Trauma, Anxiety and Stress: The Realities of being a Nurse

This blog is intended to provide insight on the reality of being a nurse in today’s healthcare and how it impacts mental health through examples of lived experience. The purpose of this piece is to demonstrate the need for change on how nurses are treated since we are humans doing our best despite working in challenging environments with minimal mental health support.

I remember going through nursing school and being so excited to be a nurse so I could help others and make a decent salary at the young age of 22. Little did I know what nursing really looked like. Nothing truly prepared me for the reality of being a bedside nurse until the day I stepped foot in the hospital on the first day of my career. Despite having a variety of placements during school, most in the hospital, I still did not apprehend the level of responsibility and traumatic situations I would face at my job. Consequently, I never anticipated I would suffer from mental health issues because of my career.

Nursing shortages have been an issue plaguing our healthcare system for decades. As we enter a time where patients are becoming sicker, nurses are leaving the bedside every day, and global pandemics are the new norm, these shortages have become a crisis. Nurses are the foundation of healthcare, yet we are underappreciated, understaffed, overworked, underpaid, disrespected, and traumatized. We are burnt out and we need change.

A recent news story made me question my career as a whole. It centered around a nurse from Tennessee on trial for making a fatal mistake. Although there are many checks to administering medication, mistakes happen. We are human after all. Is this even worth it? In a field like this where we work in toxic environments, face constant staff shortages, care for multiple sick patients at once, and have increasingly high workloads, mistakes are inevitable. This is especially true when people are working in a system that has been designed to address capitalist things like numbers and ratios over well-being and humanity. This is heartbreaking because nurses are human, after all.

A lot of people think of nursing as just technical skills; like administering medication, taking vital signs, and dressing changes. In reality, we are expected to provide “service with a smile” every shift. The problem is that many people don’t realize the situations we deal with, the high level of responsibility and how it affects our mental health. For instance, death and illness is a constant reality we face in our job. Nurses are expected to care for end of life patients, call time of death, and support acutely grieving families, just to go on and provide care to the next patient minutes later. We’re often so busy with multiple patients, we can’t provide post mortem care until hours after the family leaves. It’s not normal to face death and move on without a debrief, to then be expected to put on our best show for twelve hours, several shifts in a row.

As a 23-year-old nurse, I’ve seen more traumatic situations in just one year of work than most people will in their lifetime. I’ve been lucky to not have many personal deaths in my life, but seeing them frequently in my job does take a toll on my mental health. There are times I’ve gone home feeling so irritable and upset, and as a result not treating my loved ones the way I should. I spent my entire twelve hours using up my energy storage and patience that I’ve simply got none left when I get home.

Nurses need better support, especially when it comes to mental health. There is not a single nurse that I know who genuinely enjoys being a bedside nurse in today’s system. It’s common for us to develop a dark humor. We’re being thrown in difficult situations almost every shift, many times barely getting a break in the span of twelve hours, not being paid for the breaks we do manage to fit in our days, being forced additional responsibility due to nursing shortages, expected to cater to our patients whether we have the time or not, working weekends and holidays, and all the while doing shift work. On top of that, we truly do not get paid a fair amount for what we do while our wages are being capped. It’s not healthy, it’s not fair, and it’s not okay.

This job has triggered my anxiety and made me rethink my whole career on several occasions. I’ve now got a year of experience, starting at the peak of the pandemic and the worst nursing shortage the country has seen in a long time. Without change, the problematic system that was built overtime and exacerbated during COVID-19 will continue to be the norm in our healthcare system. We will continue to lose nurses. As long as I’m a bedside nurse, I can truthfully say I’m not okay. We are not okay. We are human, after all.

