Working at a top hospital - double-edged sword?

[adinardo]

Hi there -

I am a new-to-practice oncology nurse and have had the incredible privilege of getting my first job at a prominent academic hospital in my area. I love it because I am getting to learn about the newest treatments, see amazing research, and there is a strong focus on continuing education.

However...

Being that it is a referral center, it sees a disproportionate number of rare cases - the very young adults who are very critically ill and often have poor prognoses. While the honor and privilege of getting to participate in these patients' care at such vulnerable moments is not lost on me, I've noticed that I've begun to have anxieties of my own. Not only do I carry my patients' sadness home with me after a tough day, but I worry that I am going to die young. I can't help but feel that it's related to the specifics of my work population.

Does anyone else have this? If so, how do you cope with it?

[PeakRN]

The honest truth is that much of medicine is like that, although certainly to a much larger degree in some settings than in others.

I still remember my first code, intubating him while the family was watching (this was back when I was prehospital), and when we got him to the ED and the doc called it when he did the cardiac ultrasound. I kept running that code in my mind, never mind that afterwards we found out his medical history and he never stood a chance.

I still can remember the name, birthday, and face of the first child abuse I had where the kid ended up herniating his brain stem for a subdural that his parent let sit for hours without any semblance of treatment or care. I couldn't sleep for longer than 30 minutes at a time for days, and had to take a week off from the department because I could not function.

I also remember a young man who was the same age I was who came in completely altered from the most advanced testicular cancer I had ever seen, and the day he walked out of the hospital looking as normal as anybody else. Or the countless kids that we got to tell were in complete remission. Or the mom who had a uterine rupture that after emerging from anesthesia was told that both of her twins are in the NICU and they are doing great and that we can taker her up to see them.

For every bad day we have we get to have many good ones. For me that balance is what helps me out the most. Some days are certainly harder than others but if a day ever comes where I don't feel bad about the poor outcomes then I shouldn't be a nurse anymore. Being completely jaded is not a good thing.

As far as the thoughts you are having about contracting the diseases your patients have, I think that you might benefit from talking to a mental health professional. Most large systems have access for staff to a grief counselor and they are a great resource.

[LittleRN5678]

I work in oncology and I 100% concur with you! It's hard. The job makes you sad and a little paranoid. But I've found it helps me appreciate the little things in life. You are the best person there to help them. Just be careful and don't get burnt out. I have benefitted from therapy, meditation, crying sessions with my boyfriebd/coworkers, and reflective journaling.