Resurgence of Anxiety

Hello All,

So this is kind of both a life post and a nursing post, but i have been having a lot more anxiety lately. I think there are several factors that play into this, but I definitely noticed an increase.

I thought maybe it was (those who don’t appreciate lady talk avert your eyes) where I was in my cycle, but after several days of feeling melancholy, I felt like I needed to something more. After having now settled in somewhat to my new surroundings, I have come to the conclusion that I need to do some more self care.

One of the first things that my supervisor told me when I started working on my new unit was to take my time to settle into the unit before taking on anything extra. She said to find a mentor or a coworker that you connect with that you can ask questions or feel comfortable talking to. So now that I feel I have been able to do this, I felt like it was time to put some effort back into me, so what better day than Valentine’s Day.

As I lay in bed after a lovely dinner cooked by Ethan (salmon and veggies yum!) and some beautiful gifts (hello Tiffany bracelet…

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and some lovely smelling candles)

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we watched some TV. As we were laying in bed, Ethan snoozing away, and myself awake watching TV, I found that I was feeling amped up and starting to feel that edgy feeling coming on of just wanting to jump out of my skin.

SOOOO being 1:30am I decided naturally that it was time to hop on the treadmill. It had been WAY too long since I had done that, so I only lasted about 15 minutes, but those 15 minutes really helped take the edge off and help me get over that hump of wanting to jump out of my skin.

I now remember the importance of self care, especially in nursing. I need to make sure to take time to care for myself so I can care for others. What is your favorite form of self care? Let me know in the comments 🙂

Until next time

~Niki

Lunching in La Jolla

The other day I had a lovely lunch with my sister who I see not nearly enough. As she will be moving soon, we are really trying to make more of an effort to get together and do things.

This time it happened to be lunch at The Crab Catcher in La Jolla. With those beautiful views overlooking the water and some excellent food, it was the perfect place to have a nice relaxing lunch and catch up. With food and drink that was to die for, we left feeling very happy relaxed and satisfied.

Hello Crabby Mary

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Then we wandered over to this adorable coffee ship that is a little bit hidden, but none the less one of my favorite places that I have found for coffee so far. Elixir is one of those cute little coffee shops where they make pretty designs in your latte and have adorable little pastries. Where we sat for just a short while and chatted some more before calling it a day to go back home.

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All in all I would say it was a great day and loved spending time with my sister!

~Niki

Jump Start

So on Monday I started a cleanse, to try and jumpstart myself back into healthy eating, and boy let me tell you the first day was killer. I felt hungry a lot, but now that the week has progressed, I am getting used to the new routine and am not feeling like I am starving all the time. I am actually starting to feel like I have some more energy, but its still somewhat of a struggle since I am on night shift, and that throws off the schedule a little bit.

I have been eating the meals they provide and they are very yummy,  I am pleasantly surprised and a little inspired by all of these new recipes to want to cook more. The last one I made was a pasta dish with tomatoes, veggies, and turkey, and a spice that I hardly ever cook with and never honestly thought much of, cumin. This dish was so good i would totally make it again.

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I hope this is able to start me on a schedule that is headed in the right direction, and I will share my thoughts about this cleanse I am trying out.

Until next time

~Niki

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

 

Dealing with Difficult Patients

The other night I had a particularly difficult patient. On top of being in acute alcohol withdrawal, this individual also had an extensive psychiatric history and history of previous substance abuse. This is a winning combination that leads to a busy night. First this patient had been getting better during the day, and for the beginning portion of my shift, this patient was fine. Then as the night progressed and my other patients drifted off to sleep, the patient began to escalate. Everyone that is a fall risk in the hospital has a bed alarm on so that we as nurses know that patient is getting out of bed and can run in there to prevent any harm or falls to the patient. This patient was setting off the bed alarm at an increasing rate. I was giving this patient Valium 10mg every hour as that was how his PRN (as needed) order was ordered. The patient was not responding to Valium, and I even tried giving a dose of Ativan, which had a temporary fix for about an hour before the patient was climbing out of bed again.

12 hours worth of this is enough to make anyone lose their mind, but as nurses we need to keep our cool and treat each patient with the respect and courtesy everyone deserves. There are a couple of ways that I have found that work for me when I do this.

