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.

[Davey Do]

12 hours ago, LibraNurse27 said:

What would you suggest as a better way to determine if people are ready to be a nurse?

Excellent question, LibraNurse, and good responses others!

I felt prepared after the LPN program to the point that my first job was the MN nurse in an LTC a few weeks post graduation. I started there working in the capacity of a CNA.

About half of the year long LPN program was clinicals- about four hours on the floor and four hours in the classroom. As an LPN student, I spent three weeks in the OR, but as an RN student, I was assigned one day.

My LPN state boards in 1984 took about eight hours to complete and my RN boards in1990 took up two eight hour days.

I reiterate: I felt prepared to work as a nurse after my LPN program and believe it was because of working for hours on the floor for days in a row, performing a majority of direct care with some

[Davey Do]

12 hours ago, LibraNurse27 said:

What would you suggest as a better way to determine if people are ready to be a nurse?

Excellent question, LibraNurse, and good responses others!

I felt prepared after the LPN program to the point that my first job was the MN nurse in an LTC a few weeks post graduation. I started there working in the capacity of a CNA.

About half of the year long LPN program was clinicals- about four hours on the floor and four hours in the classroom. As an LPN student, I spent three weeks in the OR, but as an RN student, I was assigned one day.

My LPN state boards in 1984 took about eight hours to complete and my RN boards in1990 took up two eight hour days.

I reiterate: I felt prepared to work as a nurse after my LPN program and believe it was because of working for hours on the floor for days in a row, performing a majority of direct care intertwined with some skilled care.

I initially started out as an LPN because I wanted to dip my toe in the waters of nursing. I read of so many who got married, had children, went to school, landed a job, and now have so much on their plate that they feel overwhelmed. Gawd! So would I!

The only advantages that I've had over those who put too much on their plate is insight and foresight. I know my limitations and have seen what happens when expectations are set too high:

You get burned out.

[brandy1017, ASN, RN]

I think the working conditions in many places are much worse than they used to be years ago, especially with covid and the short staffing that management is justifying and resorting to crisis care, rather than hiring enough nurses and support staff in the first place!  It is so convenient to blame covid and short staffing, when the reality lies in the inhumane and disrespectful greed of corporate healthcare.

New grads were literally crying at work due to the stress and bad working conditions and were quitting less than a year in.  I don't blame them at all.  I just hope they were able to find a better employer.

I worked 27 years bedside and the last 4 were hell due to the takeover by Descension and the amoral director who I would say was an angry sociopath, destroying the hospital and telling the nurses if they didn't like it they should leave, pointing his finger out the window toward a competitor's hospital!  Deliberate short staffing combined with angry contempt towards staff lead to a massive exodus of nurses and support staff.  He got his wish, he said he would just replace us.  Good luck!  Now they have to pay for travelers and agency and can barely keep the doors open.

It is sickening to see how these evil greedy henchmen destroyed a little community gem of a hospital.  We offered state of the art medical and surgical treatments and had great staffing till Descension took over.  The nuns gave us away for free!  They only had to pay off the bonds.

Now short staffing is a deliberate business model to increase their profits, but I don't think it worked as they can't keep nurses at any of their hospitals and then had to pull nurses and other staff from clinics to take care of the patients.

I have been watching videos on Youtube about psychology, trauma, health and stress and find them highly relevant to my life and what I went thru as a nurse.   Dr Bessel Van der Kolk and Dr Gabor Mate have lots of videos on Youtube and have published many books dealing with trauma, stress and health vs disease.  I literally quit because I feared if I didn't I would end up with a heart attack or worse yet a stroke.  What I've been learning my fears were true and it was a very good decision to quit my toxic job when I did, but I probably should have quit sooner! 

I suffered with a terrible eczema dermatitis of my hand for almost 4 years that no Dr or medicine or cream could heal.  Seven months after I quit it finally healed!  I had to take steroids twice for breathing problems my last year and even got shingles the day after a confrontation with a hostile manager who had told all the new grads she planned to get rid of the older nurses!  She called me in for a meeting shortly after I received a Thank You card in the mail for my 27 years of service!    I actually had my letter of resignation ready to give to her during the meeting, but persevered three more months before I gave my notice.  Although I got a two week "vacation" due to shingles and was running around telling everyone how happy I was to have shingles just to get time off!  My body was literally crying out for me to quit.  I just wish I had respected it more, listened to it and quit sooner! 

  I really think people need to walk away from toxic jobs.  It is not a badge of honor to be overworked, abused and disrespected because you think you are needed or have to prove yourself.  Let the hospitals hire travelers or agency at top dollar instead when they treat their staff so bad everyone is quitting!  I encouraged both the new grads and experienced nurses to quit and find a better job!  I'm happy for the ones who made the decision to quit for their health and life!

[Davey Do]

Thank you for sharing that wonderfully written post, brandy.

I empathize with all that you had to deal, commiserate in some areas, and continue to have respect for your work, choices, and for you as a virtual friend.

[Guest1176712]

On 11/4/2021 at 6:10 PM, SmilingBluEyes said:

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.

Agreed. ZDoggMD videos always feel therapeutic. https://zdoggmd.com/?s=moral+injury  I was thinking how in many ways our society has been experiencing moral injury as well. But healthcare exponentially so. 