The most traumatizing experience to me, so far, was the time a patient of mine was confused and becoming a hazard to herself and others. She didn’t understand where she was and why she was “being held hostage.”. She was very sick and leaving the hospital would be very unsafe. Despite efforts of redirecting and calming the patient, she became very agitated and combative. It came to the point of having several nurses physically restraining this poor elderly lady in a four patient ward at 5AM while I had to inject her with a medication that would calm her. She was kicking, screaming, and crying while we tied her down in a chair. No wonder she felt like a hostage - she wanted to go home and we had to physically stop her. Once this happened, her demeanor changed: she went quiet, and I could tell she felt defeated. I was so shaken up that my hands were trembling and I had to try really hard to finish my work and give a solid report to the oncoming nurse. For the rest of my shift I felt numb, as if in a haze, I was defeated. As soon as I got to my car I broke down. I kept getting flashbacks to the look in this woman’s eyes for weeks. I felt like I had violated another human being. We are told that this is just part of the job. I ended up calling in sick to my next shift for mental health reasons.. After that situation, I began spiraling and wondering if I was really helping people or causing more harm. But in a different sense, I knew this was irrational as I was managing people’s lives day in and day out, which their health depended on.

That is just one of many traumatic situations I have had to face. There is a severe need for proper mental health support. I, like many nurses, suffer work related anxiety every time we come into the hospital for our shift. I feel so anxious and stressed to the point of feeling sick to my stomach at times. My heart races until I walk in the hospital and force myself to “act normal”. I always wonder if the worst will happen or if I will be lucky enough to have an uneventful shift. It’s all a guessing game since things change in a matter of seconds in the hospital. We are mistreated and disrespected. We’ve been called so many unnecessary names that we aren’t phased anymore. Nurses are first at the bedside, so naturally patients who are frustrated with the system tend to unload on us. I don’t always blame them, as they aren’t being given the proper care and time because we simply don't have the resourcing. It’s not fair to them either. Despite having good days and being assigned understanding and kind patients at times, it doesn’t make up for all the negatives we deal with. I wonder whether it's worth it every single day. Intrusive thoughts are constant. Did I forget anything? Did I do something wrong? Did I do anything to harm the patient? Did I forget to tell the oncoming nurse vital information? Did I chart properly in case I have to go to court? A simple mistake can bring me to court - let that one sink in.

Recently, I’ve heard of new nurses being thrown right in with full patient assignments without being properly trained due to the severity of the shortages. If we do make an inevitable mistake, there is such a big penalty regardless of whether or not we’ve been given the proper training, resources and breaks. The new nurses who aren’t given the proper training will not be retained, furthering the crisis of shortages. The experienced nurses don’t want to stay either. Many hospital units unfortunately don’t have many nurses left with several years of service to teach us their valuable knowledge and experience. It’s not a good situation all around. It’s not fair to the under-supported individuals at the bedside and it’s definitely not fair to patients.

By the time I get home and decompress, I am mentally and physically drained.. I can’t even tell you what goes on in my mind once I’ve disconnected from work because I feel numb. Then my phone rings and staffing is asking us to pick up another shift or extend a twelve hours shift. We are treated like numbers instead of humans. Nurses are the foundation of healthcare. Change needs to happen, we need help. We are crashing down and burning out at a fast rate. We need better support. Generally speaking, travel nurses are paid a much higher wage than staff nurses and have reasonable schedules. They are known to be more satisfied with their job as they are paid what they deserve while avoiding overtime and short swings. Travel nurses are not leaving the bedside at the same rate as staff nurses. If we were all paid a reasonable salary and given proper schedules, perhaps nurses would be retained and burnout would decrease. In addition, it is common for nurses to call in sick at times due to challenges with child care since we work long hours, night shifts, weekends and holidays. If hospitals had on-site daycares, these nurses would probably stop calling in for child care purposes altogether. The situation at the bedside itself is nonetheless a challenging one, but it would be much better if we were treated and paid accordingly. Nurses would be more tempted to show up for work, ultimately decreasing workload, mental illness, and burnout. Perhaps if we were offered free therapy, proper debriefs, fair wages, on-site daycare, benefits for non-full timers, and real support, then we could retain nurses and improve our mental health. We deserve to be properly supported and accommodated since we are human, after all.

I am now taking a break from nursing as a whole to follow my dreams of traveling. I’m not sure I can go back to exposing myself to this type of environment once I’m not in it anymore. I need to heal first from the traumatic experiences and mental health symptoms that came with the job that I was not prepared for. This is why we are losing bedside nurses at an exponential rate and the system is failing. We need to be better prepared, supported, and treated because after all, we are human.

About the author

Cole Sutton is a pseudonym to protect this author's identity. If you are interested in learning more about this blog, blog topic or the author, please contact Frayme.