Older RN, Post TIA

[oldandnew]

As my name says: I am an older RN, but new at it as I graduated 18 months ago.I spent 6 months on acute care/ortho floor until autoimmune issues kicked up and slowed me down. With as many as 8 and no less than 7 patients during the day shift, I had to resign. In short order I landed new job at a mental health day facility where I had done my clinicals, in the area I had hoped for. The only site RN with one Dr. on staff, four ten hour days, my own office with my own bathroom. I felt I could work there till I was ready to retire. Such a perfect set up! But things got all shook up when the dr. quit, leaving me the only licensed person on site. I was being asked to do things I was not trained to do as well as things that were putting my license at risk. After 2 months of functioning pretty well...I thought, I had a TIA. Well it is called a mini-stroke, but the end results have not felt so "mini". I was in hospital for a day, off of work per PCP for a week, then back full swing. I thought I was fine: no residual physical effects. BUT being back at work showed me the cognitive deficits: memory issues (I had to relearn a new EHR program I had just learned the week before), I've typed since I was 15, here at 55 I do not remember where keys are and spend time fixing errors; procedures, processes I had known and used left me loopy and feeling like an idiot. I had some speech issues even though speech therapist had passed me off in hospital. I found under stress it was much worse. I would look at forms as though it were the first time. Needless to say all of this slowed me down...a lot. In addition, the site administrator, one of my bosses, asked if I was ok giving meds. I said, "of course, I will not make a mistake...I follow habits long established." Well, number one rule: don't accept the word of someone who has cognitive issues!!! In my second week back, I had a consumer come for an injection, which I gave after following protocols and policy...I thought. So two weeks later when he returns for the next injection, in going through proper steps of reading dr. orders, I see he is one week early; not every two weeks but every three weeks. So I send him back. But this caused me to double check previous appointments including when I was out of commission. I do not know why he was in the system to come for the injection at the two week mark when it was not supposed to be for another week. I do not know why I would not have caught that by reading dr. orders and sent him back, but being in the state I was, I gave him his injection. After finding the mistake from two weeks earlier, I reported it immediately, to all I was supposed to including the Head Dr. Head RN. The dr. asked for all info on patient, which I had done the VS and assessed when I had him in my office before sending him back without the injection. All was WNL. I reported all to the dr. he said b/c the patient had been on the med for over 20 years, he doubted there were any problems and there were not. I asked for medical leave and then have since resigned. My confidence completely shaken and now wonder is there any future for an older RN that is new but is slowed by health issues, in particular post-stroke. True I am getting over the cognitive deficits, but still run into walls, and even prior to the stroke I have had the sense that I am losing intelligence and ability to think clearly. My Dr. is running gamut of tests to see what it all means. I can't really make a decision on employment till all results are in. I will be sad to lose my earning potential; the plan we had in place to have home and debts paid off and retirement lined up by the time our baby, a sophomore, begins college. I will be sad that my 40 year old dream and hard work to become RN at the age of 53 is for naught. But I certainly do not want to put patients at risk. What job can I do as an inexperienced, ADN degree of nursing. Education would be ideal, but it requires so much more schooling, which I do not have the money for at this time. I need the income now or we will slide further into debt. Am I done? Or is there something I can do safely, within time constraints facilities place on us now, etc.? Right now the way I feel is that the stress and effects on my health have been so intense, and since I still need an income, I would be happy, truly happy being a greeter at Walmart, rather than the politics and games and stuff that goes on where ever RN's work and doubt my abilities anyway. Any insights would be appreciated!

[skicoachrn]

I feel for you. You have been through a lot. I think if you still have a dream, and still have a strong desire to work you can find your place as an RN. In fact, it may be the healthiest (albeit hard) thing for your recovery from the TIA. You will work your brain and keep learning and that will help rewire your brain. And remember we ALL forget stuff every day, and have to look it all up again. That is why there are resource books everywhere! It will be challenging for you, but don't give up! Find a pace you can handle.

hugs.

[Ruby Vee, BSN]

i'm so sorry about your health issues! as i read your post, i couldn't help but wonder how many more years i (at 55) can continue to function at the level i always have. i could have an mi or a cva and be in the same spot you're in, so i feel for you.

that said, i really don't have any advice for you, except continue to follow up on your health issues. you're probably already getting cognitive testing. your doctor is the person to start with in terms of your prognosis and what kind of work you will be able to do. if you are unable to work due to health issues, you will probably qualify for some sort of disability, so pursue that.

and keep us posted on your progress.

