I feel like I got a brain transplant and nobody told me. I woke up with someone else's brain. I am so slow, I can't organize my thoughts. I am trying to wake up this morning. I had coffee and I've been up 3 hours, and I am a vegetable. I feel like crying but I don't have the energy.
Last night I got off work and I lucked out, only had one patient all day and my admit didn't arrive on time, they sent him to ultrasound first so I got away with not having to settle him and the night shift arrived and got report, and he still wasn't there. I offered to stick around and help them but they didn't need help, so I went home.
Yesterday I started my first week of doing just two 12 hour shifts a week. I am only three years into this but I already feel like it's taken everything out of me. Nursing can eat you alive.
At 46 years old, I am starting to go through a lot of ups and downs that I know are because I'm approaching menopause. I am finding that the lack of sleep, the associated fatigue and brain fog, and what I've been reading about poor concentration, memory and slower learning response that goes with hormonal fluctuations in perimenopause are all hitting me hard now. I have only been a nurse for 3 years but I started it at a time when my body was starting to go through all these changes.
I didn't pick things up as fast as my 15-20 years younger coworkers. I am struggling just to get through each 12 hour shift now, with the amount of information and multitasking that's expected and you have to be ON,ON,ON all the time and you can't afford to ever be off. The few nurses who are working full-time or close to it, who are my age, have been nurses for 15 to 20 years. They can do the job in their sleep. For me, it's difficult because I am so new and still have so much to learn.
I really do feel like I have someone else's brain. This donor brain is not agreeing with me, either. My body feels like it's rejecting it.
I go to work in the morning feeling like crap. Work is unbearable. I get into report and lately I have to slow the night nurse down, and have them repeat parts of report, because my brain can't keep up with the amount of information it needs to process in a short time, early in the morning. Getting the whole story about what went on with the patient, why they are in ICU, how they got there, all the things we are treating, it all goes in one ear and turns into a big pile of mush and runs out the other ear.
We have to do rounding with the doctors and everyone else at 9 am. On the best of days it's a mad rush to get report on both your patients, figure out everything about your patients when you have to do your assessments, give any important medications, figure out what's going on with the patient and what their needs are, and look at labs and x rays and other diagnostic results and even on the days when I slept well and my brain is sharp, it's tough.
I have serious brain fog. I feel horrible and I can't seem to function at even half the speed I usually do. I have to be on top of so much and I feel like I can hardly focus on the one thing I'm doing at the moment, multitasking is almost impossible now. Plus I've been having to give my energy to students and people shadowing me, and I feel like a complete basketcase and totally incompetent. I'm also scared. I'm afraid of losing my job because of doing something wrong, I feel like there are people with knives waiting to stab me.
Lately I get to rounding and I can barely string words together in a sentence. I feel like a babbling idiot up there. If I'm lucky, the doctor is nice enough not to rip me a new orifice in front of everyone. I can't seem to fit the pieces of the puzzle together. I feel like all the information in my brain is bouncing around in there like a pinball.
A few weeks ago, I made my first med error, that I know of. It was a Lasix drip, which is a diuretic. We hardly ever do Lasix drips, and when we do, the dose is usually pretty small, like 5 mg per hour. Well this one was written for 40 mg/hr and I read the concentration wrong on the bag. Who knows what my brain was doing when I read the label, but I set up the drip to run at what gave a dose of 4 mg/hr, or one-tenth what the patient was supposed to be getting. The patient was fine, fortunately, it didn't do anything except slow their rate of urine output but he was already peeing and they ended up discontinuing the drip the next morning anyway, regardless.
I didn't even realize it and had it there at 4 mg/hr all day, the charge nurse never checked the drips even though they were doing that for a while. Night shift came on at 7 pm and didn't even realize it until the middle of the night. So they caught it. As it turned out, I never would have heard anything about it except the next day I saw the charge nurse from the day before and she told me about it. No one else ever said a thing.
It worries me because if I'm screwing up numbers like that, what if it had been something more dangerous like a vasopressor. I am checking myself with the pharmacist because I don't trust my brain anymore. And I used to be able to whip numbers around in my head and figure out drip rates like they were 2 + 2.
This is scaring me!
I got my review a few weeks ago. In my emotional state, I was doomed. I sat down in my boss's office with her and our unit manager, and the first thing they did was give me my peer comments. They might as well have hung me out the window by my toes the minute I walked in the door.
The first thing my eyes went to were the negative, critical comments. There were positive comments in there, but I didn't see them. One in particular shot out at me and I fixated on that and didn't hear anything else the rest of the time. "Jane's attitude can be perceived as tired and disengaged."
No SHIT!
So my co-workers notice that I'm off on another planet most days.
I barely made it through the rest of my review. The next day at home, after a nap in the afternoon, I felt brave enough to look over my review again. The one I got, the official one (peer comments don't "count") from management, was good, really good. If I'd been in any better frame of mind, I would have walked out of there with confidence and feeling good about things.
In my usual everyday state now I am holding back tears and the same thing happened at the review, and I felt like a bunch of people cornered me in a knife attack.
