Sense of Dread....When Will It End?

SamyRN · Jan 11, 2012

MattRNstudent;

You said it very well when you said "I think that being self-conscious is natural for those of us who really want to be good nurses and provide the best patient care we can."

Yes, it's true that it does get better. Eventually, perhaps you'll only spend the drive home replaying your day, or just as you are walking out the door after your shift. I don't think it's a bad thing. If I were hospitalized, I'd want you to be MY nurse :-)

S

SamyRN · Jan 11, 2012

Awesome post, Babs. You made EXCELLENT points that we all need to remember. I've heard of housekeepers, etc. reporting to nurses about the patients, and were met with a much different response than you gave.

It is everyone's job to take care of the patients. Good for you for reinforcing that and being a big enough person to be good with it, and taking the comments as they were intended: to help the patient, not to make you look like you weren't doing your job.

I like your style! :yelclap:

S

cdsga · Jan 11, 2012

Yes it will take a long time before you quit taking things so personally. You learn to do the very best you can do and leave it at work. It's because you take your patient's well being to heart and you want to be the best at what you can be. I applaud you. You care. That's what it takes to be a great nurse. It will get better, but take caution when you get complacent or don't question yourself from time to time. Asking yourself evaluating questions is what makes you better. If you love your job as a nurse, you will always be a touch paranoid.

Wishinonastar, BSN · Jan 11, 2012

[ How long did it last for you? How do I get some stinking sleep?? :zzzzz

I will let you know when it stops, though I am not in ICU. I have been a nurse for nearly 27 years and I still go over my day at night and have trouble sleeping as a result. I live for the weekends and hope that someday I can retire. We are just in positions of so much responsibility and stress that I find it hard to relax and let it go. Venting helps if you have someone to vent to but I only have allnurses.com- and not every day.

midazoalm1953 · Jan 12, 2012

I'm one of the lucky ones, I get that. I graduated from an accelerated BSN course in August and by November I landed the job I wanted in the hospital I wanted. I count my lucky stars everyday.
I am working in an Adult ICU in a very big teaching hospital. The set up of our new grad fellowship is wonderful and it lasts five months. I have been there just over 2 months. My preceptors are really incredibly smart and are very understanding and patient. I am very happy with that aspect of my job. I also feel like my nursing school did a good job of preparing me for "the real world."
My issue right now is this sense of dread when I leave the hospital. For example, today I did a twelve hour shift. It went really, really well. I felt really good taking care of two fairly (sorta) stable patients. My preceptor didn't have to correct anything all day. I asked tons of questions about CRRT (one of my patients had just been taken off of it) and Good Pasture's (my other patient might have it). Everything went perfect and I reported off to night shift with no issues. So now I can't sleep because I keep running through things in my head trying to figure out what I missed. I almost want to think of something just so I can prove to myself it's not the end of the world and get some sleep. This happens every night I work and I just am really having a hard time dealing with it.
Is this normal for a new grad in the ICU? I know no one feels comfortable here right from the start but am I over-worrying? Obviously, no one can tell me how long it will take me to stop doing this every night but does everyone go through it? How long did it last for you? How do I get some stinking sleep?? :zzzzz
It never leaves you, although becomes less over the years but will creep up on you all your life. It's a curse as wellas a cathartic part of the job. I have no problem sleeping- exhaustion does take over many mornings. Night shift is the best. I also started as a GRN in ICU 12yrs ago {after yrs as a medical technologist} regardless nursing haunts you at times..it's because of all the **** we deal with-literally and figuratively....relish your good shifts and great patients....forget the *******s you encounter...we all do our best and stay honest.

midazoalm1953 · Jan 12, 2012

above was placed in you comment, sorry..those last opinions are mine.

turnforthenurse, MSN, NP · Jan 14, 2012

Totally normal, though I do not think this is limited to just new grads in the ICU. I work in progressive care and I have the same issues. I always go home thinking about what I missed, what I caught, what I could have done better, etc. I always go through my charting at the end of the shift (I usually have to catch up on it anyway) to make sure I didn't miss anything. That helps give me some peace of mind.

It will get better. I'm going on 7 months and it is getting better. I'm starting to learn how to leave work at work and try not to worry about things the moment I clock out.

As for sleep, I use sleep aids...like Benadryl (usually 25mg so I'm not groggy when I wake up) or if I REALLY need sleep, I'll take Unisom (1/2 tab because even that will really knock me out). I don't need them once I'm back on my night shift sleeping schedule, but when I'm trying to transition back to it (because I flip flop, I go back to a normal schedule on my off days) I will use a sleep aid.

CrufflerJJ, BSN, RN, EMT-P · Jan 14, 2012

The mouth care thing happened but it's not like I still freak out about missing it. It's more of a matter of the next shift coming in and being like, "Your orientee didn't chart her (insert some inconsequential thing here), didn't you teach her anything?"

In the "overall scheme of things", missing 1 mouth care probably doesn't matter. Then again, from the perspective of ICU management & some Quality staff in your hospital, failing to document a single mouth care episode may result in a "write up", no matter how hectic/crazy your day had been. As you've said, it all depends on your unit and how reasonable (or unreasonable) your management tends to be.

AICU RN · Jan 16, 2012

Thanks for all of the advice guys. It is all ready getting better. I am learning to prioritize and manage my time a little better everyday and if that means my senna and colace are an hour late then hey, so be it .

As for sleep aids, I've learned that Benadry has a paradoxical effect and wires me to no end so I tend not to use it lol. I'm on night shift now so it makes it a little tougher...

oriya · Jan 18, 2012

How to Stop the Dread.

Dread is the greatest activity of our times. So it seems. Everyone's doing it. :)

While that doesn't immediately fix your problem, its truth does.

Dread is imagination stuck in suffering. Dread is imagination stuck.

It's normal. Unfortunately.

You live in a society that is trained to go for perfection. You gotta make sure to be perfect, of to always be trying to be perfect... otherwise you won't get:

love (watched 90210 much? I did! :)

job security

happiness and joy of "making it".

In other words, you are consistently trying to be someone else.

Maybe not you - you, but our society in general.

Take a breath. Let's realize that your dread and automatic fear of "what did I miss" is simply your habit of trying to be perfect.

Perfection is a trap. It takes you out of your actual story and then you can't imagine anything new. just all the "negative" possibilities.

First step for you is your last step as well: know that you are FINE. You're more than fine. You are living your story.

Cultivate a sense of presence instead of dread.

Presence is you being aware that you are not trying to be anyone better than you.

Whatever you ARE doing, you ARE doing your best. Because you want to. Because you chose this career. You want to be here. Of course you are doing fine.

If you missed something, you would know it. You always do. Or someone tells you. And it is always okay because you are always truthful with yourself, you are proud of where you are, you don't ******** yourself and you ask for help when you need it.

Enjoy yourself!

Love