The power of negative thoughts

These past couple weeks have challenged me physically, emotionally, and mentally. They've been small struggles in the grand scheme of things but have effected me nonetheless.

I recently accepted a new position in the Emergency Department at Mckenzie Willamette Hospital. This was a choice I made for my family. It's a much shorter commute, I have the opportunity to work shorter shifts, and there's more available shifts for me to choose from. (I LOVE my job in Albany ICU and I'm planning on keeping my status there but reducing my hours.) As with any new job I was nervous... and for good reason. The ED is almost exact opposite of ICU.

In the ICU I have one or two patients and my whole 12 hour shift is devoted to knowing every detail. I know their lab values off the top of my head, I can tell you how many staples are in their incision, and I can ramble off their medical history and medications. I know their family members names and how they like their coffee. Get the picture? Detail oriented.

In the ED the goal is to get patients seen by a medical provider and moved out as quickly as possible. This is done by identifying life threatening conditions, stabilizing them, and admitting them to the hospital. Or it's done by ruling out conditions that need urgent attention and sending the patient home or to another specialist to follow up with. Things have to be done quickly and efficiently so when the life threatening conditions arise, the department is ready to accept the patient and intervene. I have yet to keep an accurate count of patients I see in a day but it's somewhere between 10-20. I have just enough time to know the really important things. But I don't have time to braid anyone's hair (yes... I really do that in the ICU). Getting the picture again? Not detail oriented.

So as you could imagine, this was a big learning curve for me. I have had to learn, and am still very much trying to learn, how to be fast, but safe. I have to gather almost as much information from my ED patient as I do from my ICU patient but in a fraction of the time, then turn around and be ready to do it all over again. Over, and over, and over. There's no, "I think I'll sit down, eat some chocolate, chat with my co-workers, and chart."

The first couple days were mentally exhausting. All I wanted to do was sit down and THINK. And chart of course. I could always chart more. My head was spinning so fast I lost all ability to think simply. I was thinking so critically that I literally couldn't figure out how to dial the phone. That is not a joke. However, I tried to make it a joke and the nurse orienting me didn't think it was funny. I think she was about ready to go tell the manager this chic was never gonna make it. For a split second I saw that look on her face... and self doubt took over.

I was discouraged. I told myself I was so dumb. I told myself everyone there was smarter than me. I told myself I was never going to be as fast as them. I told myself I was never going to be as thorough as them. I knew everyone there could see it too. I thought I should just quit and run back to my comfort zone in the ICU. I thought I'd make the wrong decision to accept the job. I thought I'd never like working there.

And then for the rest of the day I was stuck in that repetitive thought pattern. Before I even started a task I thought, "This isn't going to go well. I'm going to screw it up." And sure enough things weren't going well. Things I'm usually proficient in looked like I'd never done them before. I felt like a nursing student again fumbling to insert a foley cath. And with each minute lack in my proficiency came more self doubt. I couldn't pull myself out of the slump.

On the way home from work I called my mom almost in tears. It seems so silly. So I had a couple hard days transitioning to a new job... But Damaris Bishop is good at things. I never fail. So feeling like a failure was very hard for me. Luckily my mom is quite possibly the smartest, kindest, most encouraging person that walks the Earth (you're welcome Mama). She reminded me that I have control over my thoughts. Even typing it now it seems so simple. "Duh I have control over my own thoughts, it's my brain!" But it's SO easy to get stuck in a negative thought pattern. Once you doubt yourself, and that doubt has a chance to settle in and get cozy, that doubt overtakes your thoughts and completely squanders all self confidence.

Once I bought in to those negative thoughts I was screwed. I was stuck in a hole with a shovel digging my own grave deeper and deeper. But after a break, and some perspective, and some more perspective, and even some more perspective, I went back to work telling myself positive thoughts. I told myself: New jobs are hard, adjustments are hard, it's normal to struggle while learning new things, I am smart, I am skilled, and I can learn new skills when I give myself grace and time. When I approached my day with confidence, and allowed myself grace when I wasn't perfect, I was able to settle in to my new environment and begin to feel comfortable.

I've been working independently for a couple days now and I'm finally feeling like I have a chance to be good at this whole Emergency Department thing. I know I definitely have room for improvement but I'm seeing light at the end of the tunnel. I'm learning how to be fast while remaining safe, I'm learning new skills that I don't get to use in the ICU, and I'm most importantly learning how to go easy on myself. How to keep myself from downward spiraling, and how to remember that simple mistakes are not a reflection of who I really am.


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