Stress related near breakdown

Nurses Stress 101

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I've been and RN for 16 years. After graduation, I worked on a med/surg floor for 1 year then went into home health. That is where I stayed until 3 years ago when I went back into hospital nursing, med/surg. I did pretty well getting back into the swing of hospital nursing, however, I do find it very stressful and physically as well as mentally challenging. I have been handling it well for the most part however. I am in my late 40s.

However, the last several months, on those very stressful days, (you know what I'm talking about, when you have admissions, discharges, pt procedures, pt's going bad and being transferred, and those kinds of things happening all at once), I've noticed that the stress is almost unbearable. I feel like I am going to explode on the inside at times (I'm not talking about an outward outburst, I just feel a horrible turmoil on the inside). On the days so much is going on, I feel very inadequate as a nurse because I feel there is too much going on that I can't keep a handle on it. I am actually, a good nurse.

Our patient ratio ranges anywhere from 5 to 7, rarely 8 to one nurse. Our patients are such high acuity sometimes and we do have many unruly patients at times.

I have, at times, gone to our assistant unit manager telling her of my stress level being very high during the times it has been, and she has always been understanding telling me to take a break. However, the other day, I had a horrible stress filled day with SO much going on, I felt I may crumple up in a corner somewhere and start crying or screaming or something. I just felt so overwhelmed all day long. However, I always manage to take care of my pts, get everything done, and manage to leave somewhat on time. I still don't feel good about my days work. Anyway, I talked with my husband about it on this horrible day and I told him I don't think I can go on working like this that the stress level is so high I don't think I can bear it anymore. He was very understanding and said whatever I have to do, we will do.

The next day on the way to work, I felt as if my body and mind had been in some kind of war or something. I took report, but didn't feel right. I saw a couple of patients, until my manager came in and I told her how I felt. She told me that I needed to see a doctor, which I did. She took me out of work for a week, put me on an antidepressant, and made an appt for me to see a psychologist. I told my unit manager this and she was very understanding and I got the papers for a medical leave. My appt with the psych is in a few days.

Right now I feel better, but that is knowing that I don't have to go back to work for several days. The med has me feeling a little jittery and restless, but at least I don't have depressing thoughts. Now I'm here at home trying to figure out where I want to go from here. I don't know whether or not to try the hospital again after my rest, new meds, and appt to the psch, or try to find something else. Something else in this economy will be hard to find, and even so, I don't know where else I would want to work. I got really sick of home health care nursing....so I don't want to go back to that. MD offices are also horribly stressful I would think.

Our finances are good, we have most of our bills payed for, one child married, but one child in college which we have to pay 12 K a year for (she had a partial scholarship). If we really had to, we can afford for me to not work for awhile. But during that time, I would lose my experience, and you have to actually work as a nurse to keep your license up. So I am left pondering some deep questions. Can I really take this anymore? And if I can't, what now? I hate to lose what I have worked so hard for, but I want to live also and not have some mental breakdown, which is what came so very near to happening. I have not adequatley described the horrible way I have been feeling and my anxiety level. But suffice it to say, it was unbearable. I have thoughts of this world being horrible, nothing good in it and all kinds of things.

I can tell everyone I worked with is stressed too, so it's not just me, but I'm the only one that it has affected in this way

Words of wisdom from anyone? I'm kind of tender right now, so please be gentle. :)

Today I was suppose to go back to work after being out for 3 weeks of medical leave for the mental breakdown due to stress I had at work or whatever it was. After 2 weeks home and meds, I started feeling much better and thought I was ready to go back to work.So I had been feeling good for the last week. Last night I couldn't sleep I was so wound up. This morning in the shower I was having panic attacks, breathing hard, and feeling extreme feelings of being overwhelmed. I could not bear the thought of going back to that hospital. I called in, and asked them to ask the unit manager to call me when she comes in. I don't know what to do. I have to work because I'm the one with the insurance in the family. I feel such despair like I"m letting everyone, including myself down. I have always had a strong work ethic and have worked consistently all my life. Now I feel paralyzed like I'm in some traumatic stress disorder. I was supposed to go to my 2nd mental health appt Monday but they canceled due to some conflict with them and wanted to reschedule for Friday but I was suppose to work then so had it scheduled for next week. I am not getting any counseling at all, just meds and I feel like I need counseling of some sort to get me through this. I feel at the point of being in such mental pain and despair that I don't know what to do to get away from this pain. I feel hopeless and helpless.

