Most stressful moment as a nurse?

mom4josh · Jan 10, 2008

I had a patient whose religion did not permit a certain procedure which would have improved her health significantly at the time (although ultimately not cure her). I knew of her religion and, while I did not personally agree with it, I respected her views and NEVER ONCE approached her about this procedure and/or the benefits of it. However, one night she was obviously struggling, very short of breath, and I was concerned about her possibly coding. (I had discussed this with other nurses who were also concerned, so it wasn't me overreacting.)

On this night, I began a conversation with her about end of life issues and decisions. There was an elder from her church present, and she completely misinterpreted what I was talking with the patient about. She began to be very aggressive with me verbally and went on and on about how I shouldn't push my views on my patients and such. I eventually told her that I didn't think we should continue the conversation (after a good while that I allowed her to lecture me), so I called the nursing supervisor, who came and was, herself, lectured for a good long time. I was very distressed about this, because I treat all of my patients with the same care and respect, without regard to their religious beliefs.

Nothing ever came of it, but the supervisor wrote my NM explaining that I had done nothing wrong... I was simply attempting to allow my patient to make an informed decision about her healthcare.

I definitely learned not to do that again! Now, I let the doctors do that for the most part.

BTW mike, you didn't share yours!?

rknauber · Jan 10, 2008

Code blue on a beautiful little 6 y/o girl. She was in a car accident. Had no visable injuries.... Looked like she was sleeping. Never got a pulse, never got any rhythem. She has a ruptured aorta and had bleed out internally. Everyone involved in the code, docs, nurses, EMT's and the cops were all tore up and tearful afterward. I even has dreams about the code for months after. I've been involved in hundreds of codes and never had one affect me like that one.

mom4josh · Jan 10, 2008

Code blue on a beautiful little 6 y/o girl. She was in a car accident. Had no visable injuries.... Looked like she was sleeping. Never got a pulse, never got any rhythem. She has a ruptured aorta and had bleed out internally. Everyone involved in the code, docs, nurses, EMT's and the cops were all tore up and tearful afterward. I even has dreams about the code for months after. I've been involved in hundreds of codes and never had one affect me like that one.

Gee, mine doesn't seem nearly as bad now. How awful. :sniff:

I can deal with death and even codes... but not with kids. I'd be a blubbering idiot after something like that.

AliRae · Jan 10, 2008

In charge of a full PICU, heading out on a transport call when I got a call from the ED that they had a 1 month old in full arrest.

Let me just tell you- that day was the truest test of my nursing I have ever had.

flaerman · Jan 10, 2008

Right now is my most stressful moment as a nurse. All my wife wanted for Xmas was to go and visit her mom(she has Alheimer's and lives her older who relocated to SC within the last 18 months or so) so I sent her there. My wife is blind and has multiple medical problems including being the world's worst migraine sufferer. She had the usual H/A's etc but either late Xmas eve.early Xmas day she had a really bad one(all of her H/A's were always bad to her) with N/V which is not out of character sometimes(she was sick in bed and never got to spend Xmas with mom anyway). US Air wanted $600-700 to fly her home early so we had to crash some low level credit cards to get airfare and was due to fly home on Friday. Unfortunately she collapsed and was rushed to ER, and is now on a vent in a neuro ICU. In 22 yrs it has never bothered me looking at a sick pt, but then again there was no emotional attachment as my wife and I have. This is absolutely killing me and is moving me towards wanting to seriously give up on nursing as a career. I work in an intense med/surg ICU and am sure I would not melt down taking care of my next vent pt. Sorry for the long winded message but I am just so lost right now and trying to hang to whatever I can that we(she and I) will get over this and continue to be together(as I always tell her, "we will grow old, and fat together baby"). Flaerman

llg, PhD, RN · Jan 10, 2008

My most stressful times as a nurse have not been related to the direct care of a patient. The political battles of advanced roles have always been more stressful to me -- because they can ruin my career and threaten my ability to support myself.

As a staff nurse, I always knew I could support myself. If necessary, I could quit my job and get another job as a staff nurse somewhere else. However, once I got an advanced education, I knew that I could never be hired as a staff nurse again -- because no one would be willing to invest in my orientatin knowing that it was only a temporary job for me until I could find another advanced practice position. That has made the political threats of unemployment much more frightening for me as a single woman with no other means of supporting myself.

I am always faced with the thoughts, "No one would hire me as a staff nurse now that I have been away from the bedside for so long and have a PhD. Their orientation expenses for me would not be worth it. Also, my 52-year-old body would no take well to staff nursing any more. Finally, my clincial specialty, NICU, severely limits my clinical job options. In short, if I lose this job because of a political mistake, it might take me months to find another. How will I support myself in the meantime? Would I have to decimate my retirement funds."

I find that stress much worse than any patient situation I have ever encountered -- and as a NICU nurse, I have encountered my share of difficult patient situations.

