Rule follower-how to survive

[greetings]

I've learned since I started nursing that I am very much a rule follower. I feel like I have to do everything by the book, catch every mistake, (even if it isn't mine) and just overall feel like I have to be perfect. As everyone knows, this is impossible in nursing. I feel so overwhelmed all of the time and although I realize I'm doing the best I can, I can't keep doing this. Most people can tell themselves, this is something that can be dealt with tomorrow or they do as much as they can and then can go home and forget about it. I however can't do that, I even find myself going looking for mistakes and triple checking everything in my and others responsibilities. I am overly thorough to the point of being so overwhelmed ALL OF THE TIME that I just don't feel like acute care nursing is right for me.

I'm wondering if anyone knows of a niche in nursing where I may thrive. Is there somewhere where a highly anxious, rule follower would be able to use that thorough, perfectionist mind. I know it sounds like this type of personality should be great for any kind of nursing, everyone wants a thorough person to make sure everything gets done. But it really isn't, you have to be able to roll with the flow and know that sometimes things just can't get done, or at least every word of the policy isn't going to happen. My personality just won't let me do that and it makes my whole personal and professional life pretty miserable. Anyone have any suggestions?

[TheCommuter, BSN, RN]

I'm wondering if anyone knows of a niche in nursing where I may thrive. Is there somewhere where a highly anxious, rule follower would be able to use that thorough, perfectionist mind.

Perhaps you would thrive in the ICU or some other type of critical care unit?

[NewbieNeedsHelp]

You gotta be flexible... It will help you so much if you can be flexible, stay a perfectionist to a degree...But accept nothing is perfect.

If you can't do the above--how about being one of those nurses that audits charts? Case management? (They love to micro manage other people's work haha maybe you would thrive there?)... Legal type nursing? Like a consultant maybe

I'm a little OCD too, in certain ways and with certain things, but I roll with the punches. Thinking about work outside of work ruins your life haha. I try very hard to leave it where it belongs.. Before you make drastic changes think about it

[meandragonbrett]

Maybe you should consider a therapist to help work through some of those things?

[FineAgain]

The NICU would be a great place for you. It is highly structured, no room for errors and people are accountable. A great place for people with OCD! At least that is how it is in my unit.

[Baubo516, RN]

I am a nursing student, but just did my first clinical experience on a Cardiac Unit, and my clinical instructor was an ICU nurse. I, too, am into following procedure, and I have a very detailed mind. Most of my classmates complained about the many paged worksheet that we had to fill out to prep for our clinical patients, but I actually enjoyed looking up all of their labs and their history, and researching their conditions.

My clinical instructor got me thinking... she told me that on a Med/Surg unit I would not have time to get that in depth with every little thing that is going on with my patients, but that in the ICU you can. She said there she usually is assigned 1-2 patients, and she has to know EVERYTHING that is happening with them. It can still get crazily busy (according to her), but from what she described, ICU might be a good place for a fellow OCD-ish person (like me!)

Being a perfectionist does cause anxiety, though... I am currently getting a 97% in the theory portion of my class, yet I still feel anxious about my final tomorrow. If your anxiety is making you miserable, I encourage you to try & find some ways to let go of some of the stress. I've been walking & talking with a classmate after class and it helps calm me down.

Let us know what you decide and what you find out!

[nursel56]

I struggle with the anxious perfectionist personality, too. It's a double-edged sword. Most people, if given a choice, would rather have a nurse who is a stickler for details than one who isn't, because for the most part they don't care what's going on in our internal world.

The thing is, I think part of growing as a nurse is acknowledging where that can be a liability. If you scrutinize everything you do with the same level of magnification, and don't learn to let go of some of it, you might flounder when a wall of stuff comes at you at once, removing the possibility of fussing over everything, but with underdeveloped prioritization skills.

If you are going over your co-workers performance with a fine-tooth comb that's bound to cause problems too, unless you are assigned to supervise them.

I'd ask if you see any difference in your anxiety level between a year ago, 6 months ago, and now. If you do, you could just give it more time, realize it's normal to second-guess ourselves when we're relatively new, and let the "novice to expert" process unfold. If you get the steps right in the beginning you'll pick up speed with repetition.

Anyway, unfortunately for our type there are no easy answers! Just some stuff to think about, and good suggestions from others about what type of nursing you are best suited for. Best wishes to you!

[C-lion]

Ugh...I wish I could be perfect in Nursing. Where I work (I am sure this is true for many of you, too), there are so many policies we have to follow that often I feel like a) I can't get it done, and b) I have little time for the patients. Personally, being OCD, as you claim to be, OP, sounds like a benefit in this line of work...one that I lay no claim to.

[BSNbeauty, BSN, RN]

I consider myself OCD as well to the point where it affected my career tremendously. My first RN job was in the ICU but I had a lot anxiety because my OCD was competing with the demand of the job and this actually led me to many mistakes. Sometimes I'd be so focused on a certain detail instead of looking at the big picture. I would freak out internally when my patients would crash. I would do everything that needed to be done to keep them alive but on the inside I was a mess. Being anal is a good trait when working in ICU but not if you are overly anxious about it. I tried to work in the ER but once again, I could not just go with the flow. I was very overwhelmed with doing everything for the patient. I've decided to move into a specialty that requires sound nursing judgement but it has more of a routine. Post-Partum. I know that post- partum can be busy and demanding but I think there is lower acuity. I'm hoping that this is my niche because I'm tired of job hopping.

[nurseprnRN, BSN, RN]

OR, all the way. Checklists for time outs for safety before you start, count those sponges in and out of the field, individual MD preference cards for what instruments they like for their jobs all listed out ... perfect.

[Roseyposey]

I agree with GrnTea - the OR would be a good fit, plus you would have the benefit of working more independently, so you wouldn't feel compelled to "help" everyone else see their mistakes. You may not work well on a team if you feel that you need to correct everyone else, especially as a new nurse - it is a good way to get yourself eaten.

[Luckyyou, BSN, RN]

The NICU would be a great place for you. It is highly structured, no room for errors and people are accountable. A great place for people with OCD! At least that is how it is in my unit.

I was just about to write the same thing.