Guilt, Anxiety, and Frustration

I have been struggling quite a bit more on night shifts than I have on my day shifts. While on day shift it was really busy, I always felt like I was connecting well with patients and the work load was always chaotic but manageable. I am not struggling so much with the actual work, but more with my mental state. My anxiety and “hermit tendencies”, as I like to call them, when I go home, have dramatically increased, which doesn’t make anything better.

In the last few days there was also an event at work, that although it was not directly my fault I still feel a great deal of guilt associated with it. I realize that I am being unfairly harsh on myself, but I just can not help but feel like I am totally responsible for that. I don’t want to go into too much detail about it, but initially the medication was hung incorrectly and as I caught the medication error later, but I feel I should have taken other steps to correct the situation. I however had not ever dealt with this situation before, so I followed the lead of my mentor and charge nurse on the proper protocol for this particular situation.

That being said I of course take responsibility for my own actions and realize that I should have listened to my nursing intuition for this particular situation, and notified the MD as well.  The PFO or pre formatted order was set up in such a way that it appeared that we should be able to titrate it according to the order set, but then the medication error element of it should have shot up little red flags to notify the MD, which my sleep deprived little brain failed to see as red flag warnings.

There are a couple of elements that I think factored into this particular situation that made it less than ideal, which is why I am still beating myself up about it. One being the craziness of the shift (those full moons I didn’t believe in before I sure believe in now). I was unable to even think about sitting down to chart until 1am, and this particular evening I was unable to even make it to my lunch/break period until 5am, which is 10 hours later and 3 hours later than I normally go. All of which are fine for me, it just goes to show how insane that particular shift was.

After having had a tough couple of weeks, I am trying to remain optimistic, but I am just afraid most of the time to go back to work now because of the acuity of the patients that have been on the unit so far. It is not a nice feeling to go to work and feel like you’re going to have a panic attack or something before you even start your shift. I am also frustrated by the fact that I feel like the acuity of the unit has gotten to be high lately. Each of the patients are not necessarily medically sicker, but they require more interventions and attention so other elements of my care feels like it is slipping. I also feel that there are a lot of admissions that all need to be done at once, and all of that paperwork takes time.

There are a couple of things I have decided I am going to try as a result.

  1. Probably the most difficult for me as I am working nights and tend to want to eat junk, is to try and eat healthier meals. I don’t mean like all of a sudden I am vegetarian or anything, but try to eat more vegetables and less junk/processed foods.
  2.  Another issue that I was being great with on days but am sucking with on nights is exercising regularly. I keep telling myself that it can wait and I am tired now, but realistically that is when I should be getting up and out. I know motivation when I’m tired is such a challenge so I am going to try and just get outside and walk even if its only 10 minutes, thats better than 0 minutes :).
  3. I am also going to try mixing up my schedule as that was a suggestion from another fellow nurse that I had not previously thought to do.
  4. I am also going to continue to ask for feedback from others to see what worked for them and what hasn’t. All suggestions are welcome as there is no way to know what works until after you have tried.
  5. I have also started baking again, something I love to do, but I have let it fall to the side as I have been tired.

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Hopefully some of these changes will allow me to feel more like myself again. I know it is unrealistic to try and implement these all at once, but I feel if I set a goal to try at least 1 per day that should help. Has anyone else had a struggle like this, or is still struggling? What did you do to help you move through it?

Let me know in the comments 🙂

~Niki

 

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Night Shift Part 2

So I have now been on night shift for about a month and I have decided that I need to make adjustments to what I am doing with my sleep cycle.

Previously, I was just trying to switch completely to a night shift. This worked for a while, but then I realized that I was unable to run errands and be a human for lack of a better way to put it. Now that I have some more control over my schedule, I am working 3 days in a row I think I will try to flip flop so I can actually be a human again 🙂

I have also realized that night shifts take a lot more out of you, both physically and mentally. Physically, it is grueling to have to be awake at hours your body would like to normally be sleeping, let alone running around delivering patient care. Mentally because your brain wants to be asleep and you need to will it to be awake. Also, when I start to have some sleep deprivation, I have noticed I have less patience for everything and tend to be grumpier.

Motivating yourself to do anything becomes a daily challenge. Some days you’re unmotivated to even get out of bed from sheer exhaustion, and I know sometimes that makes me feel like a failure. Learning to forgive myself and allowing these days of rest can help you feel better both physically and mentally. That being said, I have come down with a nasty bug, which is another factor to my feeling gross as of late, and is something that can be put in another post :).

How do you deal with night shifts?

 

~Niki