help, I have burnout bad!! - page 2
I really don't know what to say,but that I have lost my ability to work as the nurse I once was. I find my self with little to no com,passion or empathy. i have always given 110% to nursing and my... Read More
Jun 22, '09Ugh, I'm sorry your family is so unsupportive. Unfortunately the public generally doesn't understand what being a nurse is all about. Oftentimes only another nurse will really understand what you are going through, which is why this board is a great source of support.
Jun 22, '09Quote from Valerie SalvaI cannot even begin to express how accurate this description is. Bravo to you!Your facility obviously has very poor working conditions and purposely understaffs, but that more and more, that is standard in nursing. With the situations I have seen in some hospitals/nursing homes, I don't even think Flo Nightingale herself could do a good job.
Is your job ones of those jobs where it is the night before you have to go to work, but you already feel behind?
I know the feeling. It is Sunday night and my shift starts tomorrow morning @ 0600, and I already feel behind. Thank goodness it's a travel contract, and I only have 7 weeks to go. At least there is a light at the end of this tunnel.
Every time you hear a pt say "Nurse?" does your heart sink because you know that whatever it is they want, you don't have time to do it, and you know you will get even further behind if you do and feel like crap if you don't?
I don't know of anything that can help other than maybe another and another and another job- and most of the time, that does not even help. When we wander from job to job as nurses we are simultaneously running away and desperately trying to run towards something which may not even exist.
I don't know what we can do, but you have my empathy and understanding.
Jun 22, '09[quote] every time you hear a pt say "nurse?" does your heart sink because you know that whatever it is they want, you don't have time to do it, and you know you will get even further behind if you do and feel like crap if you don't?[quote]
this, in particular pulls my heart strings...those days, i feel like saying to myself "gee, great, they'll probably ask me another thing that i can't do".
Jun 22, '09You need to take a break, even if it's just a few days away. Go to the mountains, the beach, somewhere that you can be anonymous, no one's going to call you nurse and demand anything of you.
We're good at helping everyone else, and we need to recharge our batteries to be able to do that.
Jun 25, '09thank you for all the suppport. I am seeing a counselor through the employee assist program and saw a pysch dr today. i am going to take about 6 weeks off work, try some meds and hopefully get back to the caring nurse i once was.
Jul 2, '09Quote from eldragonIf it takes you that long to pass meds to 7 people, you need to manage your time better. Once you are in control, you will feel less hurried and scatter-brained and stressed out.
BTW - I pass meds to 30 very needy residents in 2 hours. If I stood around talking, or even took a break for myself, I would never be done with passing morning meds. Get in there and do your job, and let (or demand) that others do theirs.
That is not a very helpful comment. I also take anywhere from 1.5 to 3 hours to pass meds to 6-7 patients. You must work in LTC if you pass meds to 30 people in 2 hours. Either that or you are not very careful. Acute care is different. You have to critically think about everything before you do it. You have to assess every pt you give meds to, make sure their vs are stable and you are not going to bottom out their blood pressure. I dont think the op has a time management problem. Every nurse I work with takes this long to pass meds and we all get out at least 30 minutes late or more. My shift ends at 3:30 and today 3 out of 5 of us got out after 6pm. It was a crazy day. We dont all have time management problems, we have hard jobs that are very demanding.
To the OP: I have been where you are. I have taken time off, looked for other jobs and swore I would never go back. The only cure for burnout, IMO, is to take a long time off if you can, to get yourself together. If the turnover is that high at your place their must be something wrong. Look around, if nothing else, it will give you hope for the future that mybe you can find a job you can stand. Good Luck.
Jul 2, '09To the OP,
It's not your fault. To do a job that is as demanding as ours, to have to think critically through all the stupidity, and to get no thanks at the end of the day from anyone, the patient, the family or the facility all contributes towards burnout. The situation many of us nurses face is not realistic at all.
Remember, it's not your fault, take some time off, look for other opportunities, even if they don't pay as well.
Aug 15, '09Just wanted to let all know that I have been off work for 7 weeks, treated for depression and will be going back to work on Monday. I am hoping that I can get back to my old self. I hope to be able to work a a nurse for at leasat 3-5 years. Thanks for all the support.:heartbeat
Aug 15, '09Quote from eldragonIt's a skilled unit and the meds change almost daily. And even our LTC patients take many prn narcotics, usually twice every shift.