[Soyrizo]

I don't think you're down for the count yet, but you need to make taking care of yourself your first priority and that may mean you need to look for part time employment at an "easier" job.

I had an illness earlier this year and I was convinced if I just worked really hard to get back to normal, it would work. Spectacular FAIL. Sometimes I think when we're struggling with illness and pressures in life, even though it's counterintuitive, the best thing to do is just let things come as they may and go with it. Your body, your mind is telling you it needs a break. Give it a break and maybe you'll find you're in an even better position as a nurse. Good luck.

[NurseCard, ADN]

I wish I had advice for you, but unfortunately I don't. I just want to say that I sincerely hope that things get better for you.

My mom was a nurse, until she retired last year. She actually worked for about 10 years or so, with cognitive and memory issues stemming (supposedly) from issues relating to her being involved in Desert Storm. She has also been diagnosed with depression and fibromyalgia. She had a fairly simple job working in an Outpatient Surgery department, until she finally had to retire somewhat early because her issues had escalated.

Also, I used to work with an LPN who had severe and numerous health issues, including something like 2-3 strokes; however she was still working full time AND, I believe, going to RN school.

You said that your cognitive issues have improved; I believe they can improve even more! Take heart, and take care of yourself!! Like you said, maybe you can work as a Wal Mart greeter or something while you are improving.

Good luck!!!!! :heartbeat

[nurse2033, MSN, RN]

Wow, I'm sending you a big fat hug. I work with two nurses (in ICU) who both had strokes in the past year (one in her 30s, on in her 40s). They have both recovered extremely well but stress and fatigue is one thing they struggle with. Get the best medical care you can, and follow your doctor's advice to a T. Be a good patient. As you feel better I think your doubts will subside. You sound extremely responsible and want to do the right thing. Perhaps you need new routines or strategies to compensate. Don't be afraid to look at your performance and find new ways to get the job done. Best of luck.

[Davey Do]

What they said.

[oldandnew]

WOW! What an awesome community of support!!! Thank you all so much.

I am so grateful to have heard from each of you, thanks for the hugs, and time you took to "listen" and give me some feedback. You have each given me something to think about and work with. I have one more test this week and will definitely be talking to the dr about options I have. I so appreciate the feedback from those who have had strokes or know/work with those who have. Seeing things from your angles is very educational for me. The stress and fatigue are really big factors. After posting this, I got a Facebook message from the daughter of an old friend. The daughter was an EMT, and after hearing about me going to nursing school, she too went back and graduated six months ago. She contacted me asking me if I would be interested in flight nurse job. She has been working for company for four months now and they need someone. WOW what timing! I told her my situation and that I need to get this last test and eval from dr. before I could commit and that she and boss need to understand where I am coming from. I would be flying with her mostly, there are two RN's to each flight. We are on call Mon-Fri 7-3, mostly stateside, no over night but about once a month an international flight with overnight. Pay not as good as what I was making, but she averages 3 flights a week, that is two days home, plus the fun of the travel. The hardest patients she has are the vents, (I had some exp with those in precepting at LTAC) and do not mind those, all are on pumps, documenting is three pages of paper, no computer, the field is about an hour's drive, depending on time of day. She has gotten back as late as 2 a.m. on some flights, if they stay over they of course put her in her own hotel room, and they feed her regardless of overnight or not. So far she has had no crisis. I am thinking wow: what could be better than that ratio? 2 RN's to one patient? She says stress is practically zero. So if any of you have any feedback or ideas on this possible opportunity. She will talk to the boss and see if they are willing to work with me, I will talk to family to see if they want to support me in this and dr. to see if it is something I should do physically, and we will see. I had been in process of applying for substitute school nurse job which would put me on same schedule as my 16 year old, which is big to me, but much less pay (not too much a factor if family is taken care of), but possibly more stress? one nurse to many kids and kids tend to go down faster than adults. But chances of there being anything awful are small, but still have to be prepared for that possibility. So that is where I am now, looking at these two options and waiting to finish things up with the dr.s over next two weeks.

Thank you all again. My prayers are with you all and the loads you all carry and do so gracefully!