Episode 15: How To Cope As A Nurse

Episode 15: How To Cope As A Nurse

July 12, 2019

 

How To Cope As A Nurse

So today, we will talk about how to cope as a nurse in our careers which can experience times of deep empathy and stress.

But first we will talk about the Current health News; Scientists have found a correlation between a disease involving chronic pain and alterations in the gut microbiome.

Fibromyalgia

Fibromyalgia is often known as a disorder characterized by accompanied by fatigue and altered sleep, memory, and mood.

Widespread muscle pain and tenderness are the most common symptoms.

fibromyalgia

Intrestinting to think about it as a “disorder” what does that mean? Definition: a state of confusion, disrupt the systematic functioning. Why is our body being confused causing these systemic issues?

 A Montreal-based research team has shown, for the first time, that there are alterations in the bacteria in the gastrointestinal tracts of people with fibromyalgia. Approximately 20 different species of bacteria were found in either greater or are lesser quantities in the microbiomes of participants suffering from the disease than in the healthy control group.

Are bacteria simply the markers of the disease?

At this point, it’s not clear whether the changes in gut bacteria seen in patients with fibromyalgia are simply markers of the disease or whether they play a role in causing it. Because the disease involves a cluster of symptoms and not simply pain, the next step in the research will be to investigate whether there are similar changes in the gut microbiome in other conditions involving chronic pain, such as lower back pain, headaches, and neuropathic pain.

Parkinson's disease (PD) is a neurodegenerative disorder that affects predominantly dopamine-producing (“dopaminergic”) neurons in a specific area of the brain called the substantia nigra.

Tremor, mainly at rest and described as a pill-rolling tremor in hands. Other forms of tremor are possible

Other symptoms: 

  • Bradykinesia
  • Limb rigidity
  • Gait and balance problems

Swallowing problems can cause patients to inhale small bits of food, which may result in aspiration pneumonia, an infection of the lungs that can be life-threatening. A 1999 study of people with Parkinson's disease that followed patients for 10 years found that pneumonia was the most common cause of death in these patients, causing nearly one-third of all deaths among patients in the study.

Patients also may have impaired balance, which can result in falls that lead to serious or even fatal injuries, the Michael J. Fox Foundation says.

How To Cope As A Nurse

How we do our job at a young age and we are surrounded by sickness and death. 

Your shift started at 1900 Larry is there, he’s been there for 14 nights. They took out his swan, the echo shows an EF of 20%, the last PA pressure showed 29/12, SVR is 1600, and the only option is a heart transplant. You check your drips and print the balloon pump strip. Talk some Bullshit with Larry for a few minutes before heading back to check the notes. 2100 you go back in and hit the 2:1 button on the balloon pump and get your strip, Larry is still hanging out and telling you that the Cardiologist came in and said they might start taking off some of the inotropes and ween the balloon pump tomorrow. Good news, Larry is moving up. 2122 the high priority alarm goes off, that sinking feeling, that feeling of I hope that not my patient. Charge calls you in and you see your friend pumping larry’s chest the code starts. Your feet get heavy you look at the time, 2123, and start recording. Few Epi pushes, Bicarb goes in, and a hand full of pulse checks. The Physician says “time of death 2144”, you look at the clock and nod in agreement. 

Maintaining healthy emotions when your patient dies can be difficult.

This is an occurrence that no book, no story, and no clinical can teach. The only way to deal with patient death is having a patient die right in front of you. 

Death is currently inevitable, no one lives forever. Everyone will die and it is the hardest thing to deal with. It doesn’t matter if it's a family member or a stranger death is hard.

Death is a physical phenomenon to the individual going through the phases of dying, but it is a mental phenomenon for everyone around.

You develop a connection with your patient and that connection grows the longer they are in the hospital. The connection grows even more if you have complete respect for the patient. It grows when you learn you are into similar subjects and it grows with each genuine conversation. 

According to ANA, 8% of nurses use alcohol or drugs to cope. Those stats are a little skewed because not everyone is willing to come out and admit it.

How do we cope as nurses with constant death?

It’s easy to fall into the pitfall of drugs when you see death on a constant basis. This has a drastic effect on ICU, trauma, combat, and hospice nurses especially. 

The question of how we deal with death isn’t asked very often. So how do we deal with death and consistently seeing life hanging on by a thread? How can the most sensitive nurse work through death?

Drugs and alcohol should never be an option for coping. Alcohol and drugs give you the most abundant short term pleasure and what makes things worse is that you develop a tolerance. Drugs and alcohol are the easiest things to get a hold of. We work with them all day and night and alcohol is readily available in stores. Access can easily lead to addiction. You feed your brain with short term pleasure, dopamine. Drugs can drastically change your synapses to be more addicted to drugs and alcohol. 

Especially new grads and nurses with a few years experience can easily fall in this trap. Were young and at such a young age we entered a career that will expose us to death, so much death that some of us may not be able to take it. I’ve heard many nurses say if you can handle the job then don’t do it. That is the worse advice you can give. Not only are you belittling the nurse but you are adding a sense of failure. This was their dream job and it's crushing them and you are not adding on to it. 

As a nurse, you try to do everything you can to save someone's life and even then it doesn't work out. There will be months in your career where it feels like every patient you have died, that has nothing to do with you, that is what life is. 

Constant death and the feeling of failure makes you feel useless and unaccomplished. We’ve all had those nights. The nights where you’re laying in bed and contemplating your career and life. Alcohol and drugs are easy to start and hard to quit. Next thing you know you go from taking care of patients to be taken care of as a patient.

If you don't get those feelings it's ok. If you can deal with death without hesitation you are no less of a human than the nurse that takes it to heart. 

I was fortunate or unfortunate, depends on the way you look at it, I am fairly immune to death. It’s not that I don't connect with humans or that I don't experience emotions when a patient dies, it's just that I understand that the process is the way it is. That is dry to say and maybe unempathetic but that is just the way I am. I try my hardest to keep my patient's alive but I don't beat myself up if it doesn't go my way. 

I've seen nurses cry over their patients and I’ve seen nurse feel like failures. Those are normal feelings to have and it takes time to heal them but you are doing no favor to anyone by being unable to move on.

Here are some ways that can help you cope on those rough nights

  1. Understand that its not your fault.
  • Talk to someone or go cry in the bathroom. No one will judge you and no one will shy away from your questions. Talk to a coworker or a friend. Don’t keep your emotions bottled up they will eat you from the inside out. Do not get lost in your thoughts, this happens because you stay silent and think you can deal with these things yourself. The same way you want your friend to talk to you about issues people want to hear how you are hurting and how they can help.
  • Take mental health days
  • It’s ok to call off after a rough night, it's ok to ask your manager for the next day off. You work hard physically and mentally. Take a damn day off, your job isn't going anywhere and no one cares that you called off. On that off day do something. If your staying at home and keep replaying the same 10 minutes of the code go outside or workout. Listen to a podcast, get your mind off it.


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