Balance

Getting into a routine should be pretty easy to do, especially since my husband and I both work straight evenings at the same hospital. Right?  Not so much. I've come to have a love-hate relationship with sleep.  I desperately need a night of 8 hrs of uninterrupted sleep (even 7 hrs would be great).  BUT, apparently one side effect of being a nurse (for me anyway) is dreaming about work.  Not just the occassional work dream either, but night after night of chasing around patients and trying to accomplish one task that never seems to get accomplished.  

Most nights unfold like so: I work at the hospital until 11:30pm or 12am (sometimes later on a tough shift), come home and chat with the hubby about our evenings (we usually car pool and have similar schedules), eat a snack, then climb into bed exhaused.  If I'm lucky enough to fall asleep right away, I tend to fall right into a dream about work.  Those nights I awake even more exhausted, feeling like I just worked a double.  Most nights, it's hard to unwind and turn off my brain so I can sleep.  It'l like my brain just keeps processing my shift, regardless of what I do to stop it.  In my head thoughts swirl of my patients and their families, their good news and bad news, their diagnosis, their medical challenges, their demands, their praise, their thanks.  All of it swirls in my head until eventually I sleep for a bit, wake up and repeat the cycle all over again.

Boundaries have been my newest area to examine.  Professional boundaries are talked about in nursing quite a bit and they seem straight forward on paper and in text books.  Boundaries seem pretty easy until you're caring for patients day in and day out who are fighting for their lives.  Patients who are going through hell; who have pain that the strongest narcotics won't touch; nausea that refuses to retract for just a moment so they can eat; constipation, diarrhea, skin problems like 'Hand and Foot syndrome'.  Pure hell for a slim chance at curing their cancer, though usually they're buying more time.  Time with family and friends.  Time to enjoy life a little longer, even though their quality of life is not what it use to be.  These are the thoughts that keep me awake at night.

The tough part about boundaries with patients and their families is that some patients are on our unit for weeks to months.  The hospital becomes like a second home to them and the staff like family. Emotional boundaries become challenging when you care for a patient for months at a time.  When you help them suffer through their treatments and then through the complications of their treatments. 

So my question is: How do I continue to care for my patients and their families while separating myself enough to leave my work at work? I've asked some of my experienced co-workers this very question , but still haven't seemed to find an answer that works for me.  My problem is that I don't want nursing to be a job that I just go to and from. One that I just make my check list each shift and leave the caring at home.  I want to feel like I'm impacting lives each day, that I'm making a difference. I want to help patients live with dignity, die with dignity and accept that life is not fair.  Yet I need sleep so I can continue to give and to care.  So how do I balance that?  How do I make a difference each day and impact patients' lives, while not letting it keep me up each night??

I'm hoping that I will discover the answer to my question in time.  In the meantime, it is my weekend off and I am awake at 1:30 am.  Hoping that blogging about my insomnia might help eventually take it away.  :)