I'm so tired and irritable and things feel so amplified. Last week I got stuck working 3 days in a row, which I never do. I had a student with me all three days, which taxes my patience. I have no patience these days anyway. Two of the three nights I got lousy sleep, and on the third day, at 4 pm when I got a really sick, hypotensive, busy post-op admit, I nearly went ballistic over priming some epidural tubing because our nurse manager is an idiot and gets under my skin.
Really, she is about the most annoying person ever known to humankind.
The patient was starting to have blood pressure issues when the anesthesiologist walked in the room. Thankfully she came up to check on the patient, because I was pushing IV pain meds because the epidural wasn't set up like it normally is when the patient arrived and I had my hands full with everything else, plus the student. The anesthesiologist started pushing Neo and then the patient's blood pressure shot up like a rocket. Then it slowly came back down. Meanwhile I had about 5 poeple in the room trying to figure out how to prime the epidural tubing since we never have to do that part. We just manage the drip.
Like a bunch of monkeys, our nurse manager and a few other nurses stopped in, all trying to figure it out. I was watching the patient and getting all the other orders going while trying to explain the arterial line, central line, chest tubes, other drains, and epidural catheter to the student.
I was absolutely at the end of my rope on the 3rd day. I felt like I had bugs crawling under my skin. It was crazy enough, then the nurse manager drags more people in the room, because she can't figure out the epidural tubing either. I don't like HER being in my patient's room. She gets under your feet and she isn't helpful.
Finally I snapped, "There are too many people in here!" and she mumbled something, saying we (meaning me and my student) are so defensive, she was just trying to help. In my mind I was saying, damn it, get the hell out of my patient's room. I'll call you if I need you.
I caught her outside the room later and said, "It was getting too chaotic in there and I didn't want a bunch of people in the room and you kept bringing everyone in. I'm not being defensive, I'm just tired and short on patience."
I held my thumb and forefinger together, rubbing them against each other.
"It's like THIS," I said. "I have THIS MUCH left."
She already knows this. We talked about this multiple times, she knows why I went part-time, she was in on my review, I've talked to her several times over the past few months about various scheduling issues because I was feeling so exhausted. She's an idiot.
She's the one who forced me into working three days in a row with a student because she didn't remember that we'd talked about this a month ago, that I needed to work Monday Tuesday and Thursday. But I got stuck on Wednesday anyway and she denied that we had the conversation when I asked her about it. I guess I need to get everything in writing from her in the future.
I wish sometimes that I could just get some validation, or some support at work. It comes in such rare, small doses, it doesn't feel like it exists. I wish I could slow things down. I need someone to talk to, someone to bounce things off of, someone who works there and knows the place, the people. I feel so alone. I know I'm not the only one struggling but I feel alone in my struggle.
Last weekend I was running with a co-worker, who is sometimes in charge on night shift. We were running in a local half marathon and we ran the first few miles together. He was so nice, he told me that he thinks most people at work are not very nice or understanding of when others are struggling. That was so validating for me.
And he validated it more by saying that when he makes assignments, he knows not all nurses are equal. Some things stress certain people out and he tries to make assignments to keep them from feeling stressed or dumped on, and somehow they can still take it personally and feel like they are always being dumped on.
Even The Mouth, of all people, just yesterday, she was saying how she feels so stressed when a certain night nurse comes on after her because she feels like she has to get everything done or that nurse will have a cow. And it's so true. I'm not the only one who gets that crap.
But for the most part my coworkers don't seem to understand this stuff at at all. It seems like they have all sorts of energy, are on top of everything, run off to do social things after work, and I have so many days where I feel like I'm spent from the minute I clock in. I'm exhausted from the time I walk in the door because I've been up half the night.
I wake up hot and sweaty, and can't get back to sleep for hours. Then I have to endure another 12 hour shift, or two days in a row, sleep deprived, when I'm having to juggle a million things and two patients lives depend on it, along with the demands of their family members, the doctors, and everyone else.
Perhaps I went into it for the wrong reasons, but I don't think so. There probably are no wrong reasons, everyone has their own life plan. I am truly at my core a creative person, and the work of nursing, because of the institutions and structures that govern it, is a rigid profession. There might be a lot of potential variety out there, but in a bad economy and a bad health care system and when cost-cutting is the priority, nurses are the ones who get hit. We have to work longer hours so there are fewer nurses to pay with wages and benefits. And those nurses have to do more inside of those 12 hour days. And there are fewer jobs in which to move around.
I've been looking at other jobs and haven't found anything that appeals to me. I don't want to be applying for jobs in desperation and thick brain fog.
Anyone who can endure years of the nursing grind, is made of a harsher, harder material than I am. I worry now that I might not even make it another year, the way I'm feeling, just praying each morning that I can get through the day. I have come to resent the energy it takes from me, so that on my days off and away from the hospital I have little creative energy left to do the things I love.
I hope that this hormonal stuff will come to pass soon or that I can find a way to manage it and live with it. I hope that my two day a week schedule will pay off in stress reduction.
Otherwise, I'm going to remain out of my mind. I don't know who that other person is who has my donor brain, but I hope it's having fun!
