Stress related near breakdown

[inthesouthrn]

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. :)

[Rhone]

I'm glad to hear there's a positive outcome here for you, and that you have such understanding and supportive managers. :)

[inthesouthrn]

I haven't posted here in many months. Not since around the time where I got so stressed out at work, that I had to take a medical leave of absence for 6 weeks. I didn't know what to do, but did go to a PA that gave me Effexor and Klonipin for my depression and anxiety attacks. While I was out, I called upon the boss of a home care company I once worked at and got a job there, which is SO much more less stressful. (I had worked at the hospital a few years). Then I started feeling SO much better! I was on top of the world and continued my meds. However, as a few months went by and the high that having a less stressful job subsided, I have found myself becoming depressed again. Again, my job is very low stress, but I find even the small problems that I have to deal with stress me out. My feelings are so tender and they get hurt so easily. My memory is horrible. (no, there is no Alzheimer's in my family....parents elderly and sharp as a tack). I don't want to be around people sometimes and during family gatherings, if they talk politics or anything else about the world that is bleak, I can barely stand to be around it. The world is becoming gray again, just like a black and white movie and I feel like I'm sliding down a hole. I dread doing anything other that my home routine. I dread getting dressed, putting my make up on, getting ready, going anywhere. And the worst of it is, my outlook on the world and the people in it is very dark. I feel that for all the goodness I see on people's outside, that there is twice as much evil within. People are often two faced, plagued with a side that some people don't see and society is filled with drug addicts and cheaters, child molesters and murderers. I know that we all have to deal with a world like this, but I feel as if I can't cope with the knowledge of it and I am so depressed.

Ironically, I have a husband that I've been married to for many years who is and always has been wonderful to me. My home life is wonderful and I never take this for granted. That makes me feel so bad because I don't have the right to be depressed the way I am. I have two wonderful daughters full of promise that I am so proud of.

I never got counseling for my problem, only meds shoved at me. I think I need a psychiatrist and some counseling.

I don't know why I posted this here. I don't know if my problem is stress induced from nursing or not, which came first, the chicken or the egg so to speak. All I know is that I can't talk to anyone I know about this, so what better place to talk than a place where no one knows you.

I just felt so bad this morning, I had to put my thoughts somewhere. Thank you for reading.

[shoegalRN, RN]

I'm no expert or anything, but it sounds like you are suffering from clinical depression.

Maybe you should seek help with a licensed therapist or maybe change your meds.

Prayer also work wonders!

I have nothing more to add. Just want to wish you the best and hope you get the help you need soon.

[mustlovepoodles, RN]

I agree with you, it's time to see a specialist in the field, a psychiatrist. Meds are a good tool, but they will not make everything better. They just help to calm you while you work through your issues. It sounds like it's time to work on that.

I have been a nurse for 32 years. Twelve months ago I suffered a nervous breakdown brought on directly and indirectly due to my career. It's been a long haul,but I'm telling you I feel better now than I have in the last 15 years. I consider my treatment team to be essential to my recovery: psychiatrist(for meds), psychologist(for therapy), a recovering professionals support group(group therapy), and a nurse's support group. I take three meds to keep my mood stable and relieve my depression & anxiety. The hardest thing for me was acknowledging that i have a mental illness. I do. And I need a psychiatrist. It makes me feel sad that I have to say that.

Just reading your post takes me back to how bad I felt last year. I was on disability for about 4 weeks when I first went back to work(I'm a school nurse) and it was a disaster! I cried every day, my hands shook, I was jumpy and shell-shocked. I wish, wish,wish I had listend to my body! If I had I wouldn't have gone back to work so fast. As it was, I did go back and everything went downhill and I started mis-using medications, mine and anybody else's I could get my hands on. I very nearly killed myself before my Dear Husband was able to get me into a facility. There I spent another 8 weeks learning how to help myself get better and having intensive therapy every day so I could root out the deep issues that were choking the life out of me.

My treatment team and I are of one mind: I cannot work full-time as a nurse and keep my recovery intact. In fact, I can't work as a nurse at all due to severe anxiety, poor concentration, and memory impairment brought on by depression and meds. So after a long career, I am officially retired today at the age of 53. DH stands beside me on this. We have all learned over the last 9 months that old adage "If mama ain't happy, ain't nobody happy" holds true. My illness made my whole family sick. I liken to having a traumatic brain injury. No one would think of pasting a bandaid on your head and giving you a few pills and think you're going back to work good as new. No! Severe depression alters your brain chemistry for long periods of time. It can take 1-2 years to fully recover.

Good luck to you. It's sad when you realize that the career you love is now toxic to your health. But you have to listen to your body. If you don't you're going to pay. And each time you suffer depression your illness gets a little worse. I wish somebody had told me this years ago. Perhaps i could have prevented my own implosion if I had pursued the treatement I needed.

[curarizing]

i know about stress, and it is part of our modern life, so i m trying to adapt to this waylife. It s the only thing i can do now.

[kcb007]

I can definitely understand what you are going thru. I am currently out of work for 2 weeks. My psychiatrist took me out! I have currently went back to school for my BSN and my professor has taken me out of that for 2 weeks as well. I just had a breakdown. I was having anxiety attacks all the time and then I go to the ER only for them to tell me my D-Dimer is elevated yet they can't find anything and no one can give me an honest answer! I had an appt with a vascular surgeon today in hopes that he could calm my nerves and I arrive at the MD office only to be told that he is in an ermergency surgery. Talk about out done. I have been going crazy!! Stressed over work, school, and now this abnormal D-Dimer. All my CT Scans of the chest have come back normal but still I would like more of an answer!! So I feel your pain. The more I worry the more my body aches and not to mention my psychiatrist put me on a med that was horrible!!!! I had to switch back to good ole' Zoloft!! So don't feel like you are alone. Nursing is a hard job but somebody has to do it, so why not it be US!!