Inthesouthrn:

Hey, don't despair! We learn something new from every experience, good and bad. If the work is giving you panic attacks and much misery, you have learned that its something you shouldn't be doing. Life is too short to be so unhappy. I don't want to sound like Polyanna here, but the good news is your body is tellling you something: "This is not for me." Nothing wrong with that. I have a pal who faints at the sight of blood, yet her brother is a trauma nurse. You never know. It's a big world out there, and lots of stuff to do besides the job you had that was ruining your health and state of mind.

Diahni

I'm with Diahni on this, it would seem that your body is telling you to do something else. It may feel more like your body/mind/emotion is betraying you, but try to consider that it is protecting you. Some people stay in miserable situations too long and it ultimately turns out worse... their health suffers, they make mistakes they wouldn't have otherwise, their family life suffers, they are distracted and get in a car accident... and all of that could end up costing a lot more than the price of taking care of yourself NOW. So while the possibility of losing pay, health insurance, pride, etc may *feel* like the worst possible thing ever - and it IS scary and stressful! - it may possibly be ultimately for the BEST that your body/mind/emotion is telling you to not to go back. Imagine fighting for your OWN health and safety the way that you would fight for it for your child. Take whatever steps you can to maintain some kind of health insurance but if you come to a point where you CAN'T, try to work from there, as opposed to beating yourself for not being "as strong as" someone else might be. We each have our own strengths and weaknesses and there are probably things out there that you deal with so well that they don't even register as problems while some other people struggle with endlessly with the same issue. Try to be as supportive of yourself as you be of a good friend or child of yours who you saw being as miserable as you are now.

Personally, I had to find myself a job that I truly felt comfortable with - which for me was a desk job with clear objectives and self-pacing. I felt sooooooo much better about myself and about life in general after that. I felt like an intelligent, competent, emotionally-stable person again. I felt like my feet had finally touched solid ground after feeling like I'd been drowning. I don't know what will work for you, but do know that your reaction to this job doesn't mean that you are any less of a person than any other person. It just means that you are a person, with limitations as we all have, no shame in that. Hopefully soon, you can again find those things that are your strengths and build your confidence in yourself back up again.

Specializes in med/surg.

Just so all my posts won't seem like gloom and doom, I wanted to post something on a positive note. For those of you familiar with my bout of stress related panic attack, the depression, and being put on medical leave, then ultimately having another panic attack after being out for 3 weeks and still not being able to go back to work (whew...that was a mouthful wasn't it?:D). Anyway, went back to mental health, she said she did not think I had been on the meds long enough to prevent a panic attack when going back to the same stressful situation. She suggested I stay on medical leave at least 2 more weeks, continue my same meds and see if I can find a less stressful nursing job.

I talked to my assistant unit manager, and she said she, the unit manager and head of med/surg said to take all the time I needed, to take care of myself first and they have about 3 areas of nursing I could be transferred to that would be less stressful then where I was. One of these areas I have worked at filling in before and it is much less stressful. I think I will go with that route.

My managers are wonderful, caring people. They have made me feel so good and helped me not be so down on myself about having this stressful event. I could have not gotten through it as well without their support. My mental health practitioner is also wonderful and helped me so much. I will see her again in 2 weeks.

So the end of the world did not happen like I thought it would. I am getting back together and feeling so much better. One thing my mental health practitioner said to me was something I will never forget. She said a doctor once told her, "It's not how you fall down that counts, it's how you get up." Words I will now live by. I am getting up.

Thank you all for being there with me through all this. There is always hope.

Specializes in ER.

