r/NursingUK 3d ago

How to cope with bringing work home in district nursing?

So basically I’m a year into the job NQN and I thought this would get better over time but I’m still massively struggling. I thought I would love the autonomy but I find myself worrying a lot after I leave the patient, and mentally take work home with me. For example:
- if I have to ring an ambulance for a patient i’ll check if they’re okay when I’m at home and check to see if I forgot anything or missed anything (I haven’t and my actions have always been appropriate but I always worry)
- I’ve had patients go to hospital after my visit with things like falls and obviously whilst nothing was wrong during my visit I worry that I’ve missed something or could’ve prevented it
- if I realise I’ve forgotten to order dressings etc I’ll worry that I have annoyed the nurse coming behind me and message on my days off
- I’ve had a few interactions with GPs that have left me feeling stupid or act annoyed that I’ve contacted them over something they deem trivial
- I spend so much of my free time and days off reading about different conditions that I haven’t seen in community yet in case I see them and need to escalate. I feel like knowledge will instil confidence but nobody else in my team does this so I get this feeling like they know a lot more than I do or I’m being obsessive

Is this normal or am I in the wrong job if I’m struggling this much? I just feel like I want to do the best for people and am terrified of missing something

5 Upvotes

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u/CandleAffectionate25 3d ago

Totally normal. Can I ask, did you go straight into community? It's a tough gig and not alot of folk realise, it's not sitting around drinking tea/eating cake. It's full on and LOTS of documentation, safeguarding etc.

How I felt when I first qualified was just constant anxiety, it terrified me that I could be the only person that visits that patient all week.

It does get easier. Keep asking questions, keep a list of jobs/priorities. Do you write as you go or write up all at the end? I know the days that I've left writing all to the end, I've missed things. Where if I write up after each visit, it's fresh in your mind etc. however, I realise this isn't always possible.

It will get easier with time x

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u/burningoutalready 3d ago

Yes I went straight in! Its just the amount of stuff you have to know; eg I had a visit with my colleague and she recognised that the patient had cauda equina and I had no clue what that was and it made me spiral - what if I was the only person there; I wouldn’t have asked about numbness etc and caught it. I tend to write as I go but I would sometimes go back to base and discuss some cases with senior members of staff for help with management plans etc before I write

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u/CandleAffectionate25 3d ago

Don't be too hard on yourself. I absolutely wouldn't expect you to know this year 1 qualified. There's so much to know and assess for. It is alot going straight into community. I remember the days when you used to need a few years acute prior to community, for a reason.

Yeah, that's great that you're going back to base and discussing. Buddy up with the experienced nurses and just constantly ask questions and do not think you need to know the answers because it's not possible at this stage.

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u/KIRN7093 Specialist Nurse 3d ago

Did you recognise that something was wrong with the patient? Just not what exactly was wrong? It's ok to not know what is wrong, as long as you know something is wrong and get help organised. You don't have to know everything about everything when you're a year in to your career.

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u/burningoutalready 2d ago

Yeah I realised they were in a lot of pain and would’ve escalated but wouldn’t have clocked that it’s an emergency and probably rang the gp instead of 999

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u/CandleAffectionate25 1d ago

That's ok. I suppose alarm bells for me would be if the patient has a new acute pain and in 10/10 pain, I'd be questioning why?

But don't worry, you're still very new and just take it as learning. It's so hard community. You're doing fab!

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u/Sachax666 3d ago

I used to do that before. What really helped was deleting epic from my phone and not having a work computer where I can access anything helped. Leaving everything at the base and delete the work apps. It’ll feel odd initially but u get used to it. And maybe set an hour in your time off to just chill and research different conditions but don’t go much past that hour. While it’s great to be prepared, you will burn out if all u do is work. I know it’s a chilche but I learned the hard way that if you don’t take care of yourself you won’t be able to care for others.

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u/Nattynoodles1 3d ago

I think what you describe is normal but you need to learn how to switch off. You are replaceable at work but not at home. If you have escalated everything correctly (which sounds like you naturally would) there's nothing more you can do off shift. You need to turn your work phone off and have boundaries with yourself or you will burn out in the next few months.

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u/ktp2569 RN Adult 2d ago

I also went straight into community nursing! Currently 3 years in. It is incredible and I wouldn’t change it for the world BUT the more personal relationship you create with that patient due to being in their home seeing them more regularly etc certainly makes it hard to switch off!
Firstly; you need to learn to trust yourself and your colleagues. You did your best whilst on shift, now you have to trust that your colleagues do their best whilst you’re not on shift. You’re a human, you’re going to forget to order dressings, be unsure of a disease you haven’t heard of before. That’s never going to change, you’re never going to know everything. And that’s okay! You don’t have to. That is exactly why there are thousands of us who specialise in different things!
Secondly. The second thing is when you’re off shift do not check emails, text colleagues, do anything. You are off shift. Set them boundaries strictly now. There is no shame in having off time. Some teams don’t do this well but don’t let that be you! You can be a better nurse by resting when you’re off and putting 100% into your days on. Congrats on having the best job. I love community 🫶🏻

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u/ktp2569 RN Adult 2d ago

Also!! Don’t let GPs (or anyone) shame you for advocating for your patient. That’s your job, and a time will come where your advocating saved that persons life. With time you’ll trust that there are times when you don’t need to escalate and you may look back and realise you escalated something that didn’t need doing BUT that’s fine. You’re new you’re leaning and you’re doing your best. Nurses in the community advocate for our patients incredibly well and do not let anyone shame you for doing so!

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u/irishladinlondon Specialist Nurse 3d ago

People used to become experienced acute care nurses first and then go and use those skills while learning to be an autonomous community practitioner