I Wish I Had Someone to Talk To About That Shift I Can't Stop Thinking About
A nurse replaying a shift in her head.
If you talk to very many older nurses, you will hear them tell you about a shift they can not forget.
It starts as they are driving home that day replaying the whole shift over and over. Never ending thinking about what happened or did not happen.
Wondering if they missed something: “What could it have been? I assessed my patient thoroughly. I had my list of concerns and addressed them.”
Then narrowing down to one patient and thinking about them all evening long.
Let’s dive in!
A nurse thinking about a tough shift.
Why Some Shifts Stay With Us
Part of the reason we become nurses is because we want to care for people. We don't just see a room number or a diagnosis—we see someone's mother, father, spouse, child, or friend.
When we receive our nursing license, we also accept the responsibility that comes with caring for another person's life. That responsibility doesn't end when we clock out. Many times, we carry our patients home with us in our thoughts.
When something difficult happens to one of our patients, we feel it. Sometimes we show our emotions after the shift is over. Sometimes we have to hold those emotions together until we leave the patient's room. Either way, we care deeply, and that's one of the things that makes nurses who they are.
At the end of every shift, we think about what we accomplished, what we didn't get done, and whether we made the best decisions we could with the time and information we had. That responsibility can feel heavy, especially for a new nurse.
Some of us are perfectionists. Others simply want to do everything right.
I know because I was a perfectionist.
Over the years, I've learned that nursing isn't about being perfect. It's about doing the very best you can for your patients, learning from every experience, and coming back the next day a little wiser than you were the day before.
The shifts that stay with us are often the ones that teach us the most. They shape how we think, how we prioritize, and ultimately, the kind of nurse we become.
The "What If..." Game
If you've been a nurse for any length of time, you've probably played the "what if" game.
I know I have.
Over the years, I've asked myself, "What if I had called sooner?"
As I've reflected on those situations, I've realized that calling sooner may not have changed the outcome. We like to think there was one thing we could have done differently that would have made everything okay, but the truth is, we don't know that.
Another question that has stayed with me is, "What if I had checked on them sooner?"
Then I ask myself another question. And another.
What do I think I would have seen that would have changed what happened?
Would I have called the provider sooner?
Would the provider have given different orders?
Would the outcome have been different?
The honest answer is...I don't know.
One more question many nurses ask is, "What if I had done one more thing?"
What would that one more thing have been?
Sometimes there isn't an answer.
Reflection is healthy. It's how we learn, grow, and become better nurses.
But there comes a point where reflection stops helping and "what if" starts keeping us stuck.
If we stay in that patient room, replaying every decision over and over, we never give ourselves permission to move forward.
Learn from the shift.
Carry the lesson with you.
But don't carry the guilt forever.
A nurse needing to give herself grace.
Learning Instead of Punishing Yourself
Of all the things I'm sharing with you, this may be the one I still have to work on the most.
I can get stuck here.
I can punish myself too long.
I can replay what happened and hold myself responsible for things that may not have been fully in my control.
So when we have a difficult shift, we need to ask better questions—not questions that punish us, but questions that help us learn.
What did I learn?
Did I learn that I need to call the provider sooner after assessing my patient?
Did I learn that I need to clearly voice all of my concerns?
Did I learn that I need to ask for help earlier when one patient is taking most of my time?
What would I do differently next time?
Maybe I would prioritize my time differently.
Maybe I would let the team know sooner what was happening.
Maybe I would say, "I need help. This patient is requiring a lot of my attention, and I need someone to check on my other patients."
That is not weakness.
That is safe nursing.
What did I do well?
This is the question that can be the hardest if you're used to punishing yourself.
But it matters.
Did you complete a good assessment?
Did you communicate your concerns?
Did you comfort the patient or family?
Did you ask for help?
Did you keep trying even when the shift was difficult?
We have to be willing to see what we did well, not just what we wish we had done differently.
What was outside my control?
This one is hard for me too.
Sometimes I hold myself accountable for things I could not control—even in my personal life, like what other people think of me.
But nursing teaches us over and over again that we are responsible for our actions, our assessments, our communication, and our advocacy.
We are not in control of every outcome.
That is a hard truth, but it is still true.
Lastly, give yourself grace when you can.
If your work bestie came to you after a hard shift and told you this same story, would you punish her?
Or would you remind her that she is human, that she cares, and that one difficult shift does not define her?
Give yourself the same grace you would give her.
The Shift I Couldn't Stop Thinking About
I remember a shift that still haunts me.
