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nurse burnout, compassion fatigue, renee thompson, rtconnections, nursing
Nurse fatigue is a big problem. It’s like a virus that infects current and future nurse depleting our energy, taking the joy out of nursing and causing us harm. But there are some things you can do to prevent and even reverse the dreaded fatigue. I’ve been writing and talking about how nurses can bring the joy back into their practice and forever squash overt fatigue. If you haven’t read my blogs on this topic or watched my vlogs, make sure you do. Lots of other great strategies for you!
Today’s tip is all about understanding the difference between ruminating and reflecting.

Are you a ruminator or reflector?  How do you know?
Your patient codes…and you KNEW it was going to happen. Throughout your shift he wasn’t quite right. You thought about calling the physician but hesitated because you didn’t have any specific information to share…just your gut feeling that something was going on. He was a bit more restless than usual, respiratory rate was up but only slightly, and his urine output was down but was still within normal range. Then the monitor alarms. Your patient has a pulse ox of 78% and stops responding to you. At that point, you call the rapid response team for help.
The patient is found to be in full blown pulmonary edema, is unloaded and transferred to the ICU. He is alive but in critical condition.
On your way home, you think about your patient and retrace everything that happened leading up to the code.
Do you ruminate over the events or reflect?
Ruminating – you relive the events over and over again saying to yourself, “I should have called earlier. I shouldn’t have waited. I missed the trending of his pulse ox and increase in his heart rate. I didn’t listen to his lungs but I should have.” Over and over you replay the events and beat yourself up because you weren’t perfect.
This is ruminating and represents a significant reason for nurse fatigue.
Reflecting – you retrace the events and identify the clues and your process for decision-making that led you to avoid addressing your concerns about your patient earlier. Then you say to yourself, “The next time I’m in a similar situation, I’ll make sure I contact the physician earlier to give him/her a heads up that I’m concerned about a patient.
This is reflecting and a healthy option to review past events.
As John Maxwell says, “Experience is not the best teacher. Evaluated experiences are the best teachers.” Meaning, beating yourself up over what you did or didn’t do is helpful. It actually causes stress and burnout. However, if you can be objective and evaluate your experience objectively and learn from it so that you can act differently the next time, you will decrease your stress and prevent burnout.
You are not perfect – nobody is (although my dad says he’s “close” to perfect). But by accepting that you are going to make mistakes but do your due diligence to avoid making the same mistakes twice, you can truly grow as a competent, joyful professional nurse.
Nurse need to feel good about the work they do!
Thanks for reading. Take care and stay connected!
For more great tips, make sure you “like” me on Facebook,”follow” me on Twitter and YouTube and subscribe to my blog.  

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  1. Renee,
    Awesome post. To start off with- I love the patient case example. One point I'd love to add (though off topic, I think) is that when we have that gut feeling we should act on it.

    As adults we are so keen on second-guessing ourselves because we have been told 'no' or we feel unworthy or not good enough.

    That gut feeling experienced by the nurse in your example… that is our body telling us we know best. So let's listen to our bodies and go with our guts!

    But back to your post- I do love the encouragement to reflect, not ruminate.

    I always say we can learn, grow, change, and then heal from every experience!


  2. Hi Liz. Thanks so much for validating and adding to this post! We do second guess ourselves when it comes to the decisions we make and our health. They say that if we would "listen" to ourselves, we would be healthier and happier.

    Air hugs!

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