So many sleepless nights

[wannabecnl]

I passed my 2 year nursing anniversary, and I still have trouble sleeping at night. I go to sleep okay, but if I wake up in the middle of the night, I immediately start thinking of my patients from that shift and can't go back to sleep. I feel a freezing cold chill run over me, my HR goes through the roof, and I can't stop the thoughts. I don't have this problem on regular nights, when I haven't worked the previous day; then I can always go back to sleep.

Today I had a great save, one of my best. And yet when I heard a respiratory alarm after the patient went to the floor, I almost went into a panic attack until I heard it was on a different unit. I dread going to bed because I know I will just wake up and worry about this patient.

There has got to be a better way. I took anti-anxiety meds for about 10 months last year, but I had to stop taking them when the side effects got too bad. I don't want to go back on the meds, but I have really got to get some sleep. A colleague recommended melatonin, and I'm thinking of asking my PCP about it, but it doesn't address the real problem: I'm still worrying too much, even when I'm awake. Can I escape this? Should I stop working critical care--is it the job or is it me? I love my job, I love my patients, and I can't imagine doing anything else, but I have to find a way to get over this.

[notyetnurse]

A little personal but I'll tell you this - I used to leave work at night (long before nursing was a thought in my head) and spend hours wondering if I did something wrong. Did u put the money bags away? Did I leave something valuable on the counter? Had I forgotten to do something? It was intense and only after talking with a therapist in years later did I realize that this was just a manifestation of some extreme form of anxiety. Don't misunderstand me please - nursing is one of the few jobs where it seems to make sense to leave and wonder because your actions can surely be life changing for a patient. But that being said, it shouldn't be your entire life. When you leave work you have to be able to mentally check out too or else you are never getting a break. And anxiety just build upon itself. My advice - try the therapy route and if you need some low dose anxiolytic go for it

[CrunchRN, ADN, RN]

I would try cognitive counseling. The true approach to getting coping ability.