I was working on a medical-surgical floor with what would have been considered a normal assignment. The number of patients wasn't the problem. It was the complexity of the assignment.
One patient, in particular, seemed to find fault with everyone who walked into the room. It didn't matter if it was me, the nursing assistant, or another staff member. No matter what we did, it wasn't enough.
As the shift went on, I found myself spending more and more time with this patient, trying to meet their needs and address their concerns.
The problem was that every minute I spent in that room was a minute I wasn't spending with my other patients.
I knew they needed me too.
I felt like I was being pulled in two different directions. No matter where I was, I felt guilty for not being somewhere else.
One of my other patients rang the call light.
I asked the nursing assistant to check on her because I was still with the difficult patient.
A few moments later the nursing assistant came back and said,
"Rhoda...she's having chest pain."
My heart dropped.
I immediately asked another nurse to go to her while I finished what I was doing.
By the time the other nurse got there, she was gone.
The team worked for nearly two hours trying to bring her back, but they couldn't.
For years I've replayed that shift in my mind.
Could I have gotten there sooner?
Should I have left the other patient's room earlier?
Could I have managed my assignment differently?
Those questions stayed with me long after that shift ended.
That experience changed the way I prioritize my patients, communicate with my team, and ask for help.
I still think about that patient.
Not because I have all the answers...
But because she made me a better nurse.
Coffee with Rhoda
☕ Coffee with Rhoda
What I Wish Someone Had Told Me
If I could sit down with every new nurse over a cup of coffee, there are a few things I would want them to know.
First, you will remember some patients forever.
Not all of them will be because something bad happened.
Some will stay in your heart because they made you laugh, taught you something, or reminded you why you became a nurse.
I still remember a resident from a nursing facility who would always tell my staff to leave her medications on the bedside table because she would take them after she finished in the bathroom. No matter how many times I explained why we couldn't do that, she was determined to do it her way. I can still smile when I think about her.
Then there was a gentleman who owned a trailer park. Every time I cared for him, he would tell me, "Rhoda, when you're ready for a new home, come see me. I'll give you a special price on a double-wide and put it anywhere you want."
I never took him up on his offer, but I still think about him and the conversations we shared.
Those patients remind me that nursing isn't just about medications, assessments, and care plans.
It's about relationships.
I also want you to know that one difficult shift does not define your nursing career.
If it did, none of us would still be nurses.
I've had difficult shifts.
I've had patients whose stories I still carry with me.
I've even had family members who weren't happy with the care they believed their loved one received.
Those experiences were painful, but they also helped me grow.
Every patient has something to teach us.
Every difficult shift has a lesson hidden somewhere within it.
Find the lesson.
Carry the lesson.
But don't let that one shift, one patient, or one difficult day define who you are as a nurse.
You are so much more than your hardest day.
Reflection Questions
Before you move on with your day, I'd like you to stop for just a minute and think about your own nursing journey.
Don't judge yourself.
Don't replay the shift looking for another reason to be hard on yourself.
Simply reflect.
Ask yourself these questions:
Is there a shift you still think about?
What made it stay with you?
What did that experience teach you?
If you could go back and talk to yourself after that shift, what would you say?
What would you tell another new nurse who had just experienced the same thing?
Sometimes we grow the most when we take time to reflect—not to punish ourselves, but to recognize how far we've come.
Remember one difficult shift does not define you.
One patient outcome does not define you.
Every difficult shift teaches us something.
The goal isn't to be perfect.
The goal is to become a safer, wiser, more compassionate nurse because of what you've experienced.
You Don't Have to Carry This Alone
If this blog felt like it was written just for you, I'd love to invite you to Coffee with Rhoda.
We'll talk about the things that don't always make it into textbooks or orientation. The moments that make you question yourself, the victories worth celebrating, and the challenges that are easier to face when someone understands.
On Thursday August 27th at 7 pm on zoom. You can come in you pajamas or whatever is comfortable. Bring your coffee, your questions, or simply come and listen. My hope is that you'll leave encouraged, supported, and reminded that struggling doesn't mean you're failing—it means you're growing.
I hope to see you there.
Rhoda Sommer, RN, MSN Ed
Founder, One on One Tips
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Share your stories in the comments or reach out—I’d love to hear from you.
Is there a shift you still think about?
What made it stay with you?
What did that experience teach you?
If you could go back and talk to yourself after that shift, what would you say?
What would you tell another new nurse who had just experienced the same thing?
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