Burned Out?

[Davey Do]

I've read posts on this forum where new nurses state that, since their first job in nursing is so very stressful, they are "burned out".

Maybe it's just a matter of syntax and I may be splitting hairs here, but that's a little too dramatic for my tastebuds. Yes, nursing is a high stress job and it will take its toll, but we learn to deal with stress by experiencing stress and developing coping mechanisms. 

To say a relatively short term stressful situation has caused burn out is throwing in the towel after the first round. True burn out is more like viciously fighting the good fight and being knocked out by a hard left to the jaw in the fifteenth round.

Seasoned nurses who leave the field may do so because of burn out. New nurses who leave the field after a short sojourn quit.

[JKL33]

I stand by my original assessment of the concept of burnout. If I'm burned out on something, it's something enjoyable that I'm just personally tired of. I would never naturally use that terminology to describe my emotional/physical reaction to something that sucks. Who would say they're burned out on getting punched in the face every day? No one. There is no amount of walks in the fresh air and singing kumbaya that makes getting punched in the face everyday personally tolerable. 'Cause it isn't a personal problem.

I think part of the reason you see people misusing the phrase (as in the topic of your post) is because it rarely made sense to begin with.

[Davey Do]

A little research on the concept of burn out yielded some interesting, and sometimes ambiguous, information.

The term was coined in the '70's by a psychologist and different sources define burn out to mean the same thing as stressed out or emotionally exhausted. I couldn't find specific time line, but did locate a progression of stages which included the honeymoon period, onset of stress, chronic stress, burned out, and habitual burn out.

The term has become somewhat cliche, and I've seen it used by members who relay that nursing has caused everything from symptoms of PTSD to a specific area of nursing is just not their cup of tea.

Certain words need to be reserved for certain specific situations and burned out, when applied to something important like the nursing profession, is one of them.

Examples based on true situations: "I have worked 30 years in high stress levels of nursing and I feel burned out, apathetic, and emotionally exhausted. I'm giving up nursing."

"I have worked as a nurse for six months in a high stress area and I feel burned out. I'd rather work in L&D because that's my dream job."

Which situation truly says burned out?

[RNperdiem, RN]

Interesting topic Davey Do.

Part of the problem, I feel, is the lack of available words to describe stress. It is kind of like the word "friend", the word covers too much territory and misses nuance, variety and intensity.

I do understand the pain of the pain of the new grad. In my first year, I can easily compare the stress of being a new nurse with my first year as a parent, my husband's cancer diagnosis and treatment, and dealing with my child's serious health problems. Only I was younger and had fewer coping skills.

The English language could use a few more words to describe emotional hardship. "Burnout" feels properly strong and dramatic, but is not a perfect fit. 

[Davey Do]

Thank you, RNperdiem.

I beg to differ, in that words carry a certain feel to them. For example, the word friend conveys a relationship closer than an acquaintance, is platonic in nature, and not as intimate as a lover. There is a defined set of boundaries within the word friend.

The pain & stress of being a new nurse, or any scope of time in working as a nurse for that matter, is paramount. However, I also differ in the perception  of comparing working as a nurse to the major life crises, as mentioned.

Loved ones' traumatic illnesses are major life crises and we can feel powerless, sometimes being able to give only our love and support.

However, we as nurses, no matter how green or seasoned, are given power indicated by milestones which we have surmounted. Passing the NCLEX, for example, indicates that we possess the ability to associate and apply information to real life situations.

What the NCLEX does not always measure is our ability to act rationally in real life situations; it measures intellectual, but not emotional, aptitude.

The ability to keep ones head in a professional crisis situation can be innate, or it can be learned. As stated previously, in order to learn how to deal with stress, we need to experience stress. Making a mountain out of a molehill, or calling something burn out when it is actually avoidance, can result in emotional stagnation.

We are much more likely to receive empathy from others if we say we are dramatically burned out, then if we say we are stressed out to the point that we feel like jumping ship. 

[Daisy4RN]

I agree and don’t think you are splitting hairs. Short term stress is just that, stress. It is the long term chronic stress that leads to burn out. In nursing it comes from lack of support, lack of autonomy etc. When a nurse/person is held accountable but has zero to little control over their own actions and environment it creates a stressful environment as well as personal emotional feelings (r/t personal values, morals, responsibility etc) when we are not able to do what we know we should and want to do. In the short term we can quit and try somewhere else. In the long term if we never find our niche, or at least a less stressful place, that stress can lead to emotional and or physical problems that at some point can become burnout with probably some s/s of PTSD. The first year of nursing is difficult but I would call it stress, not burnout. Also, I think that most new nurses are not prepared for the reality of the situation and do lack the coping skills necessary to succeed and/or do not have adequate resources, but I would still call it stress. I think the term ‘burnout’ gets thrown around much like ‘love’,  (as in I love ice cream etc).

