I was a NICU nurse and developed OCD because of the intense pressure of keeping sick babies alive

• Shannon McPeek was a nurse in the NICU who was devoted to the  patients she cared for.
• But the fear of making a mistake paralyzed her thinking. She developed OCD to "handle" the stress.
• McPeek sought treatment and later set up a nonprofit to help other nurses under similar pressure.

This as-told-to essay is based on a conversation with Shannon McPeek, a former NICU nurse. It has been edited for length and clarity.

As a nurse in the NICU, I prided myself on giving everything to my job — being a stickler for detail and caring for my patients and their families with the utmost compassion and understanding.

My thoughts revolved around the unit, even when I was off duty. The pressure became all-consuming. In 2016, when I was 22, I was just five months into the job when I started waking up at night with heart palpitations. I'd worry about each patient — some of the babies were as young as 22 or 23 weeks old — and become terrified that they'd get sicker than they already were.

One of our babies weighed only 450 grams, or about one pound, at birth. That baby, thankfully, pulled through. But others didn't. It would hit me hard, even though I knew that most of the time, the baby just wasn't supposed to be on this earth anymore.

At the height of my stress, if a baby died, I'd think, 'What could I have done differently?'

I'd look into the eyes of the bereaved parents and feel their despair. It's already a horrible situation, but if you add in the bond you've developed with them and their child, it's even harder. You'd comfort them while pushing aside your own tears and emotions — only to try and deal with your feelings off duty.

It's an unfortunate truth that we can do everything possible, but we can't save every life. I'd always think about how the outcome could have been better.

Meanwhile, though I loved my coworkers, some of their conversations made me anxious. They shared a lot of stories about errors that other nurses had made in the past. People would talk about how terrible those mistakes were and didn't understand how they happened.

The staff-to-patient ratio in the NICU was incredibly low. And, unlike doctors, nurses don't have individual liability insurance. I developed a huge fear of being the one that everyone talked about — the one who'd committed human error.

You come into the medical profession to help patients, not harm them. The concern about accidentally doing harm was debilitating for me. After a while, I thought the best way to prevent anything from happening was to check that things were right over and over again. Before long, I stopped acting human and became more like a machine. My bedside manner suffered as I became less compassionate in my effort to survive in my career.

I would check bottles 10 times before giving medication and IV fluids. I'd read patients' charts again and again, triple-checking if there was anything I could have missed. If my coworkers made comments about me fixating on something small, I'd laugh it off and say, "I'm just OCD." A lot of people throw the term around casually, so I was able to make light of my issue.

I finally got the wake-up call that I needed to prioritize my mental health

At home, I'd do dozens of nightly checks that would take 30 to 45 minutes before I could lay in bed. I'd check the doors were locked, the stove was off, and the blinds were shut in multiples of three. I'd set five different alarms because I was terrified of not waking up for work the next day. I survived on four to five hours of sleep a night. I'd wake in the early hours of the morning with chest aches.

My personality changed at home as well as at work. I was constantly irritated and snappy. Things came to a head when my significant other said they couldn't be with me anymore. "I can no longer be in your life," they said.

It was painful, but I'm grateful to that person now. They gave me the wake-up call I needed to put my mental health first. I started to research stress relievers and coping mechanisms that really helped.

Later, a therapist told me that much of my OCD centered on safety. They said I was searching for safety when I felt I couldn't provide it to some of my patients. I learned that my way of coping with a lack of control in certain situations was to try and regain it through compulsions.

Next, I began speaking to other nurses. I realized that I wasn't alone in my journey. There were so many people experiencing the exact same thing as me, but none of us spoke to each other about it. My friend and I could easily find resources for firefighters, police, doctors, and the military, but not a single thing for the nursing community.

I miss the NICU, but I'm pleased to be helping other nurses who endure chronic pressure

We founded Operation Happy Nurse in 2018, a nonprofit whose goal is to ensure nurses don't feel alone in their struggles with mental health. We currently have about 1,500 nurses using our online community for support.

I left my job in the NICU in March to concentrate on the program full time. I miss my unit, my colleagues, and all the patients and families I got to know so well. But I'm glad to be helping other nursing professionals like me.

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