Anxiety in Clinical Care
To preface, I can be a pretty anxious person (I have generalized anxiety disorder and have done some bouts of therapy), and I am about to enter my third year as a clinical RD. I sometimes experience anxiety from my job, and once in a while will ruminate on things that are either going on currently or that happened in the past, even when I am not on work. These thoughts sometimes take over and I start googling all these questions to either validate what I did or figure out where I could have went wrong. I will somehow find ways to blame myself for a patient’s course of care, specifically if they are on a tube feeding.
When I am seeing patients on tube feedings in the ICU or those on MedSurg that are at high risk, I will get very anxious if labs or vital signs change like pH, CO2, oxygen requirements, etc., or if the patient has a GI issue. I know that in most cases there are often many things going on at once with these patients, and the odds of it being from the tube feedings are low, especially if they are getting a really low rate like 10-20 mL/hr. I know that logically there are many things that can influence a patients’ labs and vital signs such as medications, vent status, etc., But I find myself tending to overthink and attribute almost any change I see to the feeds, even if it is totally irrational, since nutrition is the lens that I look through. Whereas from a doctor’s point of view, nutrition is only one piece of the puzzle. I think I might still have some imposter syndrome/lack of confidence, considering I am still a newer RD.
I also want to point out that it is not often that I am questioned on my recommendations, and I have finally been working at my facility long enough to have built a solid rapport and be respected by many of my colleagues. We also have a lot of checks and balances at my facility, and almost everything we do is signed off by a doctor. Therefore, I know most of my worrying is nonsensical, but my mind tends to gravitate toward this questioning and self-doubt every once in a while. Edit: There was one instance earlier in my career where a physician blamed the tube feedings for an adverse event, and I think that really got in my head and is hard to let go of.
Can anyone else relate to this experience? What do you do to cope with this? Also, how can you differentiate when something like a lab change or change in vital signs is due to nutrition interventions or not?