[Davey Do]

34 minutes ago, Daisy4RN said:

It is the long term chronic stress that leads to burn out. In nursing it comes from lack of support, lack of autonomy etc.

A etc. would be lack the lack of coping mechanisms, whether that lack is due to the inability, or desire, to learn them.

A truth is that we always feel better when we have someone or something else to blame for our lot in life. "They" are the cause of my suffering and pain, and if They were better, I wouldn't be in this state, so to speak.

The trouble is, if we blame others for our pain, and refuse to self-evaluate and act, our growth is stunted.

Trials and tribulations are opportunities for illuminating revelations, changes of conscious, and different perspectives, which can lead to growth. In pain there can be growth.

Or we can say we're at an impasse, we're burned out, and avoid all that nasty conscious-expanding stuff.

Thanks for your comments, Daisy.

[SmilingBluEyes]

I call what health care providers are going through "moral distress" and in a more extreme case, "moral injury"---- when they are stuck with the dilemma of trying to provide the care they know to do, but are stymied by systems and administrations designed with major flaws and pitfalls. Systems where no one cares except to get more out of us without taking away any other tasks.. Frustrated, they are called "burnt out" when they are in true distress.

[LibraNurse27, BSN, RN]

4 hours ago, Davey Do said:

What the NCLEX does not always measure is our ability to act rationally in real life situations; it measures intellectual, but not emotional, aptitude.

 

Exactly! I wish I knew this when I took my NCLEX. I answered 70 questions in 25 minutes and passed, yet I am currently on leave from work because I can't handle being a nurse. What would you suggest as a better way to determine if people are ready to be a nurse? I guess clinicals in nursing school, but those can be pretty subjective depending on who your instructor is and how involved they are.

[Daisy4RN]

4 hours ago, Davey Do said:

A etc. would be lack the lack of coping mechanisms, whether that lack is due to the inability, or desire, to learn them.

A truth is that we always feel better when we have someone or something else to blame for our lot in life. "They" are the cause of my suffering and pain, and if They were better, I wouldn't be in this state, so to speak.

The trouble is, if we blame others for our pain, and refuse to self-evaluate and act, our growth is stunted.

Trials and tribulations are opportunities for illuminating revelations, changes of conscious, and different perspectives, which can lead to growth. In pain there can be growth.

Or we can say we're at an impasse, we're burned out, and avoid all that nasty conscious-expanding stuff.

Thanks for your comments, Daisy.

I agree with most of this. I think the problem comes when we are exposed to extreme stress for extended periods of time. There are only so many coping mechanisms and so much conscious-expanding stuff we can do. At some point we (humans) just break, stop. Different people have different thresholds. If the stress comes little by little we have time to learn and cope. If we are bombarded by high stressors in a short period of time some do not do well. Personally I have had many life stressors but have learned and coped along the way (that which doesn’t kill you makes you stronger) but I don’t think everyone is equipped the same way. 
In general I agree with that we shouldn’t  blame others for our problems/pain. However it is really hard when you know (nursing) admin is constantly and consistently working against you while you are expected to perform perfectly. My coping in my last years of work was simply not to care, I did what I could with what they gave me to work with; there was nothing I could do to change the situation so just learned to accept it and move on as best I could. Others were constantly striving to meet all their ridiculous demands which were unmeetable. So I guess that might be considered an empasse (and avoidance) or they just don’t have the coping skills, IDK. 
 

Anyway, interesting discussion 

 

[Daisy4RN]

1 hour ago, LibraNurse27 said:

Exactly! I wish I knew this when I took my NCLEX. I answered 70 questions in 25 minutes and passed, yet I am currently on leave from work because I can't handle being a nurse. What would you suggest as a better way to determine if people are ready to be a nurse? I guess clinicals in nursing school, but those can be pretty subjective depending on who your instructor is and how involved they are.

Although I am not sure there is anyway to prepare nursing students for the reality of the profession I do think more realistic clinicals would help. 
 

[NightNerd, MSN, RN]

6 hours ago, LibraNurse27 said:

Exactly! I wish I knew this when I took my NCLEX. I answered 70 questions in 25 minutes and passed, yet I am currently on leave from work because I can't handle being a nurse. What would you suggest as a better way to determine if people are ready to be a nurse? I guess clinicals in nursing school, but those can be pretty subjective depending on who your instructor is and how involved they are.

Clinicals have gotten less and less effective in preparing student nurses for what to expect, in my opinion. I feel like I had a decent idea of what to expect due to working in a healthcare environment as a secretary, then CNA, before starting nursing school, so that's definitely my recommendation. I would also think shadowing or volunteering would take a little of the mystery out of it. Every nurse will have a different opinion about this career, so it's crucial to make your own judgment and not just go by what you hear.