On digging deep and carrying on

In the past, when nursing got really tough, or I began to burn out, I ran. I walked out. I turned my back and tried to re-invent myself instead of fighting it out. I told myself I needed new experiences and new learning opportunities when the truth was I was afraid to keep going. This time, I am going to try the opposite. Nurses Announcements Archive Article

On digging deep and carrying on

I have battle going on inside my head. Two conflicting ideas engaged in a tug-of-war that has left me feeling depleted and angry and just...tired. You see, I am a nurse. I went into nursing because I love science and I love the human body and all its mysteries and miracles. I also believe that caring for the sick, the elderly, and the disadvantaged is a noble and rewarding thing to do. It makes me feel important and needed. It speaks to the Humanist in me.

Lately, I don't want to be a nurse anymore. I want to throw my hands in the air and yell obscenities at the top of my lungs. I also want to crawl under my desk and take a nap. Neither impulse wins, so here I stay in limbo neither fighting nor fleeing; merely existing in my ennui.

I take complaints from angry family members sometimes. I listen as they vent their guilt and frustrations. I calmly apologize and explain the disease process taking hold of their loved one and assure them that feeling the way they do is okay. Sometimes, they are unwilling, or unable to listen.

They don't want to understand; they just want someone to blame; someone to be angry at. That usually ends up being me, as I would rather take the brunt of their anger than have them rage at my staff. I try to protect my nurses from that vitriol so they can continue to feel good about what they do. I tell my nurses how important their work is, and how it matters to me and to the people we serve. I internalize all that pain and anger and swallow it. Sometimes I come home and chase it down with rum. And cookies.

I stay because I am needed and I like the work I am doing. But I am so freaking exhausted. So tired. This constant caring, this extreme level of giving a crap; it takes a toll. I am used up to the point that I don't care as much as I should. I have issues that need to be addressed at work. I have work to do! I am the leader. I need to take the reins and steer this mad horse onto the safe path before it careens over the cliff of failing standards and poor patient outcomes. I should want to do that. I should care so deeply that I defend and fight for my nurses and my residents and my job, but instead, I just want to say "eh" and walk away. I've carried on for so long that I simply cannot any longer.

That's the thing about nurse leaders, we feel we need to do it all ourselves. We forget to call on our supports, our colleagues, our resources. We forge onward alone, carrying the crushing weight of responsibility squarely on our own shoulders, holding our heads high and being strong for everyone else. And we wonder why there is such a high turnover rate; why nurses job hop from one type of nursing to another. As nurses, we have made ourselves clean exit strategies into new learning experiences and new environments in an effort to stave off the burnout. We discuss how rotating to a new department and learning a new skill re-invigorates us and keeps us passionate for the work we do.

But what about the nurse executives? We at the top have fewer options. The higher up the leadership ranks we get, the fewer spots on the revolving job carousel there are to keep up the novelty and stave off the burnout. That is where I am finding myself tonight; cruising the job sites, looking for the new shiny distraction to keep me from realizing how awful I really feel about nursing. I've been searching postings to try and locate that "golden opportunity" that will make me fall back in love with my chosen career field, instead of leaving me wishing I had become a dog groomer at the end of the day.

This is the hard, cold realization that I have come to tonight: IT DOESN'T EXIST.

There is no perfect job in the perfect five star or magnate facility with a five minute commute and happy, engaged coworkers who all seem to "get" me. A chorus of cherubs will not sing me through the doors of a new facility, waving roses and handing me a perfect department of health survey. Healthcare is a minefield. You never know what might blow up in your face or when, but I promise you, something always will. The only thing I can control in this is my own ability to pick up the pieces and keep slogging through. I don't mean that to sound bleak, and I know this is probably the worst pep-talk ever given. I'm really only trying to psych myself up, anyway. What you do with my rambling is your own decision.

Tonight my exhaustion is channeled into anger. I don't want to move on. I don't want to start over. I want to stay where I am and continue to carry on; and I want to build up my 401K darn it! So instead, I am going to try to find that golden egg called "work-life balance".

I DON'T KNOW HOW TO DO THAT.

I've never been so tired, but I've also never been so determined to stand my ground and say "this is worth it". The changes I want make at my facility are big and I am going up against a corporate culture that expects directors to "live to work". Last year I took 3 vacation days. THREE. If I can hang on another year, I will have earned 3 weeks. My family really deserves that. I deserve that. I just have to keep calm and nurse on a bit longer. Oh, and get some . I should also lay off the cookies, call up a friend, and get a massage. I've got to start caring about myself so I can care for everyone else.

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savoytruffle

About savoytruffle, BSN, RN

I am A BSN with 10 years of geriatric experience working as an Executive Director of an Alzheimer's Adult Home.

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Specializes in TELE, CVU, ICU.

Good article. Try going back to the bedside.

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Specializes in Leadership, Psych, HomeCare, Amb. Care.

I'm not at the executive level, but this so describes what I'm going through, been going through for the last 6 months.

