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momthenRN 3,278 Views

Joined: Aug 17, '07; Posts: 74 (11% Liked) ; Likes: 13

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  • Apr 12 '11

    Have you ever wondered what the stress of nursing is doing to you? We know that stress causes cortisol levels to rise which raise our blood pressure, raise our blood sugar levels, increase our lipids, etc. Blah, Blah, Blah. The point of this article is not to teach you something you already learned in pathophysiology class.

    We know that high stress levels can cause weight gain and we know that obesity complicates every disease there is. Obesity has been linked to higher cases of breast cancer, etc. As nurses, we KNOW all this stuff.

    Let’s not go there right now. Instead the message of this article is to talk about the emotional price of high nursing-related stress in your life. Nursing stress is so unique. It’s practically impossible to explain to non-nurses…that’s for sure!

    How do you explain what it feels like to have your pager go off for two different patients at the same time? One is in severe pain and one is throwing up. Add to that scenario “a transport tech” arriving on the floor asking if your pre-surgical patient is ready to go to surgery because the anesthesiologist and surgeon are waiting downstairs. Yikes! You didn’t get the checklist done yet! Multiply that scenario several times an hour for 12+ hours at a time and you've got nursing stress.

    Nursing stress mounts so quickly that it leaves you speechless with friends and family. The thought of describing what you go through during your work day becomes so exhausting that you just don’t do it. You don’t tell your friends. You don’t tell your family. You may find yourself becoming emotionally shut down to a certain extent because you start to hold stuff in.

    Have you ever wondered, “Am I depressed and I don’t even know it?” You may find the answer to that question by examining what you do on your days off. After a brutally stressful day at work, it is not uncommon to hear a nurse describe her day off like this, “All morning, I could still hear my pager going off and the monitors too. I stayed in my pajamas until the afternoon. All I had energy to do was zone out on TV and eat.”

    It’s a matter of life and death to find healthy outlets for the nursing stress in your life!

    When the thought of picking up the phone and talking to a dear trusted friend to “relieve some pressure” becomes too much for you to handle, there may be a problem. Perhaps you used to refer to it as a “mental health” day, but when all your days off look like this, there may be a problem.

    In general, isolation (not talking, stuffing with food, not socializing) can be warning signs of too much nursing stress in your life. Beware of “shut down” mode.

    Conscious separation is a problem. Conscious unity is an answer.

    Here are some of the things that can work to combat nursing stress:

    *Talk about it. Talk to your fellow nurses, your charge nurse, your department director, your friends, your family, your mentors. If you don’t want to talk about details, at least talk about your feelings and what you plan on doing to change your circumstances.

    *Utilize mentors in your life. (spiritual, mental, emotional, physical, entrepreneurial)

    *Walk/hike with your spouse or friend regularly each week.

    *Participate in groups with similar interests as your. (Don’t just attend. Talk!) The power of a group cannot be underestimated.

    *Take advantage of nutritional vitamins and supplements.

    *Eat healthy snacks (remember low carbs/high fiber/high protein).

    *Watch your sugar intake (there are alternatives to high sugar coffee drinks!).

    *Blog on different subjects.

    *Join Online Nursing Forums and participate.

    *Write and journal.

    *Share your writing and journaling with people you trust.

    *Go on a 30 day Mental Cleanse (be extremely selective with what you “take in” mentally).

    A very wise woman once gave a speech to a group. She said that she had come to a turning point in her life and wanted to make a change. The single most important thing she did to change her life around was this: She started to “LIVE OUTLOUD”. She ended her silence.

    Nurses, if you do nothing else, start living outloud!

  • Nov 22 '08

    I primarily used Laura Gasparis Vonfrolio's CCRN Review book and video's to study for CCRN. I also saw her LIVE at a review course! She's awesome!

    I also bought Dennison's Pass CCRN! book but only used the CD-ROM for the questions that were on it.

    Good luck to you!

  • Nov 22 '08

    There's a thread here with all you need to know and more:

    I did it earlier this year, after >10 yrs in ICU, mostly CTICU. I found it not bad. I did have to review subjects outside my area of expertise, and mostly focused my review on the Pass CCRN book and doing tons (I mean tons) of practice questions. I then looked up the rationale of questions I wasn't sure of. PArt of the trick is learning what they are asking you, and how to answer the question: eg. 'best' answer is the most comprehensive, "what would you do FIRST" etc.

    I found it extremely beneficial to relearn a lot of the material (and some I never knew) - and that plus the ICU experience really made it doable.

    Good luck!

  • Nov 22 '08

    I studied my ass off! Seriously though, I bought some books and studied with co-workers who were also trying to get certified. I bought PASS CCRN which has a good review of the patho if you need review, I bought the AACNs book with just questions and tests. I also bought Laura Gasparis-Vonfrolio's green book of questions and listened to her lectures on CD. They're like $200 but totally worth it. In the end it's really just taking the time to do it. If you work in a good ICU, odds are you do this stuff everyday. And that's what the exam is, stuff you do everyday. I know lots of people will tell you this, but it's true, it wasn't that terrible!

    Good luck and you should be proud of yourself that you're trying to increase your knowledge base with this's a really big deal.

  • Nov 22 '08

    Fortunatly for me I learned to study from day one. I worked in a high acuity teaching SICU and pretty much learned on my feet. Makes it much easier when you take the test. I used a coupl eof the test books just to review.

