More Thoughts on burnout & unsafe staffing

[Genista, BSN, RN]

I know it's been discussed ad nauseum, but since it's so prevalent, I was thinking about burnout yet again. Well, it's prevalent where I work, anyway, for me & my wonderfully overworked peers, lol. The other night I was serving my time on my mandatory night shift rotation (which by the way, I am enjoying the temporary change), and after having worked yet another 10 hr workday w/o a break the night before, I was feeling quite angry. There were 2 days worth of orders that were not taken off from days & pms, let alone 24 chart checked. To me, that meant that the nurses on ALL shifts are worked to the bone, since things weren't done. I had one pt who didn't have any of his blood sugars graphed for the previous 2 shifts!!!!!

Keep in mind, I have cut back to 3 days/week, and am pending transfer off this horribly understaffed med/tele floor...but in the meanwhile I have to stick it out w/ a positive attitude. I'm trying! ;-)

So, the other night I was working and one of the phlebs came in to draw am labs from one of my patients and I overheard her tell the patient that she is going back to school to "be a nurse." I had to literally bite my tongue to keep from saying,"NO! Don't do it!"

For the 1st time I really feel like the burnout isn't my fault. I have said no to overtime, I exercise, I have a social life, I cut back my hours & I am changing units. I am still crispy! And I just want to say that the burnout isn't my fault! I am very angry because I am an excellent nurse. I work hard, I am a caring person. I am tolerant & rational. I do take care of myself. But working conditions continue to deteriorate. It is not acceptable to me anymore.

It really makes me feel resentful that we nurses are expected to to muddle through & deal with burnout, when I feel the problem belongs to administration, who refuse to staff appropriately. You know what, an extra nurse aid or two would make all the difference in the world. But they won't budge on fixing the matrix. There is obviously a problem with our matrix, if all of us are 1-2 hrs overtime everyday!!!!!!!!!!!!!

I am feeling a little better since I cut my hours back at work, but everytime I go into work I feel a little tense, wondering if I will be 1-2 nurses short, and knowing I won't get a break, let alone get out on time. And the last shift I worked, I was the ONLY regular staff RN for my floor, the rest were travelers and registry. (They were good nurses, but we need some more regular folk, you know). It is kind of scary being the charge to a staff of all registry/travelers.

We really have to do something about this problem-

I can go onto another profession, and happy trails for me, but then that doesn't fix the greater problem, which is horrible working conditions and staffing that is never based on acuity!

[oramar]

Sounds to me like you are taking pretty good care of yourself. The ball is in admistrations court, if they don't act they are going to lose you. Good God, that stuff about untaken off orders is scary.

[NancyRN]

I'm a good tele nurse and take pride in my knowledge base. I take classes that aren't required, get certifications that don't merit a pay raise. I do it because I want to be the best.

Still, after less than three years I'm leaving the hospital to work in a group home for disabled young adults. I know I'll be underutilized there. I know all my skills will suffer. But, finally I've decided my health has to take priority.

I, too, am sick of dreading my work days. It's true that I never know what I'm going to face when I go in. I'm not an ICU nurse but they keep sending me down there to work since the ICU is understaffed. How scary is that? Needless to say, the stress is horrific.

I've cut back on the number of days I work til its hardly worth my working anymore, and still it's too hard. An 8 hour shift that turns into 10 with no breaks is just sweatshop mentality. I can't move the day after I work; every muscle in my body aches. I can't work two days in a row. I don't do anything the day BEFORE I work because I have to "save my feet".

I'm bitter because I'm a good nurse with good skills. Importing nurses isn't the answer. We have lots of good nurses right here in the US who would come back to work if it wasn't physically impossible! It would be really wonderful if we had LOTS of nursing assistants , so I could spend my time doing nursing tasks. How smart is it to pay RN wages for changing beds and taking people to the bathroom? What's happening to my critically ill patient while I'm spending 30 minutes giving a full bed bath?

I'm really hoping the new job will be less stress and less physically demanding. But its only money now. My dream of making a difference is gone.

[Youda]

As you know from some of my other posts, I'm dealing with some major burnout. The good news is that I know I'm pulling out of it (after 6 weeks off work!) The bad news is that this isn't the first time I've been here. It sneaks up on me, and I think I'm handling things OK and then just one day I realize that I'm outta gas and can't go any more!

I agree that the entire US healthcare industry has GOT to change. The nurses have been screaming for years, and it is only lately that some studies have shown that what we've been saying is true! Well, DUH! (See Politics and Activism threads).

IMHO, I don't think things will change until the general public wakes up and starts demanding changes from the legislatures. As nurses, I believe we've got to get much more vocal instead of suffering silently or individually. But, those are things that just isn't going to save us now or on a day-to-day basis. It's like it's raining fire, and the only sane thing to do is just run for cover and save yourself.

