To ask HCPs how you avoid taking work home. ***TW attempted suicide***

[Overwhelmed0305]

Namechanged as potentially outing to colleagues.

End of programme student nurse here, just finished an awful shift. A teenager was brought in earlier having taken a massive overdose of prescription drugs and alcohol, the aftermath was horrific to watch and now I’m home, I cannot get the images of her out of my mind. It’s the first case like this I’ve seen and it’s unlikely to be the last. I just wondered if any more experienced HCPs have any tips on how to block this shit out when you get home, because all I can think about is her little face and the damage she’s done to herself. Sorry to put this on AIBU but I just can’t shake this one off.

No easy answers, but talking it through with someone trustworthy helps.
I shared a flat with fellow student nurses and we did share and debrief after traumatic shifts.
It is difficult.

I have no experience of this but just wanted to say I'm sorry, that sounds like a very difficult night for all concerned. I'm sure other folk who can give you more meaningful advice/shared experiences will share their thoughts. It's bound to be upsetting for you, I do think that's very normal xx

There are certain things that have stayed fresh in my mind for 40 years.

Hard - it doesn't get easier as such - you learn to cope with it better.

I remember working on scbu and waking up counting AL THE TIME. resps or pulse.

Some cope, some don't sorry I can't be more helpful

You need to talk, talk talk, when you go back to your placement. You can't talk about it at home because of confidentiality, but you absolutely should and must get the chance to thoroughly debrief on your unit.

I have many, many experiences that I could list now, just off the top of my head. Some from my very first experiences as a care assistant, before I did my training. I can still remember vividly, almost slow-motion, those events. But because I had the opportunity to discuss and reflect, I know that I did my best in awful circumstances and it's just the sad reality of our job.

Also, the day you walk out and just forget about what happened is the day you need to quit. If you don't care, you're in the wrong job. Although I do think that most HCPs go through cycles of burn-out where they feel jaded, overall, they do care.

So sorry you & the adolescent have both had traumatic experience today
Were you offered a debrief?often there’s a follow up support session arranged
Youre a student have you contacted uni and tutor
Ok so,in the here and now,you try process,rest,sleep,try distract self

You learn to switch modes to protect yourself - you have to
For want of better phrase you compartmentalise moving between different modalities

Some events,some individuals stay with you,and that’s ok.its not a failing it’s human

It’s only not ok when it’s intrusive and harmful and detrimentally impacting upon you

This is your job,and it’s a biggie. I wish you well in your career,you will become more emotionally resilient as you progress
And you learn how to cope,and go back on in

I have learned to deal with things over the years you just do. Some things hit you harder than others. We are only human
I do mindfulness, yoga and exercise regularly. I have an active life out of work which probably distracts me.
I don't talk much of work when I leave I seem to be able to leave it at the door most of the time wether this is a coping mechanism I'm unsure.

Please though if you struggle there is help and advice through placement/uni I'm sure it even just talking with those close to you.
It's a recognised difficult career path

Some things have been truly so harrowing that even ten years later, it seems like yesterday. You need to talk about it. To someone, anyone. It gets easier, and you find your own coping mechanism. You have to if you're going to survive in this job

I did something similar to this girl when I was 19. I have never in all the (19 years since) years thought of how it might have affected the staff in the hospital. I managed to go home after several days. I now as a mum feel dreadfully sad for my own parents and how they must have felt.

I'm really sorry

My son is in his first placement as a student children's nurse and I worry about this alot do they tell you how to cope

One of the things that I was taught by somebody who works with trauma, is to talk about it from before it happened, through it to after when you felt safe again. I wonder if there is an equivalent for you, so before the patient was admitted, then arriving, during and then you finishing working with them and going home. It's supposed to help regulate your nervous system by talking until after the event, so maybe even if when you're relaying it in your head you make an effort to do this it could help.

Warmth; blankets, warm drinks, human contact, cuddles, animal contact, all help the nervous system to downregulate. If you've had a massive adrenaline dump you may find exercise useful to help burn it off. Gentle movement helps the body move emotional tensions through, but I find vigorous exercise first better if I'm coursing with adrenaline.

I don’t think you can avoid taking it home really, but with experience you begin to accept the things that happen to people as being the peaks and troughs of life human life.

I was involved in a paediatric arrest once and that had an effect on me for a long time afterwards, not necessarily thinking about the child, but just mortality I general. Due to the circumstances and some of the child’s family members being HCP’s I began to question my pointlessness of everything if even they couldn’t even help them. Like what chance did anyone else have?! I would drive home from work convinced that I was one day going to find someone I loved dead and need to try and resuscitate them, and going through BLS in my head to make sure I knew how I was going to respond. It wasn’t helpful, and I eventually sought counselling, not just because of that but because anxiety in general had blown up since that arrest. Counselling was helpful and I began to be able to rationalise that everyone cannot be saved, life is horrifically cruel, but also wonderful and bright, and you have to do your best to accept the balance sometimes.

Just be kind to yourself, and make sure if you’re on an ED placement that you are invited to any formal debrief about it. Students can easily be missed off of things like that, but probably need it the most out of anyone.

Gosh, so many typos. Sorry!

MIND operate a blue light support programme, so it's worth getting in touch, however their infoline is only open 9am until 6pm. Their number is 0300 123 3393

www.mind.org.uk/news-campaigns/campaigns/blue-light-support/

You should also have somebody in your workplace qualified in Trauma Risk Management (TRiM) that you will be able to talk to.

