Nerves Are Shot!

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I am on vacation this week, and already, I am regretting that this week will be over and I'll be back to the grind on Monday. I sit here shaking sometimes, sad the next and ready to cry. There is a fine line between trying to take care of the needs of the patients, complying to stupid rules and making serious attempts to keep our sanity.

We deal with a high volume of illegal immigrants and poor people who literally have no clue about health care. It is so crowded in the waiting area. Each morning I walk in, I see LINES and LINES of people...some in walkers, wheelchairs, elderly, people bringing in their pre-school aged children to interpet for them, many are argumentative, many are really sick. By the time I get behind the door, nurses are running like insane rabbits trying to see them. By the time the patient gets to us, they are tired, disillusioned, angry, argumentative, placing blame on us. Cognitively, I know that they are unaware of what really goes on behind the scenes of the hospital. But, it doesn't make it easier to deal with them cursing us out. I cannot control the lines, or all of the mess, but I do have to try and practice safely. In fact, the more rushed I feel, the more I HAVE to slow down, before I make a mistake that I cannot take back.

It is hard to try and explain to a person that they are hypertensive or diabetic when they literally do not know that they have blood flowing through their veins (no exaggeration, folks). Sometimes, giving even the simplest explanation confuses them even more. Plenty of times, when I use the language hotline, the phone interpeters have told us that there is nothing they can do for us because this person has no concept of what they are talking about. Many of them do not know their birthdates (some of their countries don't consider this to be important), not even their addresses. Many will tell the interpeters that they do not want to have a phone translator, they want someone in person(...yeah, right...like this will happen quickly). A simple thing like a flu shot that should take ten minutes tops can be a situation that draws out for over one hour. Then, after all of that, to experience this AGAIN with about 10 more people. It can drain your energy to the toilet in two hours. I try to remember that these are someone's mother, father, sister, parent, brother, friend, clergyman, etc...but it is hard. Sometimes, I just want to run for the hills. Sometimes, it looks like a third world country walking in there, and many times, I have had to walk away from people in mid sentence before I say something that I can't take back. And management says to give it your ALL. If I did that, I would have nothing left.

When work is over, I don't want to socialize very often...I want to go straight home to bed. Read about something other than illness and nursing. Read romance, street novels, look at reality TV... I take a cab home each night to avoid more personalities and interactions with people because they are so draining. I have small rituals of pacing the floor each morning to stomp out my plantar faciitis and say to myself "You can do this". I walk out, feel the air, and from then, it is an adrenaline rush to make it back home to safety.

Thanks for listening to me vent guys. And, you all have helped by just existing and reading that I am not the only nurse that feels this way. Thank you.

Specializes in Community Health, Med-Surg, Home Health.
Reject the notion that dreading your job, and shaking and crying over your job, is some kind of norm. Reject it. "Time management skills" my derriere. Those won't help you when you're dealing with chaos or near-chaos.

Make plans to get out.

It's not you, it's the bloody system. Going down the tubes.

I can agree with you on the time management skills not an appropriate suggestion under these circumstances, but leaving is not an option because I owe them time under a contract that was made when they paid my way to become a nurse. Making plans, though, makes sense, and that is what I am doing. I am getting all of the experience I can gather while under their contract so that I have a nice, padded resume to sell myself with when I do leave.

Specializes in Community Health, Med-Surg, Home Health.

You are correct, marie, it can be indentured servitude. What we looked at when we signed is that the license will be useful anywhere. I do have other avenues of employment and my bills are paid, have more money in the bank than I ever would have had as an aide. And, I had an automatic position-did not have to experience the job search the same way as new grads do.

I can also look at the positive; the powers that be do really like me. I have no issues with them. They try and give me all that I need in terms of overtime, working in a clinic (believe me, the wards are WORST), and opportunities to learn as much as I can. I am on committees where I meet people that try and guide me very often. It is just that this situation dealing with the patients is impossible at best. Most of us know this whether they openly speak of it or not. And, they help me to deal with things under the circumstances. But, this, is not patient care. It is barnyard medicine disguised in an attractive building and modern technology. And, yeah, it is the bloody system going down the tubes. I can applaud your sentiments there!

