Nurses and OCD (Obsessive Compulsive Disorder) – is it good or bad?

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Why WordPress is a terrific blog host

I am  satisfied with WordPress as a blog host. I like the interface and the themes. Did you know that when you own a blog, you can access the statistics as to the number of hits? WordPress helps me see how many hits I get (highest was 479 in one day!) or which countries the hits originate from (about 110 countries – nearly everywhere except China and Francophonic Africa) or how many hits each entry received ( the blog about “myths of Nurse Practitioner education” was surprisingly popular). It’s a great way to get feedback in ways that go beyond waiting for a comment to appear or not.

But one intriguing thing is, I get a daily list of search terms that somebody typed into their machine and which somehow led people to this place.  There is one particular topic I have meant to expand upon and now is the time.

Obsessive Compulsive Disorder among nurses

I think this shows up because I wrote a series of blogs about the Nurses Road Map and I observed that attention to detail, ability to execute a complex plan, and work with checklists, is a trend that is not going away. To some degree, we are raising a generation of new nurses to be checklist-users. The field of nursing informatics is designed to sift through the mountain of clinical details available at the bedside and help the nurse get through all the little events of the day (while keeping track of the big ones). Anyway, there is an online quiz you can take to evaluate your own OCD. Most nurses will laugh at this because it highlights the relationship between fears of death or disease and the development of OCD; for the lay person this may seem irrational but for nurses the fear of catching a fatal illness can be entirely rational.

Now to the meat of this blog

The short answers, not based on science but based on a lifetime of observation.

OCD While in Nursing School

 1) A little bit of OCD can be helpful. As a nurse, you are accountable for followup on things you are told, and this includes organizing patient care. Read my blogs about the Road Map, please. it is my gift to humanity ( though I did not invent it)

2) too much OCD  is disabling. True story: I once worked with an IV nurse (i.e., specialized in intravenous infusions, all day long, starting, hanging meds, and running them including hyerpalimentaiton and Chemo rx) who had every symptom of OCD. She once spent fifteen minutes starting an IV on a person who had died. without noticing the lady was not breathing. Fortunately, the patient was a Do Not Resuscitate. But still……..I would have noticed, myself.  If you have OCD you can get wound up by little details and lose sight of what is important.

3) nursing school is a place where you will get feedback on how much OCD is too much.  We have all heard the war story about the straight-A student who could not actually function in real life. If you are in nursing school now, look around. You will most likely see people who are extremely persistent and meticulous. This is the kind of student who argues with the professor about every single exam answer (should it matter if they are already getting an A? experienced people know that there is no such thing as a perfect exam); asks questions in class about obscure medical syndromes (let’s focus on commonly occurring things, shall we?) and is consumed by the idea that “this is important what if somebody dies because I don’t know this?”   ( not likely. trust me). Ask yourself who in your class is dealing with OCD.

Sometimes the faculty are a bit timid and don’t call out Obsessive behavior. They are not doing the student any favors by letting it slide. I had a student not too long ago who thought it was okay to phone or email the faculty with questions at all hours, and who got huffy when there was no immediate reply at 0300 on a Sunday. Hot tip: this is not a way to impress the faculty.

4) clinical with real people is the place where the rubber hits the road. Often, a student with OCD will relax and start to “get it” when they go to clinical, because this is the ultimate place to “test reality.” You can’t always predict every single thing that will happen in clinical, not altogether a bad thing. Nurses benefit every time they meet a patient who demands that the plan fit the patient’s expectation, not the nurses expectation. As an aside, we have a new emphasis on simulated learning these days – using tightly written scenarios with expensive mannikins. When we do this, we delete the possibility that there could be a  useful  serendipitous encounter between a student with OCD and a patient who demands flexibility. The richness of the actual clinical milieu is not to be taken lightly. Simulation is like eating beans; clinical is like enjoying cassoulet…… beans are still part of a good cassoulet but there is so much more……

5) A crisis is not always a bad thing. Let me describe that another way, giving an example. Sooner or later, it’s a common occurrence in nursing school that the clinical day does not go anywhere near the way you planned it, and you feel like a failure. For a student with OCD, this gets magnified into a total crisis, because they often have the belief that they can or should control everything. ( if I can’t be perfect  I should not even try!)

Don’t let “perfect”  be the enemy of “good.”  If the faculty person is wise, this time becomes an opportunity to discuss the zen of staying on track and a whole lot of other higher-order-of-magnitude stuff. A crisis can be a “teachable moment.” Often, a breakthrough. A good way to look at ways to keep OCD in check.

In the Workplace

As I said, some small degree of OCD is probably desirable, but too much is not helpful, and it would be great if everyone got a handle on this before entering the workforce. It does not work that way in real life.

1) don’t take the work home with you. One of the great aspects of effective use of a Nurse’s Brain is that when the shift is over, you can feel good about not missing anything, and clear your mind when you walk out the door.

2) If you have OCD and you are on a nursing team, my personal experience is that you can make life miserable for everyone around you. Other nurses may have a different style of work, and if your OCD causes you to be inflexible, you will descend into madness. I will be blunt: Nurses with OCD tend to become critical of others and to engage in what Marie Manthey called the “Three B’s”. There needs to be limits on this behavior.

3) OCD is not a leadership skill. Sometimes a staff nurse with OCD is chosen to become a charge nurse or nurse manager. This is nearly always a mistake. A person with OCD lacks the ability to weigh and evaluate the relative imprtance of things, and tends to see everything in black and white.

The Great thing about nursing

I will edit this blog entry over the next few days, but the clock is ticking and hey, “it’s good enough now.”  For so many schools, fall semester begins in  two weeks or so, consequently I will hit the Publish button for this first draft.

The great thing about nursing is that to be a good nurse is to call upon your own capacity for healthy problem-solving behavior and healthy coping which keeps OCD under control…….

June 2014 update: click here for a link to an excellent blog about how to cope with anxiety if you are a nurse.

share your reaction in a comment……



Filed under Nurses Brain, nursing education

9 responses to “Nurses and OCD (Obsessive Compulsive Disorder) – is it good or bad?

  1. Nursing is not a good place for ocd sufferers . Too much stress and life is too short

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  5. Alisa

    As a nurse and someone who actually suffers from clinical OCD I am disappointed with your usage of “OCD”. This is not “OCD”. What you are describing is being picky, or having attention to detail. I sure hope you educate your patients better than this post.

  6. Pingback: Anxiety on the Job | thenewnursesite

  7. Pingback: For The Anxious Nurse – FRESHRN

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