throwaway1

I've worked some in pediatrics in the past and enjoyed it greatly but decided against going completely into the field due to a bad experience I had in clinicals in nursing school. Silly, I know, but after working with some kids in the ER, I wonder if that might be a good avenue for me. It lights me up. And yes, there have been many other issues going on. The ER I'm working in has had 7 managers in 6 years. I've already had 2 managers in the 10 months I've been there. There is a lot of turnover and a lot of other problems which doesn't help in an already stressful department. I mean, they literally dissolved a bunch of nurses' positions while they were under contract and told them their only option to stay was to take over a 10 dollar pay cut. Needless to say, we lost many nurses that day so we got super short staffed. I had no orientation really to speak of. A nurse who was new to the ER and had only worked six months oriented me. There is even more, but I won't go into it. Something really clicked when I read that I base my self-worth as a nurse on my patients' happiness. It's something that I've noticed of myself even in my personal life. I fall apart if I feel I've upset someone due to my mistake, unintentionally or not. I take it as a sign that I'm a horrible person/nurse and that I've failed. Part of my struggle is that as I said, I wasn't my best self during that interaction. I think that if I had been my best self and she was still rude, it would be easier to let it go. However, I am usually very kind, patient, and understanding. (not tooting my own horn, I swear) I have always been the one that could take care of the overly emotional, dramatic, or difficult to please patient. I truthfully have in the past even been accused of being a doormat. I had talks with management about the need to be more assertive in the ER and due to a lot of work and personal stress, frustration with patients constantly arguing and refusing treatment, especially lately, I feel I was shorter with her than necessary. I could have reasoned with her more. As I said, I was not rude but the more I think on it, the more I know I should have been more understanding of her frustration and deescalated the situation instead of allowing my own frustration with her refusal to come through in speaking with her (which is why I think she felt I was rude.) Part of my feeling of failure in situations like this is that while I know that I did not deserve how she treated me, I feel solely responsible because I am the nurse. My job is to comfort my patients and not to let my own stress and frustration affect how I handle a situation. It makes me feel that I've let myself and my patient down but I also get so frustrated with having to be so perfect all the time. But the ER feels like a different ballgame. So many patients come in over and over crying over literally everything, anxious, and often extremely rude and/or demanding on top of that. When I first started here, I remember seeing patients come in crying and the other nurses rolling their eyes and being a bit cold and frustrated. I didn't understand it at first, but I find myself starting to feel that way too. It makes me literally hate myself and feel like a monster to say that sometimes you walk in the room and see that person who is always anxious/crying and demanding and you just want to walk back out (this patient was one of those people as well). You try to be kind, but recently it feels like my patience with fighting people just to do my job runs out. Just another reason I felt I needed to leave. I don't want to lose myself. Thank you very much for taking the time to talk with me and give thoughtful advice. I appreciate it more than you know. It's given me some peace of mind. I will definitely update you all on what I decide to do. I'm spending some time soul searching and really figuring out where to go from here.

I learned a lot being there for sure! Thank you very much for your kind wishes!

Thank you very much for your reply. You are right. I didn't harm her. I just struggle to think that I upset her in an already difficult situation. I've come to realize more the last few weeks that I am not a good fit for the ER. As you said, if I really loved it, I would push through and do what I need to do, but I just don't think it's right for me nor worth all the stress to me. This incident is just one more sign to me. I put in my resignation to my manager this morning.

You are right. As I mentioned to the other poster, I had given her the lasix 5-10 minutes ago and she had used a purewick previously with me, so I wrongly assumed I had a few minuted to get things worked out. I won't make that mistake again. I've been weighing things up heavily the last few weeks due to a myriad of issues and I actually did decide this morning to send my resignation in. Onwards and upwards!

Thank you. I really appreciate it!

Thank you for your reply and advice! You are right that I need to take it less personally. I'd like to clarify a few things. I actually did ask the doctor. I did not pretend to check. The doctor told me ICU does not allow it and she herself double checked because we wanted to make sure we were being fair. I had only given the lasix 5-10 minutes ago so I thought I would have a few minutes of time. Since she had done purewicks with me in the past, I did not anticipate it being an issue. I will not make that mistake again. As for letting her use the bedside commode while attached to BiPap, it is considered a safety issue similar to how we don't let people up to the restroom who are extremely weak or came in for a syncopal episode (which is why ICU doesn't allow it either) So if she wouldn't accept the purwick and bedpan and it is a safety issue to let them up, I don't really know what else to do. Thank you for your reply. I read it yesterday, and it turned my whole day around. I completely understand that I do need to toughen up my skin a bit. I have a habit of letting things get to me.

Thank you for your reply. As I said, I offered her a purewick as she has used many times before (including the last time I took care of her). She insisted she wanted a bedside commode so I said I would ask the doctor. The doctor checked with ICU and they said they do not allow the patients up to a bedside commode while on Bipap. They also use a purewick or foley. I was back in her room in less than 5 minutes and that is when this happened.

Thank you for your reply. I know you are right. I just feel like I don't know how to let it go because I could have handled it better. I think that if I was more patient like I normally am it wouldn't have happened. How do you accept that?