Here I am at 12 am unable to sleep after coming home from work after my 4th shift in a row (what was I thinking?), unable to sleep because my brain won't stop after all the week's stress! I was glad to read about someone else's emotions mirroring my own...I don't feel so alone. When I finished today, I went to dinner with my husband, and could not even focus on what he was saying! I've only been a nurse since 8/07, so I'm still coping with the reality of nursing, and all I want to do when I get home is crawl into bed and watch light fluffy tv. We also have a preschool aged child, I am in an RN BSN program, and I work part time as a laser nurse. Husband's a stay at home dad while he studies for his architectural boards. I too find it exhausting to socialize, it's like my patient's suck all my energy out, I'm drained! When I get home I feel weird, like I'm in a different world. People tell me what the weather was like during the day (I'm on a second floor and don't go outside the bulding during my shift!). This weekend (saturday, sunday, monday, tuesday)I had 5 patients:

-an acute meningitis (unsure still whether or not bacterial or viral-glucose in LP was 38, protein high, but pt. has rheumatoid and was taking a lot of home meds) and I came in this morning to find an infiltrated vanco IV left over from night shift on this pt. (pt. said she told the nurse at 2 am the iv site was really burning) who was also cultured by me on every bodily orifice but we got a bedside PICC today, she gets 4 different antibioitcs.

- a TURP pt. (never seen such huge clots in my life) with COPD and bipolar disorder, with a peg tube. Well, he sneezed while I was putting in his can of ensure into his peg and it got all over my scrubs, and he had a bm at the same time, poor guy.

- a bedside cystscopy on an elderly pt. (who also got a dobhoff dropped by me during shift) after I had attempted twice to get in a Foley (french 16, 18) the words out of the urologist mouth where"I have never seen a stone this huge before, no wonder you couldn't get a foley in" (duh). This happened at 1930 yesterday. Temps of 102-103. CHF and small bowel obstruction. 91 year old full code. Today I got to start him on TPN, and culture his central line site. I had passed on to night shift the central line dressing change because it was on the right femoral and from the cystscopy everything was all wet and nasty. Mind you I stayed with the night shift nurse during the whole urology procedure to help her out (I left at 20:30), she was understandably flustered (doc was not too nice). But for whatever reason she was unable to change the central line dressing during her shift. When I came in Saturday this little guy was supposed to drink to gallons of Go-Lightly for a colonoscopy today. He drank 1 cup, choked and then vomited. And vomited... and vomited. Doc d/c colonoscopy order, dropped the tube.

- A dressing change requiring Daken's solution, clorhexydine scrubbing and a lot of packing (necrotizing fascitis on right upper arm from skin popping heroin), as well as seizures precautions for withdrawal and pain management. Tons of IV therapy. Physical therapy was to do the dressing change, but they were unavailable over weekend so I did it. I happily called them Monday morning to remind them that I was passing the baton.

- And my easy patient, a minimally invasive knee replacement with an orthopat (reinfused her blood 3 times), cryocuff, scd to non operative leg. PT was getting her up obviously, but we watched her closely because she had duramorph and was having those scary 80-90 systolics and vomiting post op. Telemetry monitoring r/t a fib hx. But today she was perfect, will probably go home tomorrow.

Did I mention I work on a surgical floor (yeah right)? At least I had good CNA's who understand team nursing. No aids over the weekend ( they called out). But today was good because we had some awesome BSN students who were focused and eager to learn and do procedures. It's weird to be such a new nurse and have students assigned to me, but the best part of my day was teaching them. I'm sorry this was so long, but Ireally had to vent. No one at home can relate, and I don't want to complain to my co-workers...

Mimi

Specializes in ICU, CCU, Trauma, neuro, Geriatrics.

Could you have someone make signs in all the foreign languages that say, "Don't shout at the nurses they are here to help you" "Telephone interpretation allows EVERYONE to be helped" Just a suggestion but it may suggest a limit on the angry swearing and shouting.

Specializes in Clinical Research, Outpt Women's Health.

Pagandeva,

Hugs to you for working so hard and caring. That said you need to take a giant step back and manage your expectations. It sounds like you are stuck for a time so the only thing you can do is accept the limitiations of what you can do.

Be kind, be caring, and do the best you can. Then you must let it go. You are allowing too much to be piled on your shoulders.

