Tunnel Vision

Tunnel vision. All you can see is what's directly in front of you - everything in the periphery, no matter how important, is merely a blur.  Tunnel vision is a common plague for new nurses. You are so new, and overwhelmed, and unexperienced, and a little bit terrified, that sometimes all you are able to focus on is the basic tasks. Everything else, no matter how important, blurs uselessly in the periphery. When I first started nursing I had a serious case of tunnel vision. I knew all the basic tasks I needed to accomplish in a shift, and I could just scrape by... as long as I wasn't thrown any curve balls.  One distinct memory took place my first year working on a medical unit, while delivering my morning medications. I brought in a gentleman's medications, only to find him in the shower, hospital gown half on, trapped by the IV wires running from his arm to his IV pole, covered extensively in feces.  The poor man had his full faculties but a bad case of a C-Diff infection, which can cause sudden and explosive diarrhea. So here he was, standing exposed and humiliated, obviously and awkwardly trying to salvage his dignity, and what did I do? I held out my little cup of medications and a cup of water so he could take them.  Right there, in the shower, feces and dignity slipping down the drain with the running water.  My overwhelmed little nursey mind just couldn't detour around needing to deliver my medications in that fragile 1/2 hour window.  His expression certainly followed me home that night.

Tunnel vision can have more dangerous implications.  It can blind you to those subtle clues that your patient's condition is deteriorating. You can fail to prioritize vital tasks over trivial ones. You can have a hard time thinking in terms of "this is important, this can wait," as you brain just does a "task task task" kind of a hopscotch.  One of the few cures for tunnel vision is experience.  As you gain comfort and then competence in your role and your sense of being overwhelmed diminishes, suddenly the light expands and you can see so much you didn't see before.

I think this condition can befall us in our every day existence as well.  I've noticed it crop up in my parenting.  There are so many day to day tasks to push through every day, that sometimes all I can see is cooking, laundry, muddy footprints, messy rooms, empty fridge, and I can easily forget the things I actually want to accomplish with my kids. The things I want to teach them, the atmosphere of joy and love I want to facilitate.   What will matter more later? That I always kept the house clean but I was often irritable? Or that I was generally joyful and kind, even when someone decided randomly to pee in the trash can instead of the adjoining toilet? (Oh you little boys...) In the first story of my patient in the shower, it was more important for me to quickly and graciously help my patient through his embarrassing circumstances than for me to get my medications checked off on time, but in the moment I couldn't see it. And too many times in those other moments of my life, I can't see the forest for the trees.

In nursing, when things get overwhelming (as they generally do) we have to teach ourselves to take a step back and ask, "what is most important here?" We have to teach ourselves to begin to be able to look for that big picture, not losing vital clues and fragile moments in the fray of our busyness. In life, in parenting, it's equally important when things get overwhelming (as they generally do), to teach ourselves the same thing. Take a step back. Ask yourself what is most important here, and what can I let slip this time? Because timely medication delivery is only important to a certain point. A clean house is only important to a certain point. But there's generally a bigger picture in play, and if we don't stop ourselves we will probably miss it.