The Black Cloud

DA314 · Oct 24, 2008

Maybe you could try going to a therapist. My husband has terrible anxiety issues and doesn't react well to meds. He goes to see someone everyone few weeks when he's having trouble and that helps tremednously. Sometimes having a professional to vent to and help you sort out your feelings helps alot.

Talking with family and friends helps too, but for my DH, talking to a therapist helped him the best.

Having lives in your hands is a stressful thing, and it is completely understandable that you are having trouble coping. I hope things improve for you!

:icon_hug:

racing-mom4, BSN, RN · Oct 24, 2008

You state your a new nurse(july) and have had changes at work since then, enough changes that even the Sr staff is having trouble with them. Job change is a major life stressor in itself. Add on the fact your in a new role of RN.

You state your crying every day and your family even sees changes in you.

What would you tell your patient if they told you this same story??

I agree with the above post in the fact that you should seek out some professional help, the stresses of the Holiday season is coming upon us pretty fast, I dont know where your physically located but here the days are getting darker and the weather colder, so your chances of being able to take long walks in the sun are few and far between now.

Best of luck, know your not alone, I think it would be best to get some help now before it gets even worse.

Morettia2, BSN, RN · Oct 24, 2008

Casper, it's called the new nurse black cloud and since you work nights it follows you everywhere. I carried it for the last year. And I know b/c I am writing this I am going to jinx myself.

I had and still have it from time to time. I have been a new RN for about a year and a half, and yes, I still call my self a new RN b/c I am always learning. But last night before my sift I was at home, I worked the night before came home in the morning couldn;t sleep all day, and had to return back to work last night. I was up for over 24 hours with no sleep, and had to go back to work. I was a hysterical mess before I left for work, due to lack of sleep and the fact my uncle just died in a horrible motor vehicle accident a week ago.

I knew I had to go in and put that fake smile on, I felt like crap, looked like crap, bloodshot eyes to the point that I looked like I smoked a lb. of weed, no sleep in over 24 hours and had to work another long drawn out shift.

I walked on my unit and it was utter chaos, got report, felt nauseated, and as soon as I had a moment to take a breath, raidology called telling me I had a pt. that needed a STAT spiral CT with contrast and they didn't know what gauge IV he pt. had. I haden't even seen the pt. b/c the pt. was already in raidology when I arrived at work at 7pm. So I said well what color is the IV, the raidology tech said to me, "well it's wrapped in cling so I can see it and we need to get this done now." I said,"Unwrap the cling and tell me what color the IV is" I was put on hold for 15 min. Finally I just hung up. I said to my charge nurse I am going down to raidology I will be back.

I was arrmed with an orificenal of IV's and flushes, and the day shift nurse that gave me report on that pt. said she would come with me b/c the pt. has poor veins..great just what I needed. The pt. was a 21 y.o. with cystic fibrosos and had sepesis from an infected permacath on the left arm.

We got to the CT room and saw he had a 22g IV and needed a 20g IV for IV contrast. We could only stick one arm, the pt.'s right arm b/c the left arm ws so badly infected. YEA...we must have stuck the poor guy 6 times, 3 tries each, and every time we would get a great IV flash, snap back the angiocath and no blood would follow, finally I called my floor for one of the other nurses to some down and stick him. He was such a good sport about the whole thing and even began laughing saying how many cardiac nurses does it take to insert an IV? 2 to stick me 6 times, and 3 others to watch..hahaha.

Finally one of the nurses from the day shift that was leaving for the night come down to CT scan along with one of the other day shift RN's and my girlfriend who I work with at night, to see if we had any luck. The one day shift RN found an awful vein to stick, on the posterior side of the arm, uhh I hate putting IV's there, but she said, "Ang you put it in, you need to learn to insert IV's, you never put IV's in the pt's.". OH THIS MADE MY BP SKYROCKET. I said to her, "You work day shift, you don't know how many IV's I put in at night. I wolld say that every shift I replace at least 5 IV's b/c the pt's pulled them out, they infiltrated or just blew. So don't tell me I need to learn to put a line in a pt."

My girlfriend that works day that gave me report on the pt. and came down to CT scan with me said to that nurse, "That is the only vein all 5 of us have found, Angie is overtired, emotional and had already stuck the pt. 3 times along with the 3 sticks I did, and if she sticks the only good vein the pt. has and it blows, well let's not just say if she sticks the pt. b/c she isn't going to, YOU are going to stick the pt. So keep your comments to your self and just put the line in."