But we can only hold on for so long, and there is really little choice but to move on.

Take care of your self first.

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The best managers/directors I have ever had put themselves between us and the frustrated families every single time. I know it must be exhausting, but it is so much appreciated by your staff, by us. WE become better nurses when we know there is a strong person in charge that has our backs.

So, thank you. I know that doesn't help, but really, thank you.

Spring is coming. Get your face in the sun.

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Specializes in Occupational Health; Adult ICU.

Your sentence: I internalize all that pain and anger and swallow it,” causes me concern.

Life is supposed to be win-win” scenarios. But Alzheimer's care units are essentially, by definition the opposite. There is no eventual win, only a slow, inevitable slide into oblivion and death. Yes, there is the win, the amazing win, of giving a fading person a dignified ride out and I think that such units shine in that area.

But if an Alzheimer unit is lose-lose with never, ever a single cure then it is a place where frustration and anger, mixed with all the stages of grief, is the norm.

It would seem to me that any Alzheimer caretaker must be able to move through their own stages of grief in a timely manner and in a way that by the time one gets home that grief/frustration/anger is removed or safely compartmentalized.

It seems that your only problem lies in this area as you have no complaints external to yourself. I'd often expect such comments from an Alzheimer's DON or executive such as: I don't get the funding I need…” or No matter how hard I try we are always short-staffed,” or It's difficult to find LNA's/RN's who really enjoy working with Alzheimer's patients". Your issue seems specific--dealing with the emotions of those losing their loved one.

So in short, I'd suggest finding a CSW or Psychology counselor and work on skills such that the pain and anger of others doesn't become internalized within you. Find some armor. Warriors put on armor before battle—they take it off to eat dinner, perhaps in time you could do the same.

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I feel your pain and understand exactly what you are saying. I myself am struggling whether to even stay in nursing or go to work in a different field all together. Only a nurse could understand how much of a toll this job takes on a person. The money is good but should be better. For profit hospitals pay well and work you hard, where as non profit hospitals pay less work you even harder. I think a non profit hospital should be the place to work, give more money to the nurses on the front lines, more staff to cover patients needs and not so much bonus to the executives or some foundations with lots of wealthy board members. They should cut out the upper management fat and make the work place less stressful. There is no reason for a hospital to not care enough about their employees to make sure the employees get vacations, breaks, and time off. Damn-it we are the ones on the front lines taking all the stress and providing all the care in a loving and compassionate way, not the people in upper manage that are only concerned with the bottom line and adding more charting for us to do which takes even more time away from giving the care I so want to provide my patients. Sorry to run on so much.

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Is there a way to get to the bedside, even for a fleeting moment of the day? Just to get back to basics and revel in that happy place for a bit, somewhere in your crazy schedule, e.g., 1045 - Pt. assessment/teaching until 1130. You know, instead of lunch...? OR, what about actually teaching?? In a great program five miles away from home? Mold the minds of those who have time and energy to make change... Just spitballing here. Soldier on and fight the good fight - I'm right behind you.

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Specializes in Neuro ICU.

very interesting article! thank you

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Wow. This speaks volumes. I identify with your struggle. Please know you are not alone in your concerns and feelings. There is an army of nurses working in the shadows cheering you on. I hope you find your "happy". You deserve it. So do the rest of us.

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Specializes in ED, ICU, MS/MT, PCU, CM, House Sup, Frontline mgr.

OP: Thank you for posting. I am a new manager and will not pretend to know more than I do about this new job. However, I agree that you need time off to be with your family, but when you are not vacationing, do you have any hobbies that you pursue by yourself or with your family? The reason I ask is this... :

I recall once going to a management interview and being asked that same question. I did not have any hobbies at the time because I had work, family, and a million excuses. Anyway long story short, I did get the job. Afterwards I spoke to the hiring manager regarding my interview. One of her concerns was that I had no hobbies and that to her it was a red flag that I did not know how to decompress or disassociate from the job when I am not at work. :sour: Although I did no agree with her assessment of me, I took a long hard look at myself and began pursuing hobbies and interests that I had put off for a long time!;)

Fast forward to today and I am glad I took the advice. I do not feel overwhelmed even though I am not even close to being on top of everything or on top of all that I am responsible for doing at my new job! However, just about every day I have taken care to enjoy one of my hobbies in order to decompress. :up:

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So sorry to hear about your struggles. I am concerned about ending up that way. I'm only a student, but I left my other career after 10+ years due to burnout. I eventually said "no" to management adding on an overwhelming list of responsibilities to my already impossible list.

Now I am genuinely worried that I am just leaving one version of hell for another. I was so excited about the change, about school, about my mission to go back into healthcare and help others. Unfortunately, I don't hear many positive stories from nurses about their careers. It really has me thinking. And scared.

I wish you the best in your search for your pot of gold.

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I have been in management for 9 years with 4 of those in my current position. I could have written that article!!! I am too exhausted to keep doing what I'm doing but also to exhausted to move on!!!

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