[beekee]

The past two years have been incredibly hard for many nurses, new and seasoned. Many of us may use imprecise language to try to express what we are feeling. “I’m burnt out” is easier, and often more socially acceptable, than “I’ve had three patients die this week” or “I couldn’t provide good care to my patients.”
 

I can’t even imagine how difficult it must be to go through nursing school during the pandemic and then start nursing now.  At least in acute care, staffing is short. Techs/nursing assistants are non-existent. Acuity is significantly higher. 
 

When someone says “I’m burnt out,” maybe it’s a way of saying “I need help.”  Hear what they are trying to say, not just the words they are using. 

[2BS Nurse, BSN]

Nursing schools are still teaching to the "ideal" expectations of performance. When students get into the real world, they realize these expectations are unreachable. Moral distress occurs because patient care suffers. Nursing schools need to make sure their students have realistic expectations after graduation. They will not be able to "save the world" and the necessary resources to care for patients will not be available to them.

I left school assuming that everyone would be following policy and procedure. Boy was I wrong!

[ClaraRedheart, BSN, RN]

I can't even imagine what new nurses are going through now. When I started in med-surg 7.5 years ago, I was already emotionally and physically exhausted from nursing school and was walking into a very supportive environment in which I constantly doubted myself, was afraid I'd accidentally kill someone or not keep up. I had a wonderful team that was always available to ask questions to or help with a procedure I wasn't comfortable with. Even so, depression got so bad I would cry profusely before going into work. It took a year and a half and switching to day shift to rectify. 5 years of smooth sailing and then COVID. It's thrown me for a loop. I don't cry before work, but sometimes I cry during or after. I had to be out for about two months recently and when I got back, I didn't realize at least half of the staff. So many seasoned nurses have quit in a GOOD hospital! 

Imagine walking into that as a new nurse. All of the nurses on the unit are new themselves, but yet they're precepting you. You didn't even get proper hands on education because Covid. You're unprepared to deal with Covid patients as you haven't even been allowed in their rooms to see how they're cared for. THEN all of the added stress of learning everything and being a new nurse. 

They can call it stress, they can call it burn out, whatever they want to call it. Hopefully they can stick it out because I can't any longer. 

[saltymermaid, ADN]

I will say that, in their defense, over the years more and more is being expected of nurses. I’ve been a nurse for about 8 years and even just within this time frame “customer satisfaction” and budgeting to a point that you are understaffed has become more important than actual patient care. Don’t get me wrong - some of the kids popping up just don’t wanna put in the work anymore but I also feel like if you are someone who makes it through the trenches of nursing school, you are someone who works hard. If I give the benefit of the doubt I can see why some may say they are “burnt out” already. Especially those going into units with covid! And I know many new nurses start out in places like med Surg - so it’s even tougher on them now. Especially with so many nurses having left due to their own burn out or vax mandates. Like someone said above, now they have new people precepting new people. I know for me, I’m desperately seeking to leave bedside nursing and can’t imagine how some of my coworkers have been doing it their whole lives. But I also think it takes a certain number of years and lifestyle changes to settle in and figure out what you really like. (Maybe in your 20s you could stay up all night, now you can’t, you have kids now, your spouse’s income allows you to reduce your hours, you fall in love with a new specialty, pay becomes more or less important than the kind of work you do depending on what stage of life you’re in and what your financial situation looks like etc). burn out is certainly relative, I suppose - to each their own I guess! 

[hppygr8ful, ASN, RN, EMT-I]

On 11/4/2021 at 2:00 PM, Daisy4RN said:

 I think the term ‘burnout’ gets thrown around much like ‘love’,  (as in I love ice cream etc).

I feel this way about the word bullying!

Back on topic. I concur with Davey that the term Burned Out is hyperbolic and dramatic in the extreme, especially when applied to a first year in nursing. I remember my first year, the excitement, the fear, anxiety and sheer exhaustion coupled with learning to deal with multiple personality types (Some of whom were not very nice.) I also remember the thrill and profound feeling of accomplishment that came when I mastered a new skill or concept. I had a pretty good mentor who would tell me when I vented "Well who told you this would be easy!" Or "If it was easy everyone would do it!" I also feel the term PTSD as it has been use a lot on ALLNURSES is inappropriate. It downplays the trauma that causes PTSD and the people who live with it daily and find a way to push through.

I am beginning to think that people going into nursing should have to have a psych evaluation to see if they have the emotional resilance to be a nurse. We all have very tough days, months or years and need help when we struggle but , everyday that I was in nursing school it was stressed just how hard it was going to be - so one should enter with their eyes wide open.

Hppy

[LibraNurse27, BSN, RN]

2 hours ago, hppygr8ful said:

I am beginning to think that people going into nursing should have to have a psych evaluation to see if they have the emotional resilance to be a nurse.

I wish I had been given that exam! I definitely would have failed ?

[hppygr8ful, ASN, RN, EMT-I]

9 hours ago, LibraNurse27 said:

I wish I had been given that exam! I definitely would have failed ?

At the time I entered Nursing school, I was pretty much a wreck myself- but I was pretty good at faking sanity!