  • Jul 30 '08

    Quote from momthenRN
    Help!! I have lost my kfactor calculation card. You know the one, helps me plug in my conversion factor to figure out my mcg/kg/min and ml/hour for my gtts. I have become so reliant on it that I cannot function with out it. Help from the mathmatical brains out there so I can make another one!!! Thanks......
    mcg/kg/min...........take the total amount of the drug in the bag in mgs, so lets say Neosynepherine is 10mg in 250cc's. Take 10mg x 1000 (to convert to mcg). Take that answer (10,000) divided by 250 to get it down to mcg per cc. Take the answer from that divided by 60 to get it into minutes and then take the answer from that and divide it by the patients weight in kg's to get MCG/KG/MIN. If you just need MCG/MIN skip the weight part. That will ultimately give you a "constant" which is essential the amount of drug in one cc indexed to your patient. Take the constant multiplied by the ML's per hour to get the total mcg's. Another way to do it is to take your desired dose.............lets say I want my patient on 150 mcgs of NEO, so take 150 mcg divided by your constant and it will tell you what to set your pump at. Easy enough?

  • Jun 30 '08

    Another thing you might try is to find out what sort of legal standing you have since the employer is aware that they have a bully and their actions were to remove her from a supervisory position but not to eliminate the bullying behavior.

    This is very similar to other forms of harassment. Filing a complain with HR rather than with the manager might yield a different result, since those in HR are generally highly aware of the consequences for failure to act on abusive situations.

    Good luck.

  • Jun 30 '08

    I took an assertive communication class in undergrad because I "had" to. I actually learned a few very important things. One of these being a kind of generic sentence structure for confrontation. It is "When you _________, I feel_______ and _______. " For example, "When you try to find fault in me I feel angry and I don't appreciate it." It is surpizingly effective. It's not namecalling, but to the point. It's hard to argue about how you feel.
    I've used the trick more than once, and it's worked everytime. Think of what you'd like to say before you even are in the situation. It sounds like she's pretty consistant.

    Hope that helps.

  • Jun 30 '08


    I've worked with many a p-a nurse in my 20+ years. Truly the only way to get a tiny bit of respect from them its to give it back to them. I know it's hard, but if you kind of call a bully on the carpet, they are usually shocked. What you have to be careful of is don't choose a situation that in turn makes you look bad. Management that give the "you should talk to her/him..... we all need to get along" are just doing what they can (I'm now in management) but it really isn't an effective approach.

    A good ole, "get over yourself" when you get a smart remark might help. Good luck!

  • Jun 30 '08

    Management dealing with these types of issues with the chastisement of "You need to find a way to get along" is not only ineffective, but it is also a relection of their own lack of leadership skills. They've already lost other nurses because of the behavior of this one individual, yet they CHOOSE to allow this behavior to continue.

    I would be surprised if this facility did not have any policies regarding workplace harassment. Look into them and present those policies to your manager. Either management should deal with the bully or they should ensure that you do not have to work with that person.

  • Jun 30 '08

    I have one like this -- and she is a relatively NEW nurse who went through orientation with me! She's older, though, and has prior experience in a doc's office (so what, I say) and just has a major big mouth. I am 2 inches away from letting her have it one day if she pulls it again with me.

    I actually told her to "cool her jets" the other day and she just walked away. You do have to snap back at them, and hard -- or they won't quit.

  • Jun 30 '08

    Quote from momthenRN
    My problem has been with one RN who I reported for not helping me with specific questions when she was charge.....Needless to say, I went to management with this lack of support from our weekend leader and it has gotten so much worse.
    In addition, people hate to get reported, even if they're clearly in the wrong. They begin viewing you as a snitch for reporting your concerns, and they increasingly 'retaliate' by giving you the cold shoulder, not helping, and finding dirt that they can someday use against you.

    I have noticed that people who have been reported secretly hold a vendetta against the 'reporter.'

  • Jun 30 '08

    Here's my observation...I have noticed that bullies target certain individuals, while 'magically' leaving others alone. Unfortunately, it's all about perception. If you are perceived as one who will not stand up to the bully, you'll be targeted for further harassment. If you're perceived as someone who will put up resistance and not allow anyone to run over you like a doormat, then the bully will quickly know to leave you alone.

    Bullying is a crime of opportunity. Bullies pick out the most opportune targets: people who are less likely to respond in a defensive manner to the bullying. Also, if nothing is done, the bully will continue the antisocial behavior, because this person knows that he/she can get away with it.

  • Jun 30 '08

    Actually Daytonite, this type of behavior is unfortunately NOT totally rare. Sometimes, well established, aggressive personalities become expert at avoiding work through social manipulation of the workplace.

    The OP describes it perfectly. These people know expertly how to schmooze with the right people, and simultaneously ostracize or undermine anyone whom they perceive as socially weak or isolated.

    There's no easy answer, because this type covers their bases well. They know the job well, they carve out a little empire for themselves in their workplace, and they hold on to it by ruthlessly driving away anyone who doesn't go along with their game.

    Unfortunately, I've seen this over and over. I doubt if it is unique to nursing. I don't know the answer to it, there are probably some books or seminars that might help the OP.

  • Jun 30 '08

    Ive learned, thru experience, that if you dont stand up to them, they will continue their aggressive behavior toward you. Im battling the same thing at work with a nurse on my floor. I am an introverted, timid person who has a hard time dealing with this type of person. In your situation, try to stay away from her. Be cheerful with everyone else and offer your help when needed. But as far as this one particular nurse goes, I would not offer to help her unless she asked and I wouldnt ask her for help either. Dont talk about her to the other coworkers and dont acknowledge any negative behavior on her part. Maybe in time she will see how rediculous and immature this whole thing is and how her behavior isnt helping matters. I know its hard, believe me, I know. Its a shame people have to act that way. Good luck.