New graduate reaction worries

[newnurse1611]

I am a new nurse (4th month) and I am worried I am not cut out for the job. I feel overwhelmed so easily and worry my emotions get the better of me. About one week ago I had a really horrible shift where a 23 year old patient deteriorated and had a cardiac arrest. Though I had witnessed a couple of rapid response calls for low bps and things, I had never been present for a cardiac arrest. During the cardiac arrest I felt so panicked, I managed to do everything correctly but I had to be prompted. I was able to do CPR for the first time which was a good learning experience, but the patient wasn't able to be saved and so after a while the doctor called it, the medical team left and myself and a few of the other nurses were left with the patient. I really tried not to but I started to cry and the nurse unit manager and some of the other staff took me in to the staff room to have little bit of a debrief. It just felt like I was in total panic whilst the arrest was occurring, my heart was racing and I felt almost sick. Then it was all over so suddenly and its like all the adrenaline from the rapid response just caused me to crumble.

Basically I am embarrassed that I cried as I didn't know this patient half as well as the other staff who had looked after her on and off for 2 years, so it seems selfish to put the attention on myself. I also didn't realise how messy the CPR could be, the patient just looked so awful and had all this green mucous like substance coming out of her nose and mouth during the CPR, and it was all just so intense. Seeing her young family come in distraught was heartbreaking and I couldn't even begin to imagine how they felt. Even thinking about the arrest now makes me feel emotional, and it has been a week.

Basically, I am just worried that next time I am involved in a cardiac arrest I will react the same way afterwards and worry that it is a sign that I am actually not fit for the job?

Nursing is tough

[megank5183]

Nursing is certainly tough! Your reaction is completely normal and in no way are you not meant for the job. You would be superhuman if, after four months on the job, you did not need prompting when participating in your first cardiac arrest. Additionally, the patient being so young would upset hopefully anyone and there is no need to feel embarrassed that you cried. Nurses are human and you just witnessed someone losing their life. Just because we work in the medical field does not mean that we leave our emotions at the door. I have been a nurse now for four years and I started out in the ICU and I felt sick EVERY DAY that I went to work. I still question myself constantly. I now work in psychiatry doing consults on the general medical floors and really love it. I would never want to go back to floor nursing because it is a TOUGH job. It is both emotionally and physically exhausting. Besides this incident, how else do you feel about the job? I can guarantee you that it is going to take AT LEAST a year to become even close to comfortable in your position. Being a RN is an awesome, respectable position where you can do a lot of good. Do not beat yourself up about how you are feeling. If, after a while, you still feel like you don't like floor nursing there are a bunch of other ways that you can use your degree. I would like to point out that some people are just more sensitive (including myself) and you are always going to meet patients that break your heart. It is important that you try to separate work from your personal life (I'll let you know how to do it when i figure it out Hang in there and I promise you it will get easier but having a heart is nothing you should ever feel ashamed about!

[Nola009]

I think it's ok that you cried #1 because the death of a young person would be shocking and sad for a lot of people and #2 you were letting go of some of the stress that situation caused. I also think you are underestimating yourself. This was another learning experience --- or, just an experience that will make you stronger and better!

[nursefelly]

I think it is unreasonable to expect that you wouldn't be emotionally affected by an incident like this. I'm only a brand new nursing student now, but I used to work as an EMT-B for a retirement community. I remember my first priority one patient ever. It was Christmas Day and he was vomiting blood. His wife was in the room and she was panicked and crying out of sheer worry for her husband. At first, her husband kept assuring her he'd be fine but after sometime (while waiting for the ambo), the man looked up at me and with the most heart-breaking looking on his face he asked me if he was going to die. After I was off the call, I went to the bathroom and cried my eyes out. My first Christmas as an EMT, I ended up with not just my first but also my second priority one patient. It really takes a lot out of you. However, I don't believe that crying over my patients meant I wasn't suited for the job nor do I believe you're not suited for your job. I believe that it shows that you really do care about your patients and to me that makes you a great nurse. I definitely say take the advice of megank5183 and just do your best to put up a barrier and leave your work at work. It will wear you down if you bring it home with you.

[ArtClassRN, ADN, RN]

Recently a 25 - year nurse cried in the med room because a manipulative old lady was mean to her.

Your actions and reactions appear perfectly normal.

If you like your job, keep at it. Things that haunt you at four months get easier to deal with as you gain experience. Codes are never fun (unless you are some sicko adrenalin junkie).

[HouTx, BSN, MSN, EdD]

Many organizations (like mine) routinely provide critical incident stress debriefing sessions for staff who have been involved in resuscitation efforts. Even when a 'code' is successful, it can be a traumatic experience.

Cumulative stress disorder has been identified as a serious problem for health care clinicians - and should be identified and managed in our occupational health programs. If your employer hasn't done so, start that ball rolling.