Friday, November 28, 2008

Nursing Stress - Her Lesson And My Lesson

Nursing stress can add up quickly. Between the cell phone and the pager, the demands seem to come all at once at times. And sometimes just projecting on the fact that I know I'm going to be "pulled in multiple directions at once" can bring the most nursing stress of all. However, my patient taught me a lesson the other day...and I'd like to think that I did the same for her.

My day started off like any other day. Unpredictable. No sooner did I get my pager and my phone handed to me then off it went with a message stating "room #-- wants to discharge." I dropped what I was doing and went straight to my patient's room to give her a time frame for her discharge. On my way, I stopped my nurse assistant to see what the patient's morning vitals were. "Hmmm, heart rate is 130, but no fever? All other vitals within normal limits. Interesting," I thought.

She was anxious, speaking very quickly and had a very concerned look on her face. "Am I going to discharge? Can I have a pain pill? What's the plan?" she blurted out as soon as I introduced myself. I explained that I would discharge her a.s.a.p. and I brought her a pain pill. After all, according to her chart, the doctor had discharged her two days previous. Each day, however, the discharge got cancelled due to various reasons.

Ten minutes later, I get another page for the same patient. This page says, "room #-- throwing up." I drew up an IV anti-anxiety med. (with anti-emetic properties) and an IV antacid med. When I returned to her room, she had just thrown up about 300 ml's of green liquid and was sitting on the toilet with the trashcan between her knees. I soon learned that I could definitely rule out bowel obstruction.

She was a mess. She just kept repeating over and over, "How can I go home if I'm throwing up? I want to go home, but I'm afraid." I told her that I had brought the medication but that I wanted to talk to her about something. I wanted to talk to her about her anxiety.

I told her that I knew about anxiety from first-hand experience and I've had to learn to cope with anxiety in healthy ways. I told her that she needed to learn to recognize whenever she felt herself "working herself into a lather" and getting anxious (HR raising). I explained that it appeared that she had just had an anxiety attack. Anxiety starts in the mind. In this case, her body had joined her mind in "living in the future". I told her that the bottom line was that whenever a person is experiencing anxiety, they are living a month from now, a year from now, a day from now, etc. They are mentally living in the future and projecting the worst.

It was as if I turned on a light. She began quickly speaking about how anxious she was about going home and what the future held (chemo). She had never had to deal with this type of thing before. Basically, she spilled her guts and cried with relief as she acknowledged her anxious state. Her husband also readily admitted to having depression and anxiety issues.

We talked about how acknowledging her anxiety could be a tremendous gift. She was going to get to learn other ways of coping. They both were. We talked about how she and her husband could embrace the journey into healthy coping techniques or they could continue to fight it. They both acknowledged what I was saying as being true for them and vowed to learn better coping.

The rest of the day got progressively better. By the end of the shift, she had kept down two small meals (lunch and dinner) and hadn't thrown up again. She even waved to me in the hallway as her and her husband walked by.

Her lesson: Anxiety is living in the future, projecting the worst. Living in tomorrow and being sure that tomorrow is going to be horrible.

My lesson: Once again, the power of the present moment is everything. I choose to believe that my God exists in the now, the present moment. He's not off in the future somewhere. He's right in the now with me. The future hasn't happened yet. And I'm not a puppet being controlled by God. He gave me free will. I get choices. No matter what I choose, he knows how to help me through it and support me. That's his job. He does all the heavy lifting. In fact, he wants me to get in touch with my heart's desires so that I can experience true joy and happiness in this life. It's my job to ask my Creator to fulfill my heart's desires...yes, it's my job to do that...because that's how I can build my faith and trust in him. That's how I can experience his love for me.

Projecting into the future about nursing stress is a surefire way to bring more of it into your life. On the other hand, living in the now, asking for what you want and appreciating what you already have is part of a powerful solution.

If you'd like to know more about living in the now, staying ahead of nursing stress, and how to ask for your heart's desires, visit this link. Read the e-book, "I'm Rich Beyond My Wildest Dreams. I am. I am. I am." The book contains a straight forward system for asking and receiving. Plus, you may learn some new reasons that confirm why it's so important to live positively in the now.

Take good care,

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