Taking things too personally

You posted five years ago with similar issues. Now you have 20 years in of misery. Past time to move away from the bedside.  A therapist can help you through the trauma and transition. Best wishes.

Most people go through this at the beginning but seeing that you have 20 years of experience, I'm tempted to agree with the above post.  By now you should be coping with crashing patients and death as part of the human condition of nursing and not as you say "live in fear".  

All the best.

There has been a lot of changes since my previous post. I have changed jobs, location, and work in a much more supportive environment, than I did before. 

I had made in roads with this issue, and been far more settled. Sadly a case I was involved with ended up with the coroner involved and although there was no question in regards to my practice, nore was any wrong doing put at my feet. It's reawakened old wounds and I am struggling again.

I haven't been bedside nursing for over 14 years now.

The thing is I have no choice but to keep going. I cant afford to stop being a nurse there are no jobs which pay the same and my mortgage still needs paying, and im trapped in an organisation because of its pension implications. 

So I need to learn better skills to cope, I don't quite know where to turn thats all..

Is there a chance that you struggle with underlying mental health condition such as significant anxiety or depression? If so does your treatment plan need tweaking?

I ask because at some point it is just not logical to see oneself as having that big a hand in strangers' problems and/or their demise. You know what I mean? Generally speaking others' lives do not revolve around us in that way. We are separate from our patients' problems and conditions; there are usually numerous other factors that can affect outcomes present long before our involvement.

Some people are naturally very obsessive worriers and it is very hard to change when it is part of who you are. A therapist might help you manage these thoughts with a pill, but that doesn't  cure this way of thinking. Thoughts of guilt or what if or "would coulda shoulda" persist, regardless in the back of the mind. Accept it but if you work to stop the thoughts,  they can worsen and deepen by adding cognitive fuel to the worry. I read this is in a book on obsessive thinking and it is true. You will overcome the guilt feeling and it leaves a mental scar then a scab heals it. No sooner than is healed nicely, then a new situation reopens it. Old wisdom from 170 years ago. Human nature. You got over past regrets (that were unfounded, I assume) and you'll move past this one.

 Secret---  I feel the same toward the death of my loved cats. But it was inevitable.

Lostsoul123 said:

Hello 

I know every once in a while an individual patient really does get under your skin, and plays on your mind. That I think is normal. 

My problem is that I seem to feel like every time theres any deterioration in a patient I feel like its my fault. Like I didn't do enough, didn't look hard enough, ask the right questions, or I must have took a risk too far. If someone dies I take it so personally. 

Hospital management are putting nurses in this position because we spend most of the time with the patient with not enough resources, staff, working equipment, then when things go downhill, nurses are left to clean up the mess.

OP, the kind of obsessive ruminating you describe is the dark side of a de-briefing process that all good nurses use to learn from experience. When it gets mixed up with underlying issues of anxiety, depression, low self-esteem, whatever, is when it can become a huge problem.

When self-examination goes too far into self-flagellation, it's important to realize that you do NOT control whether someone dies. Everyone dies and assuming that the outcome of adverse events is somehow yours to dictate is not rational. Learn what you can from analyzing events, change what needs changing, then say the serenity prayer and be at peace.