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This Traumatized Nurse

Part of my practice that I never planned on but am incredibly grateful for are the nurses. Nurses sticks with nurses. So it makes sense that many seek treatment with nurse practitioners.

Nurses are a crazy bunch but we wear our crazy on our sleeve. I’ve said to nurse clients many many many times…”You have a high tolerance for crazy because of your work, so I’m telling you, what’s happening in your life- insert something crazy here- is not okay, and you are tolerating it because your ‘crazy’ tolerance is way too high.” This is actually generally well received and then we process how to address whatever issue they are dealing with.

So here I am in my therapy session today. I said, listen, there’s been a lot of crazy in the last couple weeks, but I need to focus on these panic attacks I’ve been having. I’ve never had panic attacks before, and I kept forgetting I was having them because they were so infrequent.

The first one was two years ago. I was working inpatient and a patient became agitated and stood over me and threatened me. My heart raced, I completely froze, then when I finally left the room I couldn’t calm down. I had to go outside to my car, not speak to anyone, and just sit there and let myself freak out.

When I tell you this is not me…this is not me. I was an ED nurse, I’ve worked inpatient psych, and I’ve had a lot worse situations come at me. Like actually come at me. I went home that day and forgot all about it. Thought it must have been a fluke. Then I worked inpatient again. Similar situation except this time a patient told me he was picturing shoving a knife in my throat while standing over me. Again- this was not out of the ordinary for inpatient work.

Then recently I had music playing and at the end of the song there are two men who become agitated and start fighting. I forgot the song was playing and all I heard was two men yelling at each other, and I freaked out. I looked all over the house and out in the driveway thinking there were actually people getting agitated. Heart pounding. Etc. So I tell all this to my therapist and I say, we gotta do something about this. Because I’ve never had this happen before and it keeps catching me off guard.

She asked me to describe what happened. I did. Then she said, “You know those experiences where you have people physically and verbally threatening you- it’s normal for a person to have their heart race, it’s normal to feel threatened because you were being threatened. Those are not typical panic attacks, they are normal reactions to a stressor.”

Dude. I actually argued with her. I was like, uh no, those are normal occurrences when I work in the hospital. Then she argued back, and then we literally argued about me being threatened. And of course I was threatened. Of course those are normal bodily responses to feeling threatened. What’s messed up is that I literally never thought that.

I thought there was something wrong with me for reacting to people threatening me.

Sit with that for a moment.

That’s what happens to nurses who work in high acuity settings. We are led to believe that there is something wrong with us for expecting to feel safe. I argued with my therapist about my reacting to being threatened. I tried to rationalize that being threatened is normal and there’s a problem with me- not the setting.

Is it any wonder that nurses are fleeing the profession? Why do I feel weak for having a normal physical and emotional response to being threatened? Why do I feel less than and ashamed? Because I have been trained to feel that way. I have been trained to see the problem within me instead of in the messed up hospital systems who do not protect us.

I have been- kicked in the ribs, bitten, spit on, rushed at multiple times, had a chair and a laundry basket thrown at and over my head, had a knife pulled in my office (twice), been verbally threatened countless times including outpatient “I will drop your ass” “I will fuck you up” and so much more. I have witnessed horrific assaults. I have witnessed horrible takedowns. I had a patient, most memorably, leap across a table and land on his knees nose to nose with me, hands fisted on either side of my head and say, “All it takes is a punch. And poof. You’re fucked.” I sat there and stared back at him, and as the entire staff gathered outside the door because the whole unit saw what was happening I calmly leaned in closer and said, “You done yet? Take a fucking seat.” Without blinking. When the laundry basket got tossed, I said, “Dude you are not,” He said, “Ma’am, you better put that pretty head down.” I ducked. He threw it. Not aimed at me.

So many more stories. So many more memories. So you see, when a patient stood up agitated, and I epically panicked, I thought there must be something wrong with me. Because I’ve been through so much worse so many times. I never got time off after any of those events. Except the kick in the ribs. And literally only because there was some minor damage to my liver and a visible large bruise over my right ribs. I never got debriefed after most of these events. I certainly never got a raise or hazard pay.

And in fact when I got time off for the rib kicking- my manager and co-workers made negative comments about it. As if I was weak for being told to take time off by occupational health.

It was all a day in the life.

But now that I do mostly outpatient, and I’ve had space and distance and time to heal. My body and my brain are telling me this is fucked up. When I go back to inpatient and am threatened I apparently react appropriately now. I’m not in survival mode, so I can’t just compartmentalize it out.

I am not sure what the answer is. I do not want to give up inpatient. But my therapist seems to think it’s kind of a messed up place to work. And after much reflection I don’t disagree. It makes me sad to realize that this work I used to love is actually totally ass backward and so detrimental to people’s mental health. Nurses. To nurses mental health.

Even writing this feels bad. I feel shame? for having such a perceived weakness. Then I think this is soooo messed up that I think a weakness is having a normal physical reaction to being threatened. I’ve been told it’s not a panic attack when it’s a normal stress response to being threatened. So my not-panic attacks suck. Being threatened sucks. Being a nurse who thought there was something wrong with me for having an emotional and physical response to being threatened…is just tragically sad.

To all my nurses. It’s not you. It’s them. You are not wrong or bad for demanding safety in your workplace. You are not wrong or bad for having feelings in whatever capacity about being unsafe in your workplace.

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