"Coulda, Woulda, Shoulda"

meownsmile, BSN, RN · Apr 7, 2006

Im going to venture a guess that you are a new nurse? It is the nature of the beast but as you get experience you learn that everything does NOT rest on your shoulders. We are human, we make human mistakes, we have human emotions and reasoning (although sometimes that works against us). It gets better as you get experience, but i think we all have that little nagging voice in the back of our heads sometimes when things dont go the way we think they should. There just isnt much you can do about it.

chadash · Apr 7, 2006

Does anyone else agonize over what they possibly did wrong, or how they could have done something better? Does anyone else fear for a patient's outcome and feel miserable, like it's their fault, if things don't go right? Does anyone else feel responsible for things that happen? Why is this job so consuming...I wish I didn't feel this way, but I do. Is it the nature of the beast? How do you get over it, or how do you recoup if something goes bad????

Oh bless your heart! I want you for my family if we are sick!

And, irishgirl, take it from an oldirishlady, it is the curse of the celtics! Caring, worrying, obsessing, God bless you.....

rnElaine · Apr 7, 2006

It sounds from your message that maybe there was a less than desireable outcome in some area and you are somehow feeling responsible. I do know what you mean. I feel the same curse and have wondered the same things. I've been in l/d for 6 years - not exactly a new nurse. I still feel the feelings you are mentioning. However, these experiences do definitely teach you a great deal and you do get through them - maybe never forget them, but you do eventually get through them. And, it can definitely make you a better nurse if you try to learn from it.

mainstream · Apr 7, 2006

Go easy on yourself. Ive been in surgery for 24 years and I can assure you I have seen Coulda, Woulda, Shouldof's in all areas of the OR from every health profession. But always realize with each new day comes another opportunity to give the best care to your patients that you can and that is the continual gift of the health care professional.

fergus51 · Apr 7, 2006

I get that sometimes, but much less than I used to. It took a friend telling me to get over myself for me to finally get it. She basically pointed out that I was a small piece of the puzzle. There are docs, other nurses, rts, pharmacists, etc all working to care for "my" patients. I am not the end all and be all for my patients. Just like I wouldn't take sole credit for them having a good outcome, I can't take sole credit for them having a bad outcome.

I do my best. If I have those feelings, I'll discuss it with a coworker/friend. If she says I did the right things, then I believe her. I've come to realize that I don't control the world and that I can do everything right and that doesn't guarantee my patients will do well. I've also learned that I can sometimes make mistakes that don't cause harm.

onarie · Apr 7, 2006

Sometimes I think that what you are saying is typical of nurses. Isn't that why we went into nursing - because we care about people, we want to help people, be a part of the solution? I know there are many nights that I have gone home and went over things mentally and wondered what I shoulda/coulda done differently. And then if something happens to a patient - well let's just say lots of self re-evaluation of what I did. I have been on the floor six months now, and at least now I don't mentally review every patient every day when I go home. So, I believe/hope that in time I will continue to review my activities - to make sure that I am taking the best care that I can of my patients - but not be so overly criticial of what I did during my shift that day to care for the patient. Several senior nurses on my floor have reminded me - I am there for my shift - nursing a patient is a 24 hr/day job - my co-workers are there to help me and TOGETHER our efforts work to enable the patient to go home.

bethin · Apr 7, 2006

I feel that way especially after a very busy shift where I don't feel that I gave enough time to each patient. I never used to feel that way but lately I have the same feelings you do. I've been an aide for 5 years so God only knows why it's just now creeping up on me. I'm thinking maybe part of the guilt is coming from my supervisor who never speaks to me. She sees my work but never makes positive comments. It makes me feel that I'm not doing a good enough job.

wonka · Apr 7, 2006

It sounds like you really care for your patients and that you are doing all that you can to help - in that case, the couldas, etc. are phantom worries...you are doing everything you personally can to help and more!

vamedic4, EMT-P · Apr 7, 2006

Does anyone else agonize over what they possibly did wrong, or how they could have done something better? Does anyone else fear for a patient's outcome and feel miserable, like it's their fault, if things don't go right? Does anyone else feel responsible for things that happen? Why is this job so consuming...I wish I didn't feel this way, but I do. Is it the nature of the beast? How do you get over it, or how do you recoup if something goes bad????

Best thing I've found to do?? Don't agonize over the outcome, you won't last long if you do. Second guessing yourself is part of any decision making endeavor...and when dealing with lives it's scary as hell.

After the experience is over, take a look at the events leading up, and perhaps just ask yourself some SIMPLE questions..did I call the doc at the right time? Did I do everything I could to help?? OF course you did.

I had a patient in 1988 as an EMT who threatened his girlfriend with a knife, bit her...pulled her earrings out (down thru her lobes), then took the knife to his own arm...he did it right...cut himself almost to the bone from his elbow to his wrist.

Bleeding profusely on the concrete when we arrived, we wrapped him up and put him in the back of the ambulance. The medic set the patient on the cot and I obtained his blood pressure and other VS. He's crying..."I just wanna see my baby..." all that drama...when all of a sudden...he pulls out the knife!!

Luckily for us he sets it down right beside me..then he does the craziest thing I've ever personally seen in 17 years of EMS...he jumps out of the back of the ambulance at 55 mph. He bounced a few times but was still conscious when we reached him for the "rest" of the trip to the ER.

I have no idea whether or not he's still alive today, but I look back and wonder - hey, if he had been secured on the cot...would that have happened? I don't know...maybe if he had been "secured", he would have fought us and probably stabbed the both of us. Who knows?

Let each situation teach you something, so that you can do the best you can the next time. Every day in this business is a learning experience.

And have a great day!!

vamedic4

Dallas TX

Antikigirl, ASN, RN · Apr 7, 2006

I think we all do, especially when we are newer. I call them the 'what if's', and I have made it a habit to allways say in responce to the 'what if's'...."what if I learn from it!". That seems to help a ton! Focus on the positive things you CAN change or do...instead of the 'what if's' that you can't control or change. And that doesn't stop with nursing...that can be for any universal situation! (I use that a lot!).

If I focus on taking out parts of the situation that are "what if's" that I can't control...it makes a situation more realistic and less confusing for my mind! Then I can work on the learning from it, and doing anything I can do to help the situation :). It is kinda like cutting the fat off a probelm :).

Good luck to you...and yes, been there...fretted about it...hit my head on several walls...learned from it all :).

Humbled_Nurse · Apr 7, 2006

Been there done that! Been a nurse almost 8 years and still have those days as a matter of fact had one of those days yesterday. Most days go well, buy on occassion there is a day that you doubt your abilities and confidence as a nurse. People that aren't in the medical field can't understand the daily stress nurses have. We literally have people's lives in our hands. There are some days I wish I could just be responsible for emptying the trash and cleaning toilets :) I know that God has a special place in his heart for all nurses and we will be rewarded someday so hang in there!