Burnout rate-experienced nurses reply

I'm not exactly sure about burnout, but after about 2 years, things start to change.
After that amount of time(depending on the workplace), a nurse is considered experienced enough to be given extra responsibility.
After about 2-3 years nurses spend more time in charge, orienting new nurses, taking the sicker patients, and being resource to other nurses.

I think burn out peaks in the first year and then after about 3-5 years. Basically, when you are first learning and feel overwhelmed with your job, and then after you develop mastery and begin to realise the pitfalls of your situation (powerless feelings, etc).

After that, it all depends on coping, what you've got going on in your life, what is going on in your workplace, etc. There's lots of crusty old burnt out nurses, but there's also many who work a long time and don't get burnt out. Lots of people go through cycles of being a bit burnt out, feeling better and then down again too.

YOu might be interested to read The Truth About Burnout by Maslach and Leiter, which talks about the origins of burnout within an organization. It's not just nurses that have this phenomenon, and there's lots that can be done to understand and prevent it.

Although I have a number of years nursing under my belt, this is my first year in ICU. I started in August.

The last two shifts have me questioning my ability to withstand nursing in ICU in general/maybe this ICU in particular. Both days involved trying to get orders for patients who were being ignored by the primary team. On the second day, the primary team was a family practice doctor who is notorious for not answering pages and refusing to order what is needed. The charge nurse said she has had to deal with him her whole career and he's an a**, but I'll learn to deal with it.

But I CAN NOT. I can not deal with this. I can not tolerate nursing pushing the buttons for all care on a patient. The physician should be competent and involved enough to know what the patient needs. He had the gall to tell me when he rounded (at 11am, after I had paged him three times that morning without an answer) "well you know what she needs more than me, so just write what you need and sign my name after it."

What the he**?? She's critically ill, I've been here on my won for seven months and you want me to treat her?? She was vented, her MR was +4, she was in CHF, I begged for an art line and was able to get her CO (3.6), and he wouldn't order fluids despite her pressures being in the 70's and wanted me to give her blood pressure medications, and dobutamine and dopamine weren't working, her UO was crap and I'm supposed to be in charge.

Nursing talked to family and we got them to agree on DNR and it took me three hours to get him on the phone to get that changed. The office said "oh yeah we just ran the messages back to him" and I asked how often he gets messages and they said twice a day.

How am I supposed to care for a patient like this. I can not. I can not do this.

I want to quit, but I feel like I am giving up if I do. Not all patients have this particular doc, and we are starting an intensivists program, but for now they will only handle certain cases. I will still run into this problem and it makes me crazy. I can;t work under these conditions. I don't know what to do.

I would have to say that, from what I have noticed, the real "burnout" starts around 7-8 years- that is when I started feeling it myself. This is when I notice my coworkers moving on to cath lab, PACU, or clinic or something. Then, you have the "life-ers" which is where I am starting to think I fall in. I've been in Peds ICU for 14 years and as much as I sometimes think that I cannot possibly stomach another day, I feel like I could never be happy doing something else. I do admit that some of it is adrenaline factor and sick as that sounds, I really love that part of it.

Burnout is highly individualized. I've gone through stages of being crispy myself -- and come through the other side. After 32 years, I guess you could say I've conquered burnout. I've found that sometimes changing shifts will help -- start rotating, stop rotating, or switch shifts if you don't rotate. Changing positions within a hospital, or changing hospitals within your city. But then if I'm burned out enough to consider changing jobs, I've usually moved at least halfway across the country, too. That's a great cure for burnout! Sometimes a new focus in your life outside of work can"cure" burnout. At one point, I went to school and got an MBA -- I was going to be a stockbroker -- but then the stock market crashed and I realized I really didn't want to leave the ICU after all.

Over the years, I've noticed that nurses who start in the ICU are subject to worse cases of burnout earlier in their careers and with less easy fixes. It seems that starting in Med-Surg, ever so unpopular these days, is a good idea after all.

I've worked 28 out of 30 years in Critical Care and trust me, in the past if I wanted to move on, I did. I left my staff job 9 years ago to become a travel nurse and that was ideal. Now the economy is keeping me from working steadily and I'm expensive on a staff nurse payroll and trying hard to find a staff position because I am competing with 30-40 applicants who don't even have my job experience.
Don't allow yourself to burn out so easily. Take time off, take a vacation but hold onto your staff position because there are very few jobs out there. Just a fair warning. If you have to quit your present job be sure you really have the new one absolutely guaranteed because what I wanted to do was go back to my old job and there is some kind of policy about not rehiring past employees. It shocked the heck out of me and made it even tougher. Just a warning.