RN recovering from perfectionism burnout seeks experienced ICU advice

[Good_day]

After enough years in medsurg to call myself experienced, I resigned. Ongoing health problems that could eventually only be attributed to stress led me to do this. I thought it would be good to sit back & take a look at my path.

I was good at my job, often receiving good feedback from patients/families and colleagues. I was often in charge, and believe that was my downfall. Keeping track of my own business was manageable, but assuming responsibility for the floor, core measures, HCAHPS became the death of me.

Through some research & insight into what I did well & where I faltered- I realized that I am a perfectionist. When I was at work, it all had to be done, down to the smallest detail. On the scale of one person- that's stressful but manageable. Up that to an entire floor, it's near impossible without a melt-down.

If recognizing the problem is the first step to recovery, then I'm recovering. But I know that going back into floor nursing would inevitably lead to some "learning opportunities" while fighting these perfectionist tendencies.

So I'm at a bit of a loss as to what kind of nursing I should try. My instinct is some kind of QC or core measure position, but there aren't any of those available here, now. My options are back into floor nursing, nursing home, or home health. I would prefer to avoid the latter two, only due to past personal experience.

I'm not the type to over look a sick pt in order to make sure the nurses station is clean, or one who feels compulsions. I would just feel disappointed in my self if EVERYTHING was not perfectly set up for the next shift. I would feel like I failed.

i also struggled with the belief that everyone else expected perfection from me. That can wear you down quickly, mentally & physically.

An old friend thinks she can land me an ICU position in a small hospital. Part of me thinks that the ability to care for a smaller group of patients & really dive into their care- would be good for me. The other part of me worries that the intense period of tackling the steep learning curve would have me in knots- the fear of being judged. I learn quick, but hate that period of "not having your feet under you"

Hoping some seasoned ICU nurses might either relate to this themselves, or might have worked with enough "me's" to have some insight into my likely hood of success.

Thanks ya'll for your time.

For those interested, this article on perfectionism in nursing was very enlightening to me. It's a long read, but very informative.

https://www.hindawi.com/journals/nrp/2011/858497/

[ThatBigGuy]

The ICU may be a bit of a roller coaster for you. Your perfectionism can be a benefit, as you have a much smaller patient load. You can really dig in and focus on many more details than other units.

On the other hand, there will be many days when you struggle to literally keep a patient alive until 7:05, and you'll leave a boatload of things undone for the next shift. This is normal, and you'll periodically get handed a mess to start with as well. It's not your fault or your co-worker's fault, it's the ICU.

There's a chance that the ICU may be a make or break scenario for you, although hopefully less of a break situation if you have good support outside of work. I'd say give it a shot, but make sure you have your support system in good working order for that first day when everything hits the fan.

[poopylala, BSN, RN]

^^ I second that. I am a perfectionist and the ICU has been great for me because I can really focus on details with my patient and I start early for getting my supplies restocked in my room and setting it up for the day nurse if I can. There have been times I have left a mess and after giving report, I spend time cleaning up and getting things together. You have to learn to let go of things at a certain point but it's an ongoing learning process for sure.

[OnceMorewithFeeling]

I wonder, is your perfectionism internally or externally motivated? Did you feel bad because you thought you should and could do better by your patients, or because your colleagues pursed their lips at a bath you couldn't get done d/t an unexpectedly busy shift? Or because you didn't get that "one-super-super-Charge RN -Report" filled-out exactly and on-time. Based on your comment "the fear of being judged," I think that a lot of your perfectionism is externally-motivated.

I think that nearly all of us start our careers with external motivation as our primary driver. We want to please our preceptors, our patients, our managers...etc. I think that nurses in unsupportive environments stay in this mode.

In supportive environments, and with some time and experience, nurses transition into a more internally-motivated mode. They do what they know is the right thing to do, even if others might not agree, or have different ideas. They are open to discussing their rationales, and to hearing and incorporating the rationales of others. They don't sweat the small stuff, but they do respect their colleagues and the oncoming shift.

My advice would be to find a healthy place to work. One that supports nurses and one that encourages a respectful environment among colleagues.

[CardiacDork, MSN, RN]

I am far from being a seasoned nurse, much less seasoned in the ICU. However I can attest to the fact that the ICU brought out a wrath of perfectionism. It's annoying at worst, on some days. I've had to put my foot down and keep it at that and from becoming a true inconvenience to providing care.

I just REALLY REALLY like things to be in order. Room nice and clean. Clean sheets. Trash not spilling out. Equipment clean. Patient clean. Lines and tubes labeled and up to DATE. I am a control freak. I will track down residents until I get my repeat labs and replacement lytes. I will hunt down every department for the things I need for my patient. I'm sort of crazy.