  1. Remembering what the patient is here for and that patient safety comes first. I will be the first to admit after the 203 time the bed alarm rang I was tempted to just turn it off. But this of COURSE would be dangerous for the patient, and neglectful of me, so of course I did not do this, but just taking the extra moment either before running into the room to steady the patient, or after settling them back in to remind yourself that they don’t know any better and are there because they need your help is a good way to keep yourself sane.
  2. Speaking with your coworkers about it. Just allowing a little bit of your frustration to leak out and have someone who understands validate your frustration can help relieve some of it.
  3. Speaking up and knowing when to ask for help. We are nurses. We are strong. We are patient. We are also human and have our limits, so knowing when to ask for help is crucial. On my particular unit we all work as a team, so my fellow nurses would occasionally run in there as needed when I was running behind or with another patient. I of course reciprocate as needed when my patient load is not as crazy, and someone else has a difficult patient.
  4. After work activities. Make sure that your shift doesn’t totally get to you! I know this probably sounds ridiculous with the above story I just told, but have a glass of wine or cocktail with friends and just vent it out. Especially with some nursing buddies, they can relate and maybe even give you advice about how they deal with it. I included a picture enjoying some time out with friends. Or just do whatever you enjoy doing to blow off some steam.

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This is just one example of a difficult patient and they come in many different forms. What’s the most difficult patient you have ever had? Leave it in the comments

~Niki

Dealing with Stress

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Stress is a large part of what nursing is. In nursing school I struggled a lot with managing my own stress, because this was a level of stress I had not had to endure before.

Stress can come from many different aspects of the job

  1. The job itself
  2. The long hours
  3. Being in unfamiliar territory
  4. The patients or their families
  5. Co-workers
  6. Life outside of work
  7. Your own expectations of yourself

It could be one, some, all, or aspects of our lives that are not listed here that cause our stress, and it manifests differently in everyone. Personally it manifests as being grouchy, lashing out at people, and when left untended (which did happen in nursing school 😦 ) can turn in to anxiety and depression.

When I am the most stressed, I am the least equipped to deal with my anxiety and it can get the best of me, BUT on a more positive note now that I have expressed the reality of stress, there is still a lot that you can do about it! Personally when I moved, I uprooted my life to move to a new place, with no one I previously knew from a cozy little city where everything had been familiar and comfortable for so long that the transition was a difficult one.  After some time, I was not sleeping enough, I was eating junk, and I was not exercising regularly.

Initially when people were telling me to make sure I took care of myself, I kind of blew them off thinking…psh everyone says to eat right, sleep enough, and exercise, I’ll be fine it’s whatever… Later realizing that those things are KEY to keeping yourself feeling good and managing your stress.

I CAN NOT STRESS ENOUGH HOW MUCH OF A DIFFERENCE THIS MAKES!!

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Some fresh tomatoes from the garden 🙂

Once I began sleeping more than a few broken hours a night, eating more balanced meals, and taking the time to exercise (even if that means just going for a walk around your neighborhood), I felt I was able to manage my stress and start to feel like myself again and like I had control over my life (I mean to the degree we can have control over life, we can’t control every thing 😉 ). The exercises that worked best for me happened to be jogs and walks outside, because the fresh air tends to do me good, and hot yoga because I had so much anxiety, the inward reflection and focus on my breathing helped calm me down, in addition to improving strength and flexibility (something I am sure we would all like!).

What are some things you like to do for stress relief and management? Leave tips or tricks in the comments!

 

~Niki

Happy Thanksgiving!

Happy Thanksgiving all!

Thanksgiving Contest - What Are You Thankful For?

Let’s remember all of those nurses that are hard at work today!

This year, those of us that were working on our unit had set up a  potluck long in advance and will be having a wonderful feast! Dividing up all that work allowed for everyone to contribute and for there to be a lovely feast.

I am grateful and thankful for my family, friends, and to be working on such a wonderful unit where we are family! I am also grateful for the help and guidance from all of the members of my work family during this time of transition from student to working professional! Additionally I am thankful to be healthy and have plenty of food on my table this year.

Any of you out there that have any good stories, or traditions for those working or not on this festive day? Please leave them in the comments.

Happy Thanksgiving all!

~Niki

*Disclaimer,the photo was pulled from google images, I just found it to be festive and appropriate :).