Burn out in the ER - page 2
Along the way, I had moments of fatigue, stress, the feeling that I just can’t go in there one more day, you know, the feelings all of us have once in awhile. Was this burn out? Hmmmm…had... Read More
Oct 12, '09well, I guess I deal with it by remembering all of the amazing things that go along with working in an emergency room. I mean, where else are you going to see a baby born, cardiovert someone, and listen to a schizophrenic talk about the end of the world tomorrow all in an eight hour shift? It is hard, and there is alot of nonsense that comes in, alot of people that arent sick, alot of people taking advantage......but you have to remember...you work in an ER because its an opportunity to take care of the sickest, most forgotten people in the hospital, you will never get thanked, and you may even get spit on now and then....but the mother whos baby you delivered, or the guy who was having the big one that survived will always remember what you did.
Oct 12, '09Quote from traumaRUsBurn out in the ER or why its been a long time since I wrote in this blog....
I always loved the ER from the very first day in 1996 when my preceptor told me not to worry, I would get the hang of having patients that were very ill from who knows what, had some unknown object in some weird oriface, or died and no one knew why. She was right, I did get the hang of it and stayed around for 10 years as a staff nurse, then charge nurse, then case manager and finally back to staff nurse. Along the way, I had moments of fatigue, stress, the feeling that I just can't go in there one more day, you know, the feelings all of us have once in awhile. Was this burn out?
Hmmmm...had to do some thinking on that one.
So I toiled on and on and on and realized in 2002 that maybe I was aging - I was tired more, the night shift was getting busier or was I getting slower? What to do? Well, since the hospital had gone on the Magnet journey and it appeared that an ADN grad wasn't going anywhere up the food chain, I decided to head back to school.
After school, along a convoluted path, I ended up working part time in a community ER as an APN. How to put this delicately? Most of the physicians enjoyed working with an APN. However, two physicians refused to work with me, even to the point of making disparaging remarks in front of me. Why? Am not sure even to this day except that they both seemed liked bitter people in general So...this didn't help the feelings of added stress and fatigue which I once again felt. I have since gone prn at that position and you know what? My stress and fatigue levels have decreased dramatically.
I'm not advocating quitting or even decreasing your hours when you are fried - you have to do what works for you. At this point, prn works to deal with the burn out for me. Who knows, maybe one day I will go back full-time to the ER, but for now, this solution is the best.
So...my question to everyone is: how do you deal with the added feelings of stress that we experience in the ER?
sounds like that works for you,, and when you are part time, you don't get involved in the politics and everyone is always glad to see you.. go get two part times.. I used to work that way but worked agency to have more control over my time ..
Nov 11, '09I have to tell you that I feel your pain. The stress of working in the ER in this healthcare environment is hard on you. Physically and mentally. Most Nurses who work in a specialty area spend most of their time caring for the kind of patients that they love taking care of. In the ER, you get to spend 5% of your time taking care of the Trauma/MI/CVA/CODE patients that you are thrilled by, and 95% of your time working with clinic type patients who can't afford to go to a doctor's office (or just don't want to), or worse - patients who come into the ER wanting something other than healthcare, but rather a pharmaceutical answer to their problems. Add to that the changes in our society that place nurses in violent and provocative positions, and you've got the makings of a big stress sandwich that someone is forcing down your throat.
I think Travel Nursing saved my career. I was as close to burnout as I care to ever be, and then packed up and headed off on my first assignment in 2004. I've never looked back. I still deal with the day to day stresses of working in the ER. But what I don't have to do anymore is get involved with hospital politics or Nursing clicks. When I start a new position in some place new, the excitement lasts long enough to get me through the assignment and then it's time to move on. I get to see Nursing practiced in so many different settings, and my knowledge base and experience have grown. I'm a better nurse for having flitted across the country for the past 6 years. Definitely a happier nurse. Certainly, an older and wiser one!!
We can't afford to lose even one nurse to burnout, I'm glad you found your own way of getting through it and are still hanging in there with us.
Nov 11, '09I work on a laid back (relatively) tele unit. It's about all I can handle at the moment. If I am forced (you heard right) to float to ER, I just do what I can do and get help for the rest.
Nov 24, '09I don't have to be to work for another 16 hours, but I am already feeling the impending stress. I've decided to give ED at least one year, and reevaluate where I am at that point. I've done this before, when I first graduated, and I can do it again. But, I would really like to get to the point where I feel halfway competent.
Nov 24, '09Does anyone, anywhere in the country, have leads on getting an ER staff nurse position for someone like myself?
I have four years experience in med-surg at a very challenging county hospital, am bilingual, Spanish with a BA and MA but not in nursing. My nursing is an Associate's degree.
I am passionate about working in Emergency medicine and can't get any leads. Is no one doing training programs these days?
