(((((Julie)))))

We each deal with the realities of our workplace as we are able. Sometimes we place a protective shield around ourselves in order to survive. You know this.

Would you benefit from counseling? Perhaps. IF the counselor is familiar with and skilled in adressing the effects of cumulative stress, that is. You see, it isn't only the big alarms and frights of nursing that harm us. We are also distressed day in and day out by the batterings of vicarious grief. We become numb in order to survive. And we loose sight of our goals in nursing.

ER nurses and ER physicians are, in my opinion, prone to developing a pervasive cynicism as a mechanism for tolerating the extremes inherent in the ER environment. We do not have to be this way, but cynicism, emotional blunting, and/or treating patients as adversaries is very, very common.

I have been around long enough to recognise a certain 'developmental stage,' as it were, in medsurg RNs who transition to the ER. Typically they are at first little sponges, eager and able to be heroes. Little by little, the shine of their enthusiasm is dulled by the constant demands of patients who feel entitled to narcs/benzos, and by the ignorance of people in general. They become bewildered by the shattered lives left in the wake of drunk drivers and child abusers. Their hearts are broken by the senselessness of violence. They are scorched by mental illness. They begin to drown in the sea of human need. I tell these new-to-the-ER nurses that working in the ER is painful. I warn them about the ease in which jaded negativity and emotional distancing will occur. I warn them to keep their goals in mind. Some listen. Most do not.

I have also been around long enough to recognise that there is a time to change hats. There is a reason why many hospice RNs were once ICU or ER nurses.

So... if you are experiencing "caregiver fatigue," if you have some memories that you won't let yourself remember, if your numbed state is keeping you from experiencing a full life, what can you do about it? Can you take a couple/few months off to focus on telling someone the truth? Can you focus on sleeping, eating, and playing well? It may be that taking care of yourself - really taking care of yourself - will enable you to become emotionally healthy again.

Been there.

Joy