I'm truly begging for advice. I am sick to my stomach. I can hardly sleep. I was tossing and turning into the early morning and had to call off work today. I had just gotten on shift yesterday and there was a patient I had taken care of before. She was on BiPap (which she usually ends up on) and was in the ER overnight on hold for the ICU since we didn't have beds. She was tearful from the moment I walked in the room. The doctor requested that we remove her BiPap for a few minutes for her to talk to family about where she would like to be transferred. Another senior nurse and I went in and removed her BiPap. Her O2 sat began dropping rapidly, so we placed her on NC @ 5L and she came back up. I gave her a few minutes to talk on her phone and relayed to the doctor which hospital she would like to go to. Then the requests started. She can be kind of demanding. She said that she has a headache and wants Toradol since that normally works. I said no problem, I'll let the doctor know. She said she wants to eat, which I knew the doctor probably wouldn't allow, but I said I'd ask. I told her the doctor says you can't eat, but I got you another glass of water and let her have a few sips. He ordered magnesium on her, so I drew the lab for that and hung her magnesium drip. I told her once the doctor ordered her pain med I would come back to give it to her and told her that it was time to put the BiPap back on. I secured it and made sure that I asked her it wasn't too tight. She then states that she needs to use the restroom. I came back with her pain med and told her that we should do a PureWick since she is short of breath. She says, "I'm not short of breath. I want to get on a bedside commode." I said, "But your O2 sat dropped to 65% within 30 seconds when we took you off the BiPap." She did not need to be trying to transfer to a commode with the BiPap on. (We are also in the emergency room. It is ridiculous to think that staff should come transfer you with a BiPap on to a bedside commode every time you have to go. I did not say this out loud, just what I was thinking.) I ask if she's ever had a PureWick before. She says, "Well yeah," but insists the ICU staff puts her on the bedside commode and she needs to go desperately because of the Lasix. I say I will check with the doctor and walk out a bit frustrated and in a huff. I ask the doctor, and she says she will check with the ICU staff for consistency. (I normally try not to argue with the patient and just say it is up the doctor, but I have been told to work on being more assertive per management. I don't want to keep immediately running to the doctor for answers I know, so I tried to talk to her first.) The ICU staff confirmed: no, we do not get patients up with BiPap on. I walk back in and she is hysterically crying, yelling at me, "I heard what you said! You said 'I'm not doing that' as you walked out the door! I don't deserve this. I want a new nurse. Get out!" I tried to talk to her, but she wouldn't let me. I don't even recall saying that, but I guess it's possible. (Plus I don't really understand why even that phrase would be upsetting.) In my four years as a nurse, I've never been fired once. I am known as the overly soft and nice nurse. I know that I was more frustrated and less friendly than I normally would have been, but I was still courteous. Nobody could believe that I was fired from a patient. I couldn't stop crying. I don't understand what happened. I am sick over this. I know I could have been more patient with her like I normally am, but it feels like if I am anything less than perfect, this is what I get? And when the doctor tried to explain, she says the nurse was rude to me before that happened. I don't understand. I can't function like this. Please give me your opinion because I am baffled.

Thank you very much for your support and your kind words! I am feeling much better now after restarting my meds. I also checked in yesterday with the resident on-call and he said no issues with any of our patients. Since our patients come for follow up visits, they are monitored and we hear about anything that goes wrong. I am so thankful they are okay!! I am trying to have grace with myself, but to do that I feel like I need to know my patient is safe. Also, though unlikely, I've decided to get a blood test to make sure I can't pass anything to my patient since that is what would normally be done in a needlestick situation. A coworker also recommended I speak up and tell them that I don't like scrubbing, and I want to focus on circulating. My mental health is my priority right now. Thanks again to everyone who responded!

Thank you! I just restarted my medication yesterday. I was very stable on it. In the past, I have had some outside pressure to get off of my medication, and I let it get to me. I wasn't ready. So thank you for saying there is no shame in needing it. Also, I am realizing that I really need to work on doing stuff outside of work. Nursing is my whole life. I've lived here over a year and a half and have zero friends. I don't do anything outside of work besides hobbies at home. I literally just go to work, go grocery shopping, and sit at home. My whole identity is being a nurse. Do you have any advice for getting out of the house and making friends?

Thank you very much for taking the time to respond. The book you recommended looks like exactly what I need right now. I'm ordering it. ?

So I have a history of severe, anxiety, depression, and some OCD. I got off my meds a few months back and as expected had some issues but thought I was doing okay for the most part. I've been doing a pretty crappy job of taking care of myself recently and I just started being a scrub in the OR after circulating for about a year. I went through the training, and I wasn't asked to scrub for about a month and a half when they said they needed me to scrub a day. I went in extremely nervous. The first case of the day, I felt a prick feeling on my wrist. I lifted my arm and realized I was leaning on my loaded suture needle. I checked my glove, no hole. I dithered abut getting a new needle. It would have had to go through my gown sleeve and glove. Also, I feel bad saying I was worried about how incompetent I was looking to the surgeon that day. I have made many mistakes before and owned up to them. At the end of the day, I inspected my arm extremely closely, and it looked like there might have been a small red spot in that area. I had a mental breakdown about it afterwards. I had to call out for work. It's several weeks later and I've just had another breakdown. I feel so guilty even though I know the patient is okay. I'm thinking about quitting as I don't feel like I deserve to be a nurse anymore. Does anyone have any advice? What should I do?