Thank you to the College of Registered Nurses of British Columbia for permission to adapt their case study
Her shift hasn't even started and already Doris has snapped at a colleague. She knows she's become increasingly short-tempered as winter sets in.
She thought getting through the holiday season would improve her irritability but it hasn't. Each year Doris finds it harder to manage this time of the year. She is often grumpy with friends and co-workers — she has to force herself to be pleasant. She's started taking breaks alone to avoid conversations with others. Her shifts seem to drag and she has to work to stay focused.
She usually feels sad and lonely during the winter, even though she has a family. Doris avoids socializing and feels irritated when others invite her to join them. She just wants to stay home in her pajamas and be left alone. She resents having to go to work or even answer the phone. She's tired but has trouble sleeping. In the past, she has used alcohol to help her get through this time of year but recognizes it's not the best thing to do. She thinks about the time last year when she called in sick because she drank too much the night before.
At work, Doris believes she is keeping everything well hidden. She's caught off guard when her colleague, Rachel, asks "Are you alright? You're not yourself — you seem really distant and distracted. I'm worried about you." At the same time as Doris quickly responds "I'm fine, just fine," she begins to understand she is not.
Deep down, Doris knows Rachel is right. She's not fine and can no longer deny it. Rachel's concern helps Doris recognize she needs to take a hard look at herself. She's unsure of what to do next but knows she needs to do something.
Doris is responsible for maintaining her physical, psychological and emotional fitness to practise. She's accountable for her decisions, actions and professional conduct. This could include assessing her practice and undertaking self-care activities to meet identified learning goals and improve her fitness to practise. By reflecting on and addressing her fitness to practise, Doris would be taking steps towards meeting Indicator 5.9 of the Self-Regulation Standard in the Practice Standards for Regulated Members.
When you assess your practice, how do you think about maintaining your physical, psychological and emotional fitness to practise? What does it lead you to do?
Doris chose to seek help. After counselling and treatment, she's more aware of her triggers and can better manage her negative thoughts and emotions. She reflects that she has more energy and she doesn't have to work so hard at being pleasant. She feels good when Rachel tells her that she's happy to have the "old Doris" back.
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