doing and if they are okay. I rehash over and over in my head things I should have done differently the day before, things I wish I had time to do but did not, and I worry about my patients who are chronically ill. I rarely take breaks at work because I find myself worrying about my patients, I'd much rather just eat at the nursing station and do paperwork at the same time. The funny thing is that when I am actually at work I never feel bothered by anything, it is when I get home and have time to sit down and think that I begin to feel upset. On my days off, I find myself thinking so much about work that I wish I was there. Everyone tells me that I am going to get burnt out if I continue the way I am going, and it is probably true. I know other people have posted similar things before, but I am really struggling with this. I worry that if I get to the point where I can really leave work at work, I will no longer be warm and compassionate to my patients. How do you leave work at work without losing your compassion? Any advice will be greatly appreciated.

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After 32 years in nursing, I think I've learned pretty well how to leave

work at work, but I admit that now and again I have that patient that

I can't get off my mind on my days off. You don't have to shut off your

warm and compassion and I hope it never gets to the point where you

do.

You did the best you knew how for that patient in your care that day,remember

that. It will get easier. Sometimes it helps to visualize just shaking off the day

when you step outside your workplace.

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Specializes in ICU.

As a new grad, I frequently did the same thing that you're describing. It took me about a year to really learn how to leave my job at the timeclock. To be honest, some of it goes with caring. If you really care about your patients, then you will be concerned.

The way to do it, it to simply do the best you can for your patient while you're there with them. If I do the best job I can, then when I leave, I leave knowing that whatever the outcome, it's in greater hands than mine, and i've done all I can do. There will always be patients that you'll think about from time to time, however, by doing the best I can do, I don't feel guilty, or always think about work.

The one thing I will say is that I do agree with your family on one issue. If you don't find a way to resolve this within yourself, it may cause significant burnout in the future. Pick up a hobby, take vacations, spend time with loved ones. We are not given one day in the future for a certainty in this ole world. Make the most of what you have.

Best of luck...

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Specializes in ER, progressive care.

Still a new grad, and I have this problem. This is something I need to learn. I tend to "immerse" myself in nursing - when I'm not at work, I, like you, constantly wonder about my patients. I always think about what I could have done differently or if I did something wrong and just didn't realize it, or if I forgot to chart something...etc. I dream about work. The other night I had a dream that one of my patients was having a STEMI and I was running down an endless hall...I just couldn't get to the patient to intervene! We're not supposed to eat at the nurses station, but everyone does on night shift (management isn't around the supervisors never care) but I'm also the same way, I would rather eat at the nurses station and get my charting done. I spend quite a bit of time on AN lol and looking up diseases/drugs/treatments in my spare time. I'm afraid I will burn myself out really quickly by doing this.

As for worrying about patients and things, I have been told by my coworkers that this is normal and it all goes away eventually.

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Specializes in NICU.

I'm sorry for your distress. You state you work on a "highly acute peds floor." I'm thinking you are at a regional pediatric center, where you see the worst of thie worst. Peds at my community hospital gets ORIFs and dehydration kids. The regional center here gets the weird, nasty stuff: spinal muscle atrophy, glycogen storage disease, chronics and frequent flyers.

I used to work at the regional center. I described it as "a place that rips out your heart and throws it at your feet." I was frequently overwhelmed and went home just thankful that my own kids were alive. I had no energy left over for my out-of-work life.

So I made a change. I went to NICU at a community hospital where most of the parents want their kids and try to do their best for them. It doesn't meant I "couldn't take it" at the other job. It means I found a job that leaves me energy for the rest of my life.

You may not need to change jobs. You may simply be struggling with new-nurse-ness...that difficult first year.

Now, as for leaving work at work. First of all most of my patients get better, so I don't have a lot of really hard days. However it was helpful for me to find the boundary between "caring" as doing nurse stuff and being kind and compassionate... and "caring" as being emotionally attached to. The first is therapeutic nursing. The second is not and will eat you up if your patients are terribly sick.

I hope this is helpful. You sound like a good concientious nurse. You've recognized a need for self-care; I hope you find the right solution for it.

A--

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Specializes in ICU.

Set your boundaries.

When the door closes behind me when I leave, I forget it.

Self preservation.

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Specializes in Ortho, Neuro, Detox, Tele.

I always take 1 or 2 hours when I get home before bed just to decompress. an.com, ps3 games, reading, cleaning, etc. I talk over things with my wife on occassion when I've had a bad shift, or if I took care of a really nice patient, or one with a sad story. It's helped me find a balance. I do things for me on my days off, and I find that my first year I remember having many of the same feelings.

It will come in time. You'll always remember things you could/should have done different. but TAKE that lunch break. the time helps you recharge at work. as long as work doesn't call you, it probably wasn't a big deal. And you'll remember those things you could do better.

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Specializes in I/DD.

I always let myself work through my day for 45 minutes or so after I leave, trying to think of things that I have missed. I usually come up with something...an output that I never recorded or something about the patient that I didn't pass in report. If it is important I will call the floor back. If not, then I let myself relax and forget about work. If I haven't thought of something in that 45 minutes then it was not important anyways.

As far as wondering if I did the right thing? You can learn from your mistakes, but you can't go back in time! So maybe I should have hung the antibiotic before tackling insulin (because giving one insulin shot ends up taking 20 minutes by the time you have taken the patient to the bathroom, refilled their ice pitcher, and cut their food into bite size pieces). I do it differently the next day but I don't let myself get beat up over it because it is in the past.

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Even as an expirienced nurse I have these times where I take certian thoughts or emotions home with me. I have to remind myself that I will better serve my patient if I come in with a fresh rested mind and good attitude. It is difficult to "recharge" when I have no downtime...I work on a busy med/surg ONC floor. We see all kinds of patients with many needs and also ONC patients in all stages of treatment and often see these patients more if they are sick for a stretch...they stick in my mind and on my heart at times. I have shed a tear more than I like to admit and shared my good and bad days with my family....I struggle more with this than with worry of something I may not have gotten to or forgotten. If you did the best that you could do and You work just as hard as anyone else who could have done your job then you can be confident that it was the best care that could be expected in that circumstance and if there was something that you could have changed you probably would have if you could while at work right?

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Specializes in ICU.
Geeze, I hope you are not my nurse should I ever land in the hospital.

Why?

The nurse who made the above observation was just quoting a coping mechanism. To some extent, every nurse has to do this. I care all that I can while i'm there. Once I leave, I have to leave it all behind...or as was stated...self preservation.

All things in life must have a balance. All work and no play makes jack a dull boy :)

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As a new nurse, I struggle with the same problem every day. It was bad enough, causing enough anxiety that I was considering leaving nursing. After getting some feedback through this board and experienced nurses, I am giving it a second shot. I just recently have started working on taking care of myself off duty and to decompress when I get home, for me that is listening to some music, go for a drive, talk to family, etc. I am learning to manage stress during the shift and how to leave work at work. It is tough sometimes, but as I get in the elevator to go to the carpark, I stop and try to visualize all my problems and concerns from the day falling away. When I can do it, it actually gives me a feeling of relief and freedom. At home when the thoughts creep in, If it is over something I missed, I contact work to address the issue. If it is over a patient I am worried about I make a point to follow up when I go back and then try to refocus and put it out of my head. Like me, you have got to learn some survival mechanisms to stay in the field. I wish you luck and hope the folks on here can provide you as much help as they did me.

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Yes I understand somethings are hard to let go...Like the previous person has posted you need to find a way to let it fade out and away from you. I used to walk home or ride my bike to just get some of the frusterations go and get some fresh air in and I lived about 6 miles away from work.

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