I just stood there in shock that my girlfriend said that, so not like her, but she knew much I have been through in the last week and knew I was sleep deprived and had been crying all day when i was susposed to be sleeping, not an excuse I know but she gave me a hug and said to me, "Ang, you are awesome at IV sticks and I knew if you couldn;t get a line then let some one else try, right."

So we got the stupid IV in, then every one leaves and it's me and the pt. waiting for the CT tech. My pt. tells me, "Ang I think my O2 is running low." I didn;t transport the pt. to CT b/c the pt. went before I was even at work. I look a the tank it's empty. I ask the raidology tech to you have a full o2 tank, of course NO. Pt's SpO2 sat. w/o O2 dropps into the low 80's. I look around I see this O2 wall unit that i swear has never been used, I wheel the pt. over to the wall unit, thank god it as there and hook him up to it.

I call my floor for a CNA to bring down a full O2 tank to CT scan. As the pt. and I are waiting for about 40 min I am wondering where the ******* O2 tank is for transpot back to my floor. I call my floor 3 times no answer. The CT unit clerk says, "are you understaffed tonight?" I said "No, we have a unit clerk, 3 nursing assistants, and 5 nurses." She began laughing and the pt. and I just broke out into hysterical laughter.

Finally I got to fed up I went into the ER, next to CT Scan and which is like walking into WWIII, and found one of my girlfriends who is an RN and asked her for an O2 tank, she hands me this almost empty tank and said,"Ang this is our good tank, bring it back when you are done" WITH A STRAIGHT FACE. I said, "you are kidding right? Please tell me that you are not serious." She was dead seriious. I walk back to Ct scan with an O2 tank that has maybe 10 min. left to it b/c my pt. was on 5L O2.

Finally my nursing assistant shows up, 50 min. after i called the floor originally with an O2 tank.

Yes I did return the "good" O2 tank to the ER and also sent down 3 full tanks when I got back to the floor..

Thank GOD the pt. was so awesome about the whole thing. i can say as my pt. and I were wating for the O2 tank in CT scan he said to me, "Ang I know I just met you, and your are my nurse tonight but are you ok? You seem upset? I know pt.'s think that they are the center of the world and that their nurse isn't allowed to have emotions or personal problems, and I am not prying but you seem like such a nice girl and you just have this forced smile on your face b/c you feel that you arn't allowed to be upset." I looked and said, "I never bring my personal problems to work, I am here for you guys to help you, but how did you know I am emotionally upset?"

He said to me, "Your eyes, you look like you have been crying and you are quiet, and I have heard alot about you from the other nurses, how you make them laugh and how you have a way of making pt.'s smile, at least that's what my day nurse said. She told me that I would love you as my nurse and how great you are. But you seem like you are sad. You seem withdrawn." I apologized, and said to him, "My uncle died in a car accident last week, he had a heart attack and it caused him to drive off the road causing his car to flip over 6 times" I was SHOCKED that came out of my mouth.

My pt. said, "Nurses are people too, pt. forget about that how their nurse is human and has feelings, I am sorry to hear about your uncle." As i am hearing my pt. say this I am looking at him thinking, he is only 21, has cystic fibrosis, has septicemia, struggeling to breathe, and is asking if ME, his nurse, if I am ok?

My black cloud lifed as soon as he asked if I was ok, he is the only pt. I have ever had that has asked "are you ok?"

At the end of my **** this morning I gave him a hug and said "thank you", He said, "If I have one purpose on this planet in my short life, why not help others" I found out he had a PhD in Psychology...hahah

Ok enough I am going to bed>

glasgow3 · Oct 24, 2008

I don't know if you need a therapist now but you surely will if you continue in that current job.

You've said it yourself, the more experienced nurses on your unit believe the recent changes have made the conditions unsafe. You as a novice have come to the same conclusion. In my view that makes you a superior nurse: You can foresee what can go wrong under the current conditions, you are not blinded by either management's praise that everything is fine, nor management's admonitions that any problems stem from poor time management etc.

All too often newly licensed nurses believe that hospitals would not provide inadequate resources to do the job safely. They are told that those who believe otherwise are just "complainers" and that you are doing just fine-----until the inevitable happens: a serious event occurs at which point those same people will not hesitate to recite which hospital policy you had violated in an effort to distance themselves and the hospital from the consequences....and from YOU!!!

For the sake of your license and your mental health----Get out of there pronto!!!

