Part 3 Nurse’s Brain – Nurses and Obsessive-Compulsive Disorder (OCD) – how is yours today?

NOTE: run your mouse over this section, and the hyperlink will show up……take the quiz!!!! the whole point of this blog is to discuss your reaction to the quiz….

True Story of my daughter when she was five

One March, a blizzard started working its way up the east coast of the USA, and in Maine we had five days to read the daily report on the front page of the local newspaper which breathlessly warned what it was going to be like by the time it got to Maine. It was the topic of conversation every day. My younger daughter was worried. we lived out in the country. In addition to the lights and fridge, we had a well with an electric pump. We expected to lose power.

To assuage her worries, the family sat down with paper and pencil over a cup of cocoa, and made a list of all the things to do to be prepared for a blizzard. Buckets of water ( to flush the toilet), flashlights, candles, wood from the woodpile, snow shovels handy, groceries stocked up. Every thing. then we checked off the list and said ” the only thing left is to make snowmen when it gets here and keep the driveway shoveled.”

It helped. the blizzard was serious, but we felt better about it. we were ready. The list was useful. the fears were greater than what the truth turned out to be. And in the meantime, our daughter got the demo of a terrific coping tool.

Thought for the day

Are we raising a new generation of nurses to have Obsessive-Compulsive Disorder?

Recent blog entries

I have written about the ways to use a Nurse’s Brain in the recent past, and also about ways to succeed at the job search as well as at work once you get the job. I gave contradictory advice as to whether nursing students should be taking ACLS or not, and I also heaped praise upon the book by Atul Gawande, The Checklist Manifesto.

It’s been clear to me for years now, that if you want to succeed in a hospital staff nurse role, you have to develop a system for keeping track of dozens (hundreds?) of small details during the course of a day, in order to be on top of what is happening. The Nurse Brain is an aide to your brain to do that without going crazy.  We have developed an entire discipline, “Informatics” to study the science of how to assist people in doing this kind of detailed work.

There is a point, however, when you have to step back and ask yourself whether you have stepped off the path of sanity and into the wilderness of doubt,  and developed Obsessive-Compulsive Disorder.

Take This Quiz.

AT a site named Psyche Central, they have a self-quiz.  I invite you to check it out – take it. you don’t have to share the results with any body.

Rational fears versus irrational fears

Naturally, there are flaws with the questions – for example, the person who built the quiz probably thought they were dealing with takers that had the irrational fear of such things as death, accidents, contracting AIDS, etc.

The truth is, in many nursing settings, for many nurses, these are entirely rational fears. We have a job that is a bit unusual in that respect. “Do you find yourself washing your ahnds every five minutes or perhaps cleaning compulsively?” – yes I sure do especially if my patient has a communicable illness…… so – I suppose it may be skewed – or maybe it is one more indicator that what I am talking about is real. You can go overboard….. or can you?

In defense of the Brain

if it is any consolation, one way to use the Nurse’s Brain is to re-assure yourself that you did do everything you set out to do – and then to fold it up and shred it at the end of the day, knowing that you do not need to worry anymore about what you left undone. We are all in search of certainty, the knowledger that we did what we could. Certainty is not exactly the same as serenity, but it gets you there…..

Hospitals face a challenge with OCD among nurses

this will be a short blog, but I leave you with one thought. after you have checked your own OCD level, look at that of the nurses you work with. If the workplace is dominated by nurses with OCD, chances are, they spend time focusing on the small details, beating each other up as a means to feel better about perfectionist behavior. I would politely say that such a work environment is out of balance, and not a healthy one.

And it’s worse if the manager has OCD

OCD is a reaction mechanism to try to control things that are essentially not able to be controlled. Yes, a nurse with OCD can be a great nurse, but what happens when such a nurse is hired to be in a leadership role? usually they are the ones who have the least ability to delegate, the least flexibility, and the least ability to inspire and lead.

what do you think? take the quiz and let us know the result ( if you are brave…). agree/ disagree?



Filed under Maine, nursing education

6 responses to “Part 3 Nurse’s Brain – Nurses and Obsessive-Compulsive Disorder (OCD) – how is yours today?

  1. Elizabeth Kim

    Haha… here’s what I got:
    “Based upon your responses to this screening measure, you are most likely suffering from an obsessive-compulsive disorder.”
    I guess I’m going to have to agree with the notion that Nurses are destined to become somewhat OCD, but I don’t think that’s always a bad thing. Personally, I’m glad I have some OCD habits; they keep my life somewhat organized and structured.
    After I think about it… the use of a Road Map can be a sign of OCD :)

    • Thank you for taking the quiz. It’s been a mystery to me that more readers have not clicked on the hyperlink. Bravo!

      The trick with every illness you learn about in nursing school, is to get past the point where you recognize the symptoms in yourself. As a young nurse, you start out saying “I sure hope that never happens to me” – and adjusting your life accordingly. The fact is, this only goes so far, and everyone eventually gets sick and dies (it’s the reality of life and also the “raison d’etre” of religion).

      There is a great song by Carrie Newcomer in which she uses the line. “….the journey down so far that it has nowhere else to go but through…”. It applies here. The nature of the work *requires* a bit of OCD, the question becomes one of controlling it and using the tendency without going crazy at the same time.

      In other words, keep up with using the Nurse’s Brain also known as the Road Map, and feel free to share this blog widely.

  2. Lauren F

    I am probable also with the majority of the response that would lead to this conclusion directly relating to nursing school or organization to just try to survive nursing school.

    I wonder if OCD is still OCD if it is based on rationale versus irrational fears

    ex: habitually showering after i get home from the hospital due to the rational fear of having gross stuff on my body/uniform that could cause illness its not an irrational fear

    • Thank you for making this point. I agree wholeheartedly, and I certainly have come across things in nursing practice which cause rationale hyper-awareness of the for ritualistic behavior, such as highly commucable diseases.

      There is something to this handwashing thing so many people talk about all the time! ;-)

      I suppose the point where It becomes OCD is the place where there is no longer a rational need but people do it anyway. And. Can’t. Stop.

      There was a famous lawsuit in Texas, where the patient fell down the stairs and hurt his elbow. At the trauma center, he got a foley catheter and NG Tube and two IVs along with Type and Cross for transfusion. Why? “Because that’s what the protocol said”

      Bottom line is, checklists can help but they can also get in the way.

  3. Future Nurse

    16 = OCD is likely…. Hmmmm… I would not call myself OCD… I don’t believe I have too many irrational fears… nor do I have to organize my groceries… nor do I have strange pet peeves such as refusing to let other keep their bag on their lap…. But alas… I agree that meticulousness can be necessary and wonderful, but at the same time can allow for inflexibility and just plain impractical care. One checklist will not fit every client, but can help organize thoughts….
    Having kids, too, has probably added to my “OCD score.” For instance… when I take my kids to my family’s house and bring food to feed them with, I am automatically picking food that they would be least likely to choke on… And yes, sometimes because of fears and scary visions, I will avoid places all together… Sorry kids, no swim camp unless I am there, or you have years of swim experience behind your belt… Ok so maybe I am going off course here…

  4. Pingback: Nurses and OCD (Obsessive Compulsive Disorder) – is it good or bad? | Nursing in Hawaii

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