TazziRN, RN · Jan 10, 2008

right now is my most stressful moment as a nurse. all my wife wanted for xmas was to go and visit her mom(she has alheimer's and lives her older who relocated to sc within the last 18 months or so) so i sent her there. my wife is blind and has multiple medical problems including being the world's worst migraine sufferer. she had the usual h/a's etc but either late xmas eve.early xmas day she had a really bad one(all of her h/a's were always bad to her) with n/v which is not out of character sometimes(she was sick in bed and never got to spend xmas with mom anyway). us air wanted $600-700 to fly her home early so we had to crash some low level credit cards to get airfare and was due to fly home on friday. unfortunately she collapsed and was rushed to er, and is now on a vent in a neuro icu. in 22 yrs it has never bothered me looking at a sick pt, but then again there was no emotional attachment as my wife and i have. this is absolutely killing me and is moving me towards wanting to seriously give up on nursing as a career. i work in an intense med/surg icu and am sure i would not melt down taking care of my next vent pt. sorry for the long winded message but i am just so lost right now and trying to hang to whatever i can that we(she and i) will get over this and continue to be together(as i always tell her, "we will grow old, and fat together baby"). flaerman

it's always different when it's your own. when it's not one of yours you can be the best nurse in creation, but when it is you turn into a basket case. i went through the same thing with my brother. i am sending prayers heavenward for you and your wife.

bigsyis · Jan 10, 2008

Right now is my most stressful moment as a nurse. All my wife wanted for Xmas was to go and visit her mom(she has Alheimer's and lives her older who relocated to SC within the last 18 months or so) so I sent her there. My wife is blind and has multiple medical problems including being the world's worst migraine sufferer. She had the usual H/A's etc but either late Xmas eve.early Xmas day she had a really bad one(all of her H/A's were always bad to her) with N/V which is not out of character sometimes(she was sick in bed and never got to spend Xmas with mom anyway). US Air wanted $600-700 to fly her home early so we had to crash some low level credit cards to get airfare and was due to fly home on Friday. Unfortunately she collapsed and was rushed to ER, and is now on a vent in a neuro ICU. In 22 yrs it has never bothered me looking at a sick pt, but then again there was no emotional attachment as my wife and I have. This is absolutely killing me and is moving me towards wanting to seriously give up on nursing as a career. I work in an intense med/surg ICU and am sure I would not melt down taking care of my next vent pt. Sorry for the long winded message but I am just so lost right now and trying to hang to whatever I can that we(she and I) will get over this and continue to be together(as I always tell her, "we will grow old, and fat together baby"). Flaerman

I am really sorry to hear that your wife is so ill. Your next vent pt will likely get the best care yet. Not that you haven't likely given excellent care in the past, but now your awareness of this specific situation has been personally heightened. I hope that you and your wife get to grow old and fat together!

Ms Kylee · Jan 10, 2008

Since I'm not a nurse yet, I can only respond to what was the stressiest day as a nursing assistant...

I was taking before dinner blood sugars, and I went in to see my patient that was next on the list (I had a bunch that day). He was wrapped up in his blankets, shaking. It had to be 85 degrees in the room. I asked him if he was cold, and I got a weird answer. I took his vitals and his blood sugar, and while I was doing that, I was looking at his pupils, feeling his skin, etc.

I got everything including his sugar, and went to report to his nurse. I reported vitals, and sugar, how the skin felt, etc. I thought for sure he was having a sugar crash on me.

Altra, BSN, RN · Jan 10, 2008

Pediatric codes.

In the first one I participated in, I was "fine" until I started seeing other members of the team getting emotional. The RRT turned his back for a moment & blew his nose. The cop who had been first on the scene walked away with obvious tears in his eyes. Up until then I had been so hyper-focused on what was going on that my emotions were held in check by sheer adrenaline. Seeing others allow themselves to take in the larger picture - a child was dying - made it exponentially more difficult to remain clinical and non-emotional. We "successfully" resuscitated that child - she went to the unit with a pulse and breathing over the vent. But the overall clinical picture was so poor I felt like the parents were being cruelly deceived thinking that we had "saved" her.

A close second on the "most stressful moment" scale:

Being assigned to trauma but having 5 patients. Being in CT with one bad trauma, who I expected to code at any moment, while the other unstable hypotensive trauma patient was out of my sight, out of my reach, in the trauma bay.

Trauma Columnist · Jan 10, 2008

Flaerman - I am so sorry for the upheaval in your life and that of your precious wife. May you both have peace. Prayers...judi

As to my most stressful moment: July 1996, I was on orientation in the trauma bay of a level one trauma center and we coded a 4 y/o girl who had been tortured to death over a 90 minute period.

Fast forward two years later and I'm taking care of this depressed adult in the ER and she shares that she is depressed because her son was in prison for killing this baby! She stated to me, "well, he didn't want to babysit that child anyway." (As though to absolve him from guilt!).

What is wrong with people!!!???