When you think of long-term-care, you may think of people who take the same 3 pills every morning, but that's not the case where I work. Our doctors are pill-happy and most patients take around 10 pills in the morning, and another 6 throughout the day, spread throughout the day. And many, many of them have eyedrops, inhalers, patches and narcotics to deal with, both prn and scheduled. And then the supplements that are offered, meds that are crushed on well over 50% of our patients, and numerous peg tubes, etc. Plus I have to take my own vitals for every single patient who takes bp or heart medications.
So what happens in a hospital setting that takes longer?
May I make a suggestion or 2? First, God Bless you as you sound like you care so much but also you sound soo very tired. I know what burnout feels like starting with the feeling that you have given all you can give (and it doesn't seem to make a difference), that you have tried many different strategies again no difference. And "just what the heck am I doing here?" I feel for you.
How are other nurses handling this? Is your manager aware? Have you tried to speak to her (1rst and if no help, follow the chain of command). Nursing just can't afford to keep loosing seasoned nurses!
Ok that being said I may have some practicle suggestions:
1) Do speak with your manager and look at staffing ie, are there enough CNA's on the floor?
2) What are your CNA's assigned to do? (As a nursing manager all CNA's are skill tested for competency on completion of vitals. This should be assigned to them at shift start with a time that you expect them to give to you.)
3) Do you give a report to your CNA's? Often (50% of the time)I have seen that nurses do not do this, then complain when a new hip fracture patient has been transfered inappropriately. Truly, the CNA's will respect you more if you do this. It shows them that you respect their judgement and also gives them 'clear' instructions as to expections that you have of them as they work 'under' your license.
4) If a resident has more than 9 medications, this is a PA/Medicare 'flag'. You would do a service to the patient, the facility and your time if you call the pharmacy to come out to do a 'Medication Review'. They will then f/u with the doc to decrease meds if possible.
5) Something you can either do independently or during the pharmacy med review is to get all 'crush' meds changed to liquid form. Crushing pills is not only a time waster but has the potential for causing drug interations if not done properly. And thinking of this in the future, whenever you admit a patient that requires meds to be 'crushed' think automatically to get the order changed to a liquid. You may even be able to suggest this to the Medical Director and DON to get this as a standing order when appropriate.
6) All eye drops/heparin injections/patches at my facilities are routinely done by the noc shift NOT am's. This is done for several reasons a)the patient is already in bed, laying back (easy to instill eye/nose/ear drops; b) again, they are in their rooms and therefore you don't run into the privacy problem ie, stop what you are doing, get medication, take them to their room etc, etc.; c) water and washclothes are readily availble to 'prepare the eyes for the eyedrops!; d) You don't have nearly the number of medications to pass on nocs as days; e) again, the patient is in bed with much less clothing on so the nurse can easily and quickly and privately locate the previous patch, remove it and reapply.
7) As for medications, something else we did was to change some of the med administration times. It is not necessary for example to give MVI/Zinc/Vit C in the ams. Just by changing this to noon or 2pm will save loads of time in the am.
Well these are just a few of the things that you may want to try. It does all begin with first looking at your practice. Talk to your fellow nurses then follow-up with your nursing manager. Either by yourself or if this is a growing problem at your facility, get other nurses to go with you. Please when you do, don't make it a gripe sessiond or play the blame game but come with the problem clearly spelled out, then bring some suggestions for a positive change. Who knows, you may be the one to save several careers, not just your own. Not to mention how much better the lives of the patients will be made!
All the best to you!
Aug 15, '09Quote from jrbl77Let me just say, coming from an aides point of view- that you should not have to be doing those things (changing people, cleaning them, changing bed linens, etc) Although you are an even more amazing nurse for it, your aide should be doing it for you!! And if she got sent home, where were the rest of them? I was always the aide argueing with the lazy ones because the poor nurses were running all over trying to be super nursie while they were hiding in rooms eating fried chicken and sitting in the bathrooms on their cell phones. I'm sorry that your having such a rough time, that really stinks. And I really hope it gets better!i have been very organized in the past. unforntunatley, i can't get back to that spot. i know what i need to do and how to do it. i can't get past the fact that i would not want to be laying in a pile of p--p or a wet bed. how do you say to someone, i can't help you. it often takes longer to find someone to help the person than to do the job yourself. several weeks ago, my aid was sent home at 1130 am due to a drop in the census. i was not told for an hour later. none of my patients could get out of bed by them selves, unless they were not supposed to and then they were crawling out of bed. several needed help with feeding. family members stand at the door and look at you and expect you to attend only to their loved one. when i first strted nursing, we were expected to do what ever was needed to be done- no questions asked. it is a hard role to break. i guess i am just tired of being everything to every body.