[Kittyfeet]

You sound like me, a new grad, maybe you're experiencing it all over again after so many years away from med/surg

Maybe you could transfer within the same hospital to a different area? But it might also just take time to get used to it.. everyone keeps telling me "in about 6 months you'll feel better". I hope so!

[inthesouthrn]

Well, 2 years later, I wanted to give everyone an update. Even though I went into a less stressful nursing job since I had the near breakdown at my previous hospital job, I feel like now I cannot ever get back to the person I was before this happened. I have been on SO many antidepressants that either worked, but only for a short time then stopped helping, didn't work at all, or caused horrible side effects. Then my psych MD thought I may have bipolar type 2 and then a whole new parade of meds with the same above problems. Becoming dissatisfied with my treatment and hoping to find a professional that can better help me, I've been through about 3 different ones......mental health practitioner, psychiatrist, and lastly another nurse practitioner. I've been to 2 different counselors and found no beneficial help either. I try to eat right, though being depressed, the only thing that makes me feel better is to eat, but I do try. I exercise regularly and that does not help. About 3 months ago, being so disillusioned and not being able to find helpful meds, helpful MD, or helpful counseling, I decided to give up on all of it. Quit going to my appts, and weaned myself off all my meds. My reasoning was that I was still suffering with the meds and the huge cost, so why not just suffer without meds at no cost? So here I am, still suffering.

I work in a much less stressful nursing situation now, but I have still had so many occasions where my disillusionment of the health care system has been reinforced. I hate my job. I feel ruined and still don't know where to turn.

I'm sorry I can't post anything more positive. But as nurses, please guard your mental health. If you see it is bothering you to live in such high stress, please try to find another alternative.

[caliotter3]

I am sorry to hear that things are not going better for you. I do hope that you can find some way of making your existence better. Life is hard enough without having to deal with debilitating depression. Best wishes.

[tokmom, BSN, RN]

Hi,

I didn't read all the other posts, so this might be a repeat.

First of all, I was in your shoes about 7-8 yrs ago. I actually quit nursing and was out for almost 5 yrs. I HATED my profession and sooo didn't want to go back. Due to my husbands health, I was forced back into it. I cried for a week and stayed in bed for 2. I'm now a little over 2 yrs into my job and I LOVE it. Yeah, it has it's days, but rarely.

You can find your love of nursing again. IMO, you don't need a psych or meds, you just need to step back for awhile.

I thought I was the one with problems, when in fact it was my crappy facility that made me go near psycho!

Our ratio was like yours and the acuity was freakishly high. We worked with no breaks, lunch or anything...You came to work, worked your a$$ off and went back the next day to do it again. ONLY when I quit, and found my current hospital, did I realize that where I worked was a dunghole, and I worked in it for 16 yrs.

Why not go PRN? You can choose your hours and still keep your finger in the pot?

What drew you to nursing to begin with?

What would make you happy at your job?

Has it become task oriented for you? How can you change that? Believe it or not, there are small things that you can do to prevent burn out and regain your love of your profession. Administration can tell you how many patients you have to take, but they can't take away how you practice. Take 5 minutes, pull up a chair and visit with your patient. Sounds like a lot of time, but overall, the patient feels like you spent 15 (by sitting down) and will call on you less. You learn about your pt and they feel more cared for. The best part is, it makes you feel more connected to your pt and IMO, better job satisfaction.

I know this all sounds corny, but small things like this worked for me.

Hugs :hug:

[xtxrn, ASN, RN]

Well, 2 years later, I wanted to give everyone an update. Even though I went into a less stressful nursing job since I had the near breakdown at my previous hospital job, I feel like now I cannot ever get back to the person I was before this happened. I have been on SO many antidepressants that either worked, but only for a short time then stopped helping, didn't work at all, or caused horrible side effects. Then my psych MD thought I may have bipolar type 2 and then a whole new parade of meds with the same above problems. Becoming dissatisfied with my treatment and hoping to find a professional that can better help me, I've been through about 3 different ones......mental health practitioner, psychiatrist, and lastly another nurse practitioner. I've been to 2 different counselors and found no beneficial help either. I try to eat right, though being depressed, the only thing that makes me feel better is to eat, but I do try. I exercise regularly and that does not help. About 3 months ago, being so disillusioned and not being able to find helpful meds, helpful MD, or helpful counseling, I decided to give up on all of it. Quit going to my appts, and weaned myself off all my meds. My reasoning was that I was still suffering with the meds and the huge cost, so why not just suffer without meds at no cost? So here I am, still suffering.

I work in a much less stressful nursing situation now, but I have still had so many occasions where my disillusionment of the health care system has been reinforced. I hate my job. I feel ruined and still don't know where to turn.

I'm sorry I can't post anything more positive. But as nurses, please guard your mental health. If you see it is bothering you to live in such high stress, please try to find another alternative.

I also didn't read through all the posts- and apologize if this is redundant or irrelevant

If the meds aren't helping, have they checked various labs for hormonal, vitamin, or chemical imbalances....????

[inthesouthrn]

I also didn't read through all the posts- and apologize if this is redundant or irrelevant

If the meds aren't helping, have they checked various labs for hormonal, vitamin, or chemical imbalances....????

My gynecologist thought that the depression was not caused by menopause, but I don't think she's checked my hormone levels. I'm thinking of getting another gynecologist and start all over again with them. I didn't get this severe with depression until I hit menopause combined with the stress.