When the Shift Hits the Fan.
It is inevitable. It will happen to you.
No matter if you are a new graduate or veteran nurse, there will be that shift that will almost break you. Staffing is short. Your patient is crashing. Maybe it’s downtime to boot. The stress is overwhelming. You are heading to the med room to cry.
I have been there and shed those ugly tears. You feel like you’re drowning, and there is never enough help. I wanted to write a quick post with some advice about stress-management strategies that have helped me cope during those really hard moments when the shift is really hitting the fan.
Remember - You can’t do it all.
That moment when you start to feel like you need to clone yourself 10 times, stop and remember that you cannot do it all. THAT IS OK. You are a single human with a maximum capacity to take on tasks. Luckily, nursing is a team sport. Reach out to others and throw up the S.O.S. signal. Get some help. This is not a sign of weakness. This does not mean that you are not a good nurse. You are recognizing your limitations in the moment and putting patient safety first. It is appropriate to ask for assistance. If you try to do it all alone, you are putting yourself and your patients at risk. Don’t do it. That is never OK.
Take a deep breath. Try counting to 100 by threes.
Victor Lipman wrote for Psychology Today – “Get your body in hand first, and the mind will have a better chance to follow.” By using distraction techniques (like breathing and counting), you start to take control of yourself physically. This will help slow down your racing heart, help you avoid hyperventilation and allow you to think clearly. Nursing is a high-stress job. We are asked to do an impossible number of tasks (see the previous section) as fast as possible with less and less support. And not to mention, we are responsible for human lives. It’s normal for you to physically respond to that kind of stress. To succeed in a time of crisis, you will need to calm the body as well as the mind.
Triage. It is time to triage.
I am 100% an ER RN, so I am going to preach the importance of triaging your situation. It is time to get organized. You need to sort out what are the tasks that need your immediate attention, what you can delegate out to others, and what can go on the back burner. We already established that you cannot do it all. By triaging the urgency of your duties, you will complete the super STAT things quickly and figure out a way to get the other things finished without losing your mind. There is the possibility that you might not get it all done. And that is also OK. If all your patients are alive, your documentation is done, and no one is yelling at you, then all that extra stuff probably was not as necessary as you thought.
Don’t buy into the crazy.
When it’s busy, everyone gets stressed out. Emotions will be running high and sometimes, logic starts to fly out the window. It is SO important to not start down the road to Senselessville. Medicine has standards of care. Hospitals have policies and procedures. There is always structure to be found, even when it seems like the walls are crumbling around you. Let those rules guide you in the times of chaos. It can be very comforting (not to mention extremely helpful) to tap into those policies and procedures when the shift is blowing up. If you’re not sure if what is happening is kosher, take a minute and check the rules. You may be surprised at what you find.
Thank your coworkers.
Gratitude works magic. If you had someone come help you in a pinch, find them later and give them a “thanks” and a high-five. Nurses and other healthcare workers do not appreciate each other enough. We do some amazing work in ridiculous conditions. Find a minute to tell your colleagues that they did a good job. I find that appreciated coworkers are more apt to help in the future.
Take time to decompress.
This is for after the shift-show has calmed down. You need to take some time to process. Whether it is in the car on the way home, in the shower after your shift or during a run the next day, find some quiet and let yourself go through the stress of the day. When we carry around too much stress, it can manifest as physical symptoms. By allowing yourself to work through the bedlam of your nurse life, you will find better balance in your personal life.
Have a great shift!
- Sarah @ New Thing Nurse
About the Author - Sarah K. Wells, MSN, RN, CEN, CNL is an educator, speaker, blogger and owner of New Thing Nurse, a professional and academic coaching company for the nursing world. New Thing Nurse is organized to provide support and guidance to aspiring nurses, newly graduated nurses, and veteran RNs looking to make a change in their life.
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