I think I can echo most of what you are experiencing.
I have not worked in the hospital since September 2006 and though I think about going back - I just can't seem to do it. I do have moments where I really miss it and I, too, took a LOT of pride in being very good at what I did and being that "team player". Maybe it's like childbirth (not that I have kids - just what I've been told) or that really great looking guy you loved, but was toxic (not had one of those either - thank God) - you know the kind of situation where you look back and think - it wasn't that bad.... And then you "selectively" pick the good bits to remember and let the pain, tears, frustration, feeling of low self worth or whatever "fall" away.
When I left nursing in 2006 - I was at the end of what I could tolerate mentally, physically and emotionally. Burnt out - nah, just burnt through and through. I was in a very bad place and not living the life that I had envisioned for myself. I was not a good friend, good wife or even good person - I didn't have compassion fatigue - I was out of compassion for most everyone, including myself. I don't make a lot of discussion about this and DO NOT have any type of a substance abuse issue - but, I found many shifts ending in a blender full of margaritas consumed SOLO post shift. Every shift. It was the ONLY thing that got me though the shift - knowing that I would get to "zone" out and maybe numb it all away for while. Not a road I would be able to travel long. A road with consequences. Bad ones. I had been contracting/traveling and away from my husband (I was in a period of self-exile and punishment, in hindsight) and woke up one day and knew that if I did not quit - I was not going to survive. I would not call it despair - cause you have to feel something to even despair - I was at the end. NOTHING was left to give - I think it is a miracle that I found that scrap of self preservation and enough fortitude to act on it. My husband and I are financially secure (even without my income) and so once that was reinforced by my husband - the real question came down to self destruction and he did not give me anywhere else to run and hide - get out , come home or stay away. "I don't care if you go to work again, go back to nursing someday, go work at WalMart or sell flowers at the airport as long as you get well, get to place to be able to take care of yourself and us - it stops now."
So I left and did NOTHING. That's right - nothing. Now just a rest period - but a full on existential crisis. I knew that old paradigms of life would have to shift and something different would have to happen - but, I had hit the point of no return and my life was in flux. I needed to be able to care for myself as well as I had cared for others.
I ate well. Drank very little (thank God, that path came to an end). Exercised. Spent time with people I needed to reconnect with and mend more than a little neglect. Found solace in nature, quiet and the grace of God. Lot of soul searching. I spoke with a counselor to keep me in a forward motion and get my "self talk" repaired.
Sounds pretty - woowaahootaawoowee - but, not so much. The point was I had lost my "center" and needed to re-center myself. I worked to find that "spark" I had lost and had to realize that I did not want to spend another second doing something, anything that took more from me than it gave. I had been so good at what I did - I forgot that doing it well should be rewarding or fulfilling or heck, even moderately tolerable.
Before - I had been able to "center" myself - I would focus on teaching, preparing and passing multiple certifications and focus on being a GREAT NURSE or PARAMEDIC. Worked hard to be better tomorrow than I am today. And most of the time I could find that "spark" and get back to it. Eventually, I think some burn out is expected and most can work through it - but, you have to look at the "big picture" and be honest with yourself about your capabilities
and just as well, to know your limitations.
Like you - I was great with the "sick" or urgent cases. It is a PRIVILEGE to be able to care for someone that is really sick and have them trust you and you be any small part of helping them through (either to wellness or the "good" death - free of suffering as possible and with all the support they deserve). So, that was the last bit of "reward" - but, those cases are draining in their own way and even being good at something does not make it good for you. It was the other 90% of the ER "crap" that got plated up for you to chow on - your own little buffet from hell. Yum...???
the entitled, b*****, whiney, demanding and must have my way set of patients that suck your energy out. The best part is those with the least amount of illness have the biggest demands - demands I could never fulfill - no matter what I did, how I did it, the amount of time I spent or anything. Complain, complain, complain. Call admin and "get that nurse fired" - I loved those most of all. Administrations with the "patient is ALWAYS right" position - is a special kind of employee abuse (most of these are the ones that could not staff their hospitals - wonder why?). I was always respectful, tried to treat folks the way I'd want my loved ones cared for). I never tried to reason when someone wanted to yell at me (just let them finish - apologize for everything and ask "what will it take to make this right sir?). I was courteous and treated folks equally (bum under bridge treated as well as a bank president - actually the bum was often the "better" patient). I did not care about insurance or payment - I did all I could for everyone. RX for motrin so your medical card would pay, cause you spend your single mommy money on cigs, blinged cell phones, the baby daddy and fake nails - no problem - wait here (for the next 15-20 minutes, so I can retrieve your chart, track the doc and hold your d/c, it is so OK - clearly, why should anyone here expect that you would BUY motrin when you can get it for FREE - your right, were stupid to think that a $2 OTC med should come out YOUR pocket like it would ours). I had hit the wall. I was done.
Add the bad behavior patients, with bonehead docs you had to keep from killing patients, administrations that had a new customer service program monthly, service recovery that was exhausting when a patient did not get their correct meal tray, risk management that were the REAL directors of your work and impossible schedules, no staffing for a break/meal much less a vacation, co-workers that were as miserable and even less able to be "team" players and snark, snipping, and downright childish behavior at times - and well, a perfect combination for - I. JUST. CANNOT. WILL NOT. KEEP. DOING. THIS. TO. MYSELF.
So, I left - and had no plan other than to BE STILL.
And just be open to possibility and see what comes your way.
I found (or it found me) a transport job in December of 2006 and was hired on a resume alone. I could do my first love (paramedic) and yet, be a nurse. Sounds good. Did it - loved most of it and worked into flight over the next year. I did 3 and due to travel involved, the fact that a bad day at work on a helicopter will get you DEAD and the fact that finances were very comfortable - my husband preferred that I stop. So I did. I was tired and while it was not a "perfect" job by any measure - I got out of it what I needed. I had been getting anxious about the crash thing. While I was relieved to be "safe" - after about 6 months I considered going back PT - I did and do miss it. But, I have a hard time saying NO - and before long I'd be everywhere again. So, now I teach some - am finishing an educational program focusing on new nurses - I also do some antique and repurposing of furniture and textiles and while, I "miss" it at times - I have the life I want.
So, if you can financially - just stop or go PRN with the understanding that you need a few months to "cool down" at a minimum. Make self care your #1 task. Be quiet. Reflect - maybe seek counseling. Learn to be present and still and work through your options. Best case/worst case - you can always get another job - but, there is only one you. Make YOU the PRIORITY and you may find your peace. I did.
Good Luck - keep up posted. I cheering for you.