TakeTwoAspirin, MSN, RN, APRN · Oct 24, 2008

I would encourage you to get another job. Seriously. This environment sounds as if it is toxic for you. Other people may be able to handle it, and that's great for them. Clearly, you are stuggling with it for whatever reason. Sometimes you just have to save yourself first and this sounds like one of those situations.

I don't know if you have a mental illness that requires treatment or not, but I don't think you will be able to tell until you get out of this environment. It's just not healthy for you and the sooner you get out of it the better imho.

Midwest4me · Oct 25, 2008

Bless your heart! I'm sorry to hear of your nightmarish shift, however,I have two pieces of advice for you:1) don't go to work if you've been up 24 hours or more--you're doing yourself an injustice! 2) Get the heck out of that job!

Black Jade, BSN, RN · Oct 25, 2008

I understand how you feel, casper. I work in a community health setting, and even though people think that it is not as stressful as working in a hospital, it is. Especially for a newbie like me, because you have to oversee the LVNs and the MAs. Sometimes I wished I should've done at least a year of hospital to get the foundation and practice on my assessments, but I don't see myself working in that setting. For some reason, the thought of giving too many unfamiliar medications just gives me anxiety.

I'm already on my third week and the orientation is a mess. Ideally I was supposed to be working one week in adults, the next in Peds... Instead, the schedule is very inconsistent in where they are floating me to work one day in Adults, the next day in Peds, then phones, then working as an MA, etc... because we are short of staff. When they told me that I would be working alone on my second week one night, I told my supervisor that I didn't feel that I had enough orientation to be on my own. But I survived that night. When my supervisor was making my schedule, she asked me where I needed more orientation. Obviously, where I'm needed more as a nurse, especially if I will working on my own again and there might be an emergency. They have receptionists and MAs who can be rotated to do phones, but nobody can do what a licensed RN can. (ie. IV push, IV meds, etc...) As a result, I need more practice in that area. The policy and procedures are a joke. The RN, LVNs and even providers don't follow the same protocols which I think it would be easier for everybody and less confusing for a new person like me.

I've asked myself many times, "What did I get myself into?" My patients consist of at least 95% of the hispanic population and are very uneducated. I thought I wanted to work in this type of setting, because I wanted to educate my patients. But I find myself sometimes feeling frustrated. Also, almost everyday I stay late and this Thursday I worked almost non-stop. Ten minutes before my shift was over, the RN lead asked me if I was doing anything, because a patient needed an ear lavage (ear lavages are time consuming and nobody likes doing it). I had just finished with another patient and he wasn't busy and he could've done it himself. I told him that I had to leave and I still haven't even finished my charting and why don't you leave it for the evening nurse. He used to be sort of my mentor. But ever since that day, he has been acting like an ass****. Either he doesn't hear me or he is just ignoring me.

So yes, I feel like walking under a black cloud. Friends call me or email me to ask how I'm doing in my new job. But I isolate myself from them because I don't want to complain especially because it took me awhile to get a job. I like helping my patients, but this orientation mess is dragging me down and affecting my self-esteem even the respect of my peers. I know that I'm smart, but sometimes I feel dumb and incompetent. I don't know if the fact that I graduated almost a year ago and haven't been exposed or the fact that I was diagnosed with a learning disability two years ago has anything with feeling this way. Like you, I feel like I'm on the edge, because I don't know if I will be able to handle whatever comes my way such as do certain procedures or give certain medications that I don't know how to administer. As a result, I can never seem to relax.

But, I try to think positive. I try to think that things happen for a reason and this is God's way of testing my abilities and my patience. You will be learning things everyday and will be learning from your mistakes. My goal is to prove to myself (and others) that I am capable of being a great nurse. It's only a matter of time.

Thank you for posting your message and for letting me vent as well. It's good to know that I wasn't the only one feeling this way. May you have a great week ahead of you. :wink2:

casperx875x · Oct 28, 2008

I wanted to thank those who took the time to read and/or post a reply to my post. I have sought out coworkers for support and have gained some excellent insight from them. I've seen my PCP and have an appointment with a Psychiatrist for additional support and treatment. I am hoping for positive changes to come! Thank you again. :redbeathe

GrumpyRN63, ADN, RN · Oct 28, 2008

Maybe see if your employee assistance program can refer you to someone to talk with. You are new yes, but it seems you are under more than the usual amount of stress . Maybe you can talk with your manager and see if you can have a lighter assignment for a couple of weeks . Sometimes the unit is going thru a rough patch and the pts can be high acuity for a while. You should talk to someone before you lose your self-confidence. If the unit itself is toxic or not the right fit, move on. No job is worth that much psychological and physical turmoil