I v much value what I have,I don’t take it for granted.i don’t sweat small stuff
You need to be aware in health and social care you see a v skewed view of life,by its v nature you see catastrophe/trauma/dysfunction
And then you finish,go home,pick up the messages put a wash on

You know, you won't forget about this one. Will it will make the next one easier.

I feel firyou tonight. I've been there. But try switch off three nothing you could have done to prevent it. There was nothing you could have done at the time but they are getting treatment now.

I agree you need to talk, talk, talk.
I find talking to people in different roles helped too because they have a different perspective to me.
If it’s resus/ED any notion of debrief probably went out the window but perhaps ask to speak to someone next time you are on shift.

I find running helps, as does having hobbies. I like baking including making bread and more mindful things like intricate decorating of biscuits. Knitting, sewing and crochet help too. Yoga (blogalates sp? on YouTube) soothes and helps focus.
All things that can be done around shift work.
I find the worst thing I can do is come home and get straight into bed, even if I’m exhausted. I’ll often switch on the radio and crochet for 30 mins to disengage or if something is sticking in my head I’ll write down notes.

If it bothers you, you care but equally you need to find your coping strategies so your shoulders aren’t too burdened.
Do you have any hobbies you are interested in?

The best thing I ever did was get a gym membership for a 24hr gym with a pool. Even just sitting in the pool calms me.

Plan a debrief with your mentor/supervisor. If you can face it take a list of thoughts or things that upset you. They have seen it all before, and just describing what happened will help to share the awful pain.

After terrible shifts and sad times on the ward or in clinic I find it helpful to go home and get back to basics. Tea, comfort food, box set. I have 2 DCs so nowadays they are my back to basics!

Sounds very odd but since you show such compassion and empathy towards this particular patient and her circumstances, it might be worth exploring that more. Could you do some specific drugs and alcohol training, or perhaps mental health. Believe it or not there are HCPs who aren't affected, usually because that's their personality. But a bit like palliative medicine, it takes all types of personalities, so use it to your strength. I know that isn't what you asked, I digress!

I think, also, that we see the extremes of everything. I once cared for someone who had been going about their daily business, then without any action on their part, were suddenly being rushed to hospital, then theatre, for emergency treatment (very vague to protect confidentiality). It really was one of those 'lightning strikes' incidents, except there was no storm to warn of its arrival. That sort of thing makes you appreciate the fragility of life.

Whenever I see someone in a desperate situation related to drugs/alcohol/mental health/self-harm, I always think 'there before the grace of God go all of us'. Any one of us could be that person in other circumstances. Never listen to anyone who tells you any patient deserves their condition. Nobody sets out to be someone who dies of alcoholism, drug use, self-harm or any other self-injurious condition. They are just people, using the tools they found to get through life. Never see 'just another drunk'. They are a daughter, a son, a mother, a father, a brother or sister.

Sorry, I feel quite passionately about compassion in health care!

It is hard, I'm an HCP but not involved in Emergency Care , sometimes I go home worrying about a patient , even once I've done everything I am physically capable of.(Mainly elderly , mainly in situations where they need more help than I can give and it's trying to get them this help. And persuade them to accept it)

YY to talk to others, have a sounding board,
I think once you get to the stage where you don't go home worrying a but then you lose a vital part of your role . (I sometimes f=go home thinking 70, you did a bloody fantastic job there but self praise is no honour .

Looked after similar that expressed regret and then deteriorated. Still remember it like it was yesterday and feeling helpless.
Solitary exercise helps me - eg a country cycle or run. Find talking sometimes helps with other staff but not in a formal debrief way. In reality just more crap stuff happens and compounds the last. Like a random spate of unsuccessful paediatric arrests which seemed nonsensical.

Debrief isn’t necessarily a big formal event,it’s simply checking in how folk are
However as others have said the pace,and volume of work can be such that you move from one event to another.
And that’s the job. You do learn resilience and you become able to cope

I'm a paediatrician. I've been doing paeds for over 20 years. The day it stops getting to me I am walking out, whilst I still have any of my soul left.

It gets to you because you are human. Because you have compassion. Because it is harrowing stuff. You will learn to cope, but don't let yourself become numb. Because being human makes you a better HCP, and a better person.

When I get home after a bad one I might cry. I might garden, or walk by the sea. I have some very, very good friends who are also colleagues. We have a standing rule that if it's too much we can call each other for an emergency debrief. Any time. Hardly ever have to use it, but invaluable to know we can. Icecream and carbs can be useful. Solo alcohol is a really bad idea.

But ultimately, the way I cope is by knowing I did the best I could. That I tried to make things better. And that if I couldn't make them better, I did everything in my power to make them least worst. Even if that was only salvaging a tiny grace note in total catastrophe, like managing a cuddle as stopping resus not after.

It is not an easy job we do. But the world would be worse if none of us did it. You will learn to have the little triumphs carry you through the bad times.

Stay safe.

Talk, talk, talk, talk.

Not comparable really I guess, but I used to work in a police control room and had some horrible things that stay with me still now.

Is there any kind of debrief process at work? To be fair, where I worked was pretty hot on that. I did come home some nights and cry to DH about what happened. I think he's the only one in my 'real life' who knows the shit side of it.

But for all the horrible things, there are also the ones that stay with you for good reasons. The people who went out of their way to help, seeing your colleagues rally round one another etc. It's a horrible job that both tests and restores your faith in humanity on a daily basis.