Nursing is so many things. It is critical thinking, technical skills, proficiency and efficiency, prioritizing, strategizing, questioning—using our minds and also our hearts. Overall, we are caregivers. Regardless of where we work, we all experience rough days, tough patients, and trying codes. Sometimes, the experience stays on our minds and weighs on our hearts long after the shift ends. Some of us can compartmentalize it and can easily move on. 

There will always be patients, families, codes, and experiences you just can’t shake. You mull over every single decision you made, dream about the situation again, dissect everything you could have done differently. You get down about things you could have executed better. These aren’t productive behaviors, and over time they can increase nurse job dissatisfaction and emotional burnout. What can you do when you find yourself ruminating?

1. Debrief.

Debriefing after a resuscitation event is one of the single most important things you can do with your team. Some units are better about facilitating a debrief than others, so if your team seems reluctant to do so, push for it yourself. It can be both educational and healing to discuss the way the code progressed as a team. You can focus on what worked and what could have gone better, you can brainstorm ways to improve the system and processes, and you can talk about improving patient safety and communication. Codes are stressful, and debriefs are a way to rebuild communication, enhance teamwork, and decompress.

2. Find your friends.

After rough experiences, I often find myself texting or calling my nurse colleagues who participated in a resuscitation with me about what we went through. Sometimes it’s easier to talk it out after some time passes and you have a clearer head and mind. If you’re still thinking about a patient or a code response the day after, reach out to your work best friend and talk it out.

3. Write it down.

You may not be a writer, but you’d be surprised at how much better it can make you feel to write down your thoughts. For some people, writing them down is the best way to process feelings and put them behind you. If you don’t have a journal, you could write on a piece of paper and then throw it away, or open a blank computer document and type it out instead. It can help organize your feelings and provide a powerful release.

4. Reach out to management.

Many employers offer employee assistance programs, which can provide additional resources if you still feel troubled after a code. You could also try getting in touch with your facility’s chaplain for extra support.

5. Be kind to yourself.

Exercise. Breathe. Get together with non-work friends. Visit family. Read a book. Do something for you. Allow yourself to feel how you feel, and don’t be too hard on yourself about your performance or your experience. Part of nursing is the art and science of caring, so let yourself care. It’s why we do what we do.

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Laura Kinsella

Laura Kinsella, BSN, RN, CEN, is an emergency room nurse in Washington, DC.

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