Do what you can and then take a deep breath and allow yourself to relax. It will all be there again tomorrow so do not KIL and burn yourself out.

Let go a little. You can do that and still be a good nurse.

At the end of the day you are not responsible for all those people's situations.

So clock out and move on to living your life the rest of the time.

They will still be very lucky to have you!

Specializes in Med-Surg.

I hate to hear that your daily grind is so bad, it is ruining what should be very pleasant for you.

:hgu:

Sounds like you have far too much to deal with at your current position. Have you considered something less stressful (yea, I know nursing is stressful, but some positions are less so).

Also, I dont' know if you have tried this or not, but my husband recommends his patients with plantar fasciitis to freeze a bottle of water at night, and in the am put it on the floor and roll it under your feet. A lot of patients have said it helps.

Wish you the best dear. And remember, it is just a job. Your job supports home, not the other way around. So don't let it stress you so much you can't enjoy your time away.

Aw, honey, I just saw this.

I can't imagine working in your clinic.

Have you thought of taking Spanish? Would that help?

And I'm a phone call away, girlfriend. You can always vent at me aloud.

:)

Specializes in Corrections, neurology, dialysis.

How much would you have to pay if you quit before you put in your time for the financial aid? It might be worth it to pay them back and move on to a better situation.

My own clinic manager suggested this to me once. She said "go ahead and get the financial aid, then once you get graduate get another job. You would make more money someplace else and be able to pay off the financial aid in a couple of pay checks."

It turns out I didn't take the financial aid and found some other ways of paying for school. But the advice stuck with me. Sometimes what you have to pay back is the cost of doing business, or in this case, getting farther ahead in life.

Specializes in LTC, Med/Surg, Peds, ICU, Tele.

It was exhausting just reading your post, PaganDeva! Good luck!

Specializes in Community Health, Med-Surg, Home Health.
I hate to hear that your daily grind is so bad, it is ruining what should be very pleasant for you.

:hgu:

Sounds like you have far too much to deal with at your current position. Have you considered something less stressful (yea, I know nursing is stressful, but some positions are less so).

Also, I dont' know if you have tried this or not, but my husband recommends his patients with plantar fasciitis to freeze a bottle of water at night, and in the am put it on the floor and roll it under your feet. A lot of patients have said it helps.

Wish you the best dear. And remember, it is just a job. Your job supports home, not the other way around. So don't let it stress you so much you can't enjoy your time away.

Thank you for your hug. I went to see a podiatrist today, a private one rather than one at my job, and he suggested the water bottle. He gave me injections of Kenalog and dextamethasone, and told me that it would be best that I get several injections of this (at least 3 more sessions), ordered an xray and I will probably purchase a pair of his orthortics.

Not sure about changing positions at this time, because the clinic is the lesser of the two evils, believe it or not (can you imagine going through this plus more at the bedside??), and I get weekends and holidays off. Again, thanks for the kind words and advice.

Specializes in Community Health, Med-Surg, Home Health.
How much would you have to pay if you quit before you put in your time for the financial aid? It might be worth it to pay them back and move on to a better situation.

My own clinic manager suggested this to me once. She said "go ahead and get the financial aid, then once you get graduate get another job. You would make more money someplace else and be able to pay off the financial aid in a couple of pay checks."

It turns out I didn't take the financial aid and found some other ways of paying for school. But the advice stuck with me. Sometimes what you have to pay back is the cost of doing business, or in this case, getting farther ahead in life.

It would be a considerable sum to pay back. At this moment, the tally includes our paid salary, paid tuition/books and also, the salary of the agency person who took my place while I was gone. This leaves a balance of at least $60,000 for an LPN to repay...impossible. Thanks, though...words to the wise...be careful about tuition pay for these facilities!

Specializes in Community Health, Med-Surg, Home Health.
Aw, honey, I just saw this.

I can't imagine working in your clinic.

Have you thought of taking Spanish? Would that help?

And I'm a phone call away, girlfriend. You can always vent at me aloud.

:)

I have thought about learning Medical Spanish, but am not in a rush to. It would be extra money to spend that would take me from my goal to financial freedom (just a daydream...financial freedom would never happen). Also, it is not just Spanish, it would be Punjabi, Hindi, Mandarin Chinese, etc...

Thank you my friend!!

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