[midwestRN]

My dream came alive. I was overworked, overstressed working in an understaffed ER. Managed to stay for 3 years. Finally gave up and went to ICU. Only 3 pts at a time, and they can't bring anyone extra and stick them in the hallway. I still have bad days, but it is so much better. I am not "wiped-out" the next day after work. Downside is I am getting attached to my pts and think about them at home. Never did that in ER.

[deespoohbear]

kona2-I hear ya! Management doesn't seem to get it! I am getting burnout on my unit after 7 years. I am actively looking for a new position, but haven't found anything yet. I used to be the 2nd shift supervisor for our unit up until a year ago. I resigned that position and went back to day shift. You wouldn't believe the amount of people who come to me during the shift (especially during the weekend) with problems. I don't mind helping my fellow co-workers with your normal day to day tasks that nurses usually help each other with, such as admissions, crashing pts, and so on. What I do mind is being asked to help with problems that are definitely management problems. On the weekends I if it is a management problem, I tell the inquiring person to notify the on call management. I figure they get paid to make the tough decisions, let them decide. Everyone on my unit knows I am getting burned out, including my managers. But nothing seems to change. They ask how can they help and I tell them what is wrong and give them proof of why it is wrong, and still nothing happens. Anymore, I just give the best possible care I can to my patients, clock out when my shift is done, go home and forget about it. That is all you can do for now. Hang in there!!

[rebelwaclause, ASN, RN]

I have come to the conclusion that floor nursing is not my niche in life. Who could do this longterm without changing facilities/shifts/states frequently? Time to go back to school. Dang.

[TheLionessRN, RN]

I have gotten to the point where I almost refuse to work in a hospital anymore. I have tried hospice, then teaching. I do not want to work on a floor, cause of all the problems that we all know about. I am waiting to hear about a position at a VA, but will be doing temp stuff until then in an industrial setting. I haven't been on a floor in almost 6 months and really don't want to be....even tho I miss the actual nursing NURSING a whole lot.

[sjoe]

All this sounds like a good argument for per diem and/or agency work. (Or taking a VERY long vacation.)

[Youda]

I just posted this on another thread. So if you read both of them, forgive the repeat, but I think this needs to be said here, too. It's a lifeline.

Six weeks ago, I was having panic attacks everyday on my way to work. It finally occurred to me that I was becoming unsafe to myself and was no longer functioning at my best at my job.

So, I prayed about it and felt that taking a leave of absence was the right thing to do. And, it has been a life saver to me.

Anyone who has been at their job for at least a year, has worked at least 1250 hours during that year, AND their employer has at least 50 employees at all facilities combined within a 50 mile radius of your worksite, then you can take a Family and Medical Leave for nurse burnout. The law provides that you can use your accrued sick AND vacation time (so it turns out not to be an unpaid leave if you have any benefits accrued). You don't have to tell them why you're on leave. You don't have to give them anymore notice than you are able to give. They can't refuse or deny it.

FMLA can be used for nurse burnout, according to the definitions in the law. It says any "serious mental or physical condition." And burnout definitely qualifies for that!

Some employers also allow a personal leave. But, the FMLA protects you in every possible way. They can't even count it as an "absence!"

I walked in, filled out their stupid FMLA form and walked away for 6 weeks. I talk to the other nurses from time to time, and they are doing just fine. Yeah, they had to jiggle the schedule. So what? I made ME the most important person in the universe for a change, and decided whatever I needed to do to feel better, that's what was going to happen.

Going FMLA doesn't solve the problems of nursing. But, it can give you some time to regroup, get some help, talk with your doctor, look for another job, take walks outside, and learn to enjoy life again.

Please don't continue to suffer under burnout! There are ways to deal with it. I've found them, and so can you. Maybe you don't believe in God, but I do. I talked to Him a lot to guide me, and I really feel like this last six weeks gave me a new lease on life and my nursing. Step back and take a breather. Be happy! Don't do like I did and keep going until you are in as bad of shape as I was! Please don't do that to yourself. Go on a leave. Use your hard earned sick and vacation time on yourself! Go FMLA!

[Dave Frederick]

Taking back our power might help. May I suggest a solution.

I think we can corrent all of the major problems in nursing by simply having all of us take the same day off. Let's say February 11th, 2003, all nurses on duty go home and no, I repeat no nurse comes into work that day. This would include all LPNS, RNs, ADNs, BSNs, MSNs, and RN/Phds. Exactly 24 hours later we return to work and have some meaningful discussion with the powers in charge.

[NCTraumaNurse]

That sounds like a fabulous idea!