I will go ANYWHERE for an ED position.
Thanks in advance.
May 13, '10I would like to thank everyone for posting. I am currently in my own moment of desperation. After 11 years of ER nursing, I am struggling to find the joy in my work. Many of the reasons are mentioned here but in summary the issues are: violence or potential for violence for ER staff and vulnerable patients, constant new policies with no new resources to achieve success, triple charting everything, expectations to do everything twice as fast with half as much time, and the cultural crisis of our population's inability to care for itself due to declining education. I love a good STEMI that walks in the door. What I can't manage is the bogus "indigent" patient with no insurance or ability to pay for services that sits in a pt room, BIBA with a chief complaint of N/V/D X 2 weeks, eating doritos and talking on their iPhone. Really? I've sacrificed a day with my family for this?Everyday, I chant "I am my brother's keeper" but it's starting to become more and more hollow. I appreciate everyone's positive suggestions like change your environment, advanced education and travel nursing. I am considering those and I am grateful for all of you who have visited this dilemma. I am also grateful that you do what you do. Thanks and stay safe. It's a dangerous world out there.....
Oct 3, '10I feel everyone's pain of working in the ED and the curiosity of being in the ED. I have been there. My first ED experience was being sent by my agency to the MICU, but when I got to the hospital... the nursing supervisor told me go to the ED - "you're much needed there!" I was like, "WHAT!? but I've never worked in the ED?" And she said, it's ok just help the nurses out start IV's and give meds. Walked in the ED and they gave me 2 OB/GYN rooms for vag bleeds. And the place is a trauma mad house! LOL! I laugh at it now, bc that night when I started my shift at 11p, I had no clue how to prep a pelvic on a reversed bedpan. I was completely clueless! Didn't know what to do. A patient walked in, I didn't even know what to tell her! But a, "Hi, my name is... and I'll be your nurse... hold on, ok? I'll be right back!" I figured she was fine bc she was ambulatory... sat out in front of the computer, went to the another nurse for assistance... Finally, an ER resident did everything without my assistance as I apologized for not knowing what to do. Soooo weak of me!!! But I felt blebs of sweat saturated myat that time as I freaked out in my head and couldn't wait to get the heck out of there! Everyone was so busy with a gazillion patients and no one had time to even at least give a quick tour of where things are. I was like a blind person in a department store. I was so mad at my agency for that! I threatened to leave them! I would have been fine with taking care of ICU overflows in ED. And so... that's exactly what happened. I started taking care of ICU overflows that got stuck in the ED for longer than 6 hrs bc there's no ICU bed anywhere in the hospital. And, I kept on doing that for the next 2 weeks. While taking care of ICU overflows... I was being a team player and helped the others out and learned the flow from observation. Finally ended a contract there and now I am an ED nurse since. I only left for 2 reasons: relocation (SO has new job) and new baby #3. Now, I had to go back for unfortunate financial reasons, but thought it's be ok, bc I was happy in my old ED. It was organized and we all played like a team and we have equipments. Now going back to a different ED, in a different state, away from my comfort zone, with higher nurse to patient ratio, missing equipment... in the ED makes me just want to leave. I count the days/minutes when I will be off again as soon as I get to work. But, I love what I do, but not where I do it. So, in consolation... I am looking into other opportunities where I can be happy and find balance.
For the ones who are interested in working in the ED... there are lots of places out there that will hire you. If you have not found your ED yet...Work on your certs. ACLS, PALS, BLS, TNCC. Just do it even if you haven't done ED yet. It's a good learning tool and it looks good on your resume`. Or you can try agency and maybe they will eventually send you to an ED (not recommended, bc I never got an ED orientation, so even tho I have been a nurse for a while.... I know I still have a lot to learn in the ED). The 3 ED's I've worked all hired new grads, just gotta be persistent and be optimistic =)
PS: Pls check out my thread. I am curious to know... current "ED ratios across the US" - Thanks in adv!
Oct 19, '10NewbieEDRN,
Perhaps, maybe you need to take in to consideration that you may have a bit of a drinking problem. Dealing with not being able to drink plus pregnancy= miserable!!! It also could just be that you're pregnant. When I was pregnant with my son I just felt awful. I was constantly nauseated, plus heartburn, and just felt bad. At the time I wasn't a nurse, but I was working, and being on my feet all day just killed me! It really stinks that you have to work while pregnant, I know it's hard, but try n hang in there!!! I bet after you have your baby n ur at home with him/her for a while you'll feel much better returning to work. If not maybe you should try another specialty of nursing. Good luck! And try to enjoy this special time!
Jan 5, '11UPDATE:
I have since left even the part time position as an APN in the ER as my full time job is just that: more than full time.
I still keep my hand in pre-hospital care as a volunteer on my rural fire/EMS squad but not in the hospital any longer.
Really miss it though.