Need encouragement - sad and stressed

[natsumi]

Hi nurses, I have been feeling so stressed, emotionally burdened, sad, and tense lately. Let me give you some context. (This is a long post.)

I started a job in inpatient oncology a few months ago (not my 1st job) and even though I thought this was exactly where I wanted to be as a nurse, I think I was wrong. It has been so sad to watch people suffer and pass away, especially young people. I know it is part of the job, but I didn't anticipate it would be this hard. I get flashbacks and nightmares sometimes of my dying patients, and it is very difficult for me to shake it off sometimes. By the way, I am not emotionally attached to specific patients or anything like that. It is the overall suffering here that bothers me.

My husband has been travelling for work, pretty much gone for most of the time I have been at my new job. He is a great listener and very empathetic but we all know that if someone isn't a nurse, they just can't understand what we are experiencing. On top of that, I work night shift (I used to work day shift) so I am feeling pretty isolated and alone.

I see friends 1x/week or more, and I chat with some on a regular basis, but I feel like I am a "debbie downer" or that they dismiss my feelings. Obviously work isn't the only thing I talk about but if they ask, I will start to open up a bit and gauge how they will handle the subject of death/suffering and my feelings related to my job. I feel that most of the time, they become uncomfortable and some have said things like "oh, I'm sure it's not that bad" or "it'll be fine" or "I GUESS that can be frustrating."

I do a lot of things on my days off, such as exercise, get fresh air, cook, read, etc., so it's not like I sit around and dwell. But I cannot shake the feelings or images from my mind sometimes. Even when I am busy or being active, I will get these sudden pangs or a pit in my stomach thinking about things that have happened at work.

As for my coworkers, who are fantastic nurses, I have confided in a few only asking advice about dealing with the suffering and sadness of our unit, and they have basically told me it is ok to cry sometimes but I will just get used to it. I don't feel comfortable sharing anymore of what I'm going through with them since I am new and I don't want people to think they need to treat me with kid gloves.

Before each shift, I feel tense and anxious and find myself pacing in the elevator for example. I don't let anything show at work and am really focused on patient care, but I just feel...crazy.

If you made it this far, THANK YOU for reading. Can anyone offer words of encouragement or advice? Has anyone been through this or anything similar? How did you get past it? Should I seek professional help?

[VivaLasViejas, ASN, RN]

I believe the rule of thumb is, if you THINK you need professional help.......you do.

As for "getting used to it", in time you will adjust and be able to handle things better emotionally, but I hope you never become so "used to it" that you lose your compassion and humanity. It really is OK to cry sometimes; obviously you're not going to want to be a blubbering mess at the bedside and needing comfort more than that patient or family, but there's nothing wrong with a few tears. The nurse I remember best from my husband's time in the hospital last summer, when he was diagnosed with stage IV carcinoid tumor of the pancreas, was the one who misted up as she hugged me while I was crying. She didn't lose control, but it touched me greatly that she shared our sorrow.

It sounds to me like you do a good job of taking care of yourself when you're off-duty. Keep up the good work; I think it probably helps you more than you know.

I wish I had more of value to offer you, but just know that you are not the first, nor will you be the last to feel anguish in such circumstances. IMHO being able to feel makes you a better nurse, however, you have to manage it so that you don't spend your days agonizing. Life is too short for such misery. In the meantime, do see a mental health professional (you can always try the Employee Assistance Program if your workplace has one); they can help you find constructive ways to deal with the emotional side of your job.

Wishing you the very best, and Thank You for your work with cancer patients!

[Mysteriousdarkness]

I struggled with this too- seeing people, sick and dying is stressful and heartbreaking, there's no denying that. It's a traumatic thing to witness someone's last days/ moments, and even more traumatic to prepare the body, perform the last care etc. I am still haunted by the deaths of people I cared for years ago- their names or faces come to mind and I still feel sad.

One young lady dying was the reason I left acute hospitals and actually moved into aged care for years because I couldn't watch young people die- it damn near destroyed me. I held her hand and sang to her, I watched the colour leave her face as she died. I went home and applied for every non-hospital job I could find. I got into aged care.

At least the elderly have lived long lives and achieved the things they wanted- a lot of them are quite ready for death and are very peaceful about its coming. That gave me peace- to see their peace. Rather than being traumatic, there was something special about caring for someone at the end of their long life as they peacefully awaited the next stage (god, reincarnation, peace- whatever they believed). Rather than be horrified and traumatised, I tended to feel more thankful- thankful they got the peaceful quiet painless death they wanted and could now move on to whatever's next which is what they wanted. Many talked about heaven, god, seeing dead loved ones again- it was very comforting to know they were prepared and content.

But deaths till bothered me- I still got attached and would mourn and grieve for my lost patients- I cared too much. Even though I knew they were in a better place- it hurt me to miss them. But I'm someone who is very sensitive to suffering and death- I get very attached and it was like a kick in the stomach every time I heard a patient had died overnight- especially if it was a surprise or a patient I particularly bonded with. I'll never forget trying to comfort an old man who was terrified of death- he knew he was dying and predicted it would be that night (he was right). I also knew he'd die that night, I could see it in his colour and face. The fear in that mans voice I will never forget. What could I say? I couldn't lie to him- we both knew it was the end. He had no family, no friends, no money or belongings, nothing. It was all I could do to hold his hand and swear that he wouldn't be in pain, and encourage him to talk about his belief in god and heaven- this comforted him. My shift finished but I stayed for hours, until the palliative care team took over.

i quit not long after that. I was done. My heart just couldn't cope anymore. I don't think that I'll ever nurse again- not in any area, not even in support roles that don't involve patients. I'm going to become a teacher.

you could try areas of nursing where there isn't so much death- med/ surg, endoscopy, day dialysis, blood bank, doctors clinic, district community nurse, school nurse- the possibilities are endless. Don't give up yet- I tried for 5 years before I called it a day.

In the meantime you should find a counsellor- they can talk you through these nightmares and negative feelings you are having about what you have seen and help you come to terms and to peace with it. They can also help guide you towards finding ways to cope with the sad things we sometimes do see in any area of nursing. Therapists have really helped me.

always remember- the only reason you feel sad and haunted by memories is because you cared in the first place, and caring is the most important part of being a nurse. So you gave your patients your care and compassion- they need that more than any drug or medical procedure