"It's not how you fall down that counts, it's how you get up."

Funny, that's what I tell myself frequently too. Getting up is always hard, but something to be proud of.

How wonderful to hear that something positive is happening for you. Most people have the opposite experiences and it sickens one to read about how they lose jobs and careers. Hope that you are able to pick it up and transition to a position that is good for you. Please, somehow, convey to your supervisors that others are heartened to hear about how understanding and wise they are. If only all managers conducted themselves in this manner. Good luck on your way back to health.

Specializes in TraumaER ,NICUx2days, HEMEONC CathLab IV.

I agree with Canoehead, everyone falls, not everyone gets up, dusts themselves off, holds their head up high and goes on. All those trials and tribulations become experience. You now have the experience to recognize the signs and symptoms... you know first hand. You are stronger for it and will be able to help the next panic ridden soul through their experience.

As for Depression and Effexor, watch your cholesterol levels!check out the side effects listed. My MD said I was crazy when I told him my lipids were over 300 because of Effexor. I was right. I took a YEAR to wean off. read up about it. It was a horrible year of nursing for me, all my staff and my supervisors, but they helped me through it menopause on top of it all too. ARRRrrrGGGaahhhhhhh

Glad you are up... and at em.

I agree with Canoehead, everyone falls, not everyone gets up, dusts themselves off, holds their head up high and goes on. All those trials and tribulations become experience. You now have the experience to recognize the signs and symptoms... you know first hand. You are stronger for it and will be able to help the next panic ridden soul through their experience.

As for Depression and Effexor, watch your cholesterol levels!check out the side effects listed. My MD said I was crazy when I told him my lipids were over 300 because of Effexor. I was right. I took a YEAR to wean off. read up about it. It was a horrible year of nursing for me, all my staff and my supervisors, but they helped me through it menopause on top of it all too. ARRRrrrGGGaahhhhhhh

Glad you are up... and at em.

I have been on effexor for 6 years and even if I am an hour off my dosing schedule, I feel horrible. I tried a couple of times to stop taking it and the withdrawal was absolutely hideous!!! Sorry this is off topic, OP I am happy that you are better!!

It's so great to hear that you are doing better! It's truly wonderful that you are able to take the time you need in order to get better. And your managers and NP sound wonderful as well! It is truly empowering once you feel like you have gained enlightenment and have made progress.

I suffered for years from anxiety and panic attacks until one doctor said the one thing that finally clicked. After asking me to go through every single step of my panic attacks, she repeatedly asked, "...and then what?" until I said, "Um, that's it. I cry and freak out, and then eventually it goes away." Then she said, "Exactly." She helped me understand that if I just go though the horribleness of it, that eventually it will pass, and I'm not going to die or anything. That was a breakthrough for me. Now, if I feel anxious, I think about that because I know that it will be ok no matter what. It just may be a little uncomfortable.

I hope this helps you in some way and that everything goes well with your transfer! A new start--how very exciting! Remember... baby steps : )

Inthesouthrn, I am so glad to hear you're feeling better and have a plan to reduce stress at work in the future. Antidepressant medication can be difficult to wean off, but it can also make all the difference... Keep up your visits to the mental health care provider - talking really helps. Also, alternative therapies, such as yoga, acupuncture, meditation, or any exercise activity or hobby that you enjoy (something that has nothing to do with work) can help. Take time for yourself, even if it's only 30 minutes, every day.

My mantra (like Miss77) is "This too will pass" and it does!

Specializes in A myriad of specialties.

So very glad things are looking up for you. What wonderful managers you have; sometimes that makes all the difference.

I am so glad that you have compassionate managers. Sometimes what's scarier is what COULD happen..not what actually does when you face up to an unpleasant situation and things turn out okay. You are doing great! :)

Specializes in Infusion Nursing, Home Health Infusion.

TX for sharing......I am so happy to hear of nurses supporting other nurses....this is the way it should be.....and this is the way I decided years ago I would practice......if a nurse is really trying...I will help.....this profession is trying to say the least

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