Burnout or just a "rough patch"?

allnurses Guide · Jul 15, 2008

Hi - I don't know what to call what you are going through because I'm not you.

I will tell you that I went into nursing thinking L&D was my dream. I worked in a small rural hospital and did med-surg and then trained to do OB too. I have to say that I never loved it. For many of the reasons you posted and for the scary times too.

I left the hospital after nine years . . .for other reasons. But I do not miss L&D at all and would not go back.

Initially I worked in a bigger city ER but that wasn't the right fit for me, mainly due to being 70 miles away.

By chance I started working part-time for Hospice and I love it.

Working part-time is a big part of it. I am also in a RN-BSN program one night a week. I want my public health certificate but I may end up staying with Hospice.

There is nothing wrong with having questions about your career choice.

I wish you the best.

steph

icyounurse, BSN, RN · Jul 15, 2008

I am sorry you are going through this. I will say that I can somewhat relate to the grad school issue, as I recently got into a somewhat prestigious CRNA program and devoted a whole year preparing for it, moved my husband and me to another state, spent tons of $ and time and told everyone how excited I was to be going, left my family and friends to go, and got all the way out to Florida to start the program and.............I hated it. I mean after everything I had went through to get there and all the sacrifices I made I just found that it was truly not what I wanted to do after all. I was of course devastated, but I picked up the pieces and started a new job out here in Florida, which I love, and I just started Nurse Practitioner school for adult acute care and so far the program is a MUCH better fit. While it was really difficult to start all over doing a different program, I feel like this is where I am supposed to be. The anxiety and bad feelings about going to school everyday are gone. Anyways I am sorry this is so long, but my point is that maybe if you give this some time and still really feel its not what you want to do, then dont do it. You have so many options as a nurse, too many not to try something different if its time, and maybe its just time for something different.

By the way I followed a hospice nurse for my practicum when I went back for my bachelors and I loved it. The patients and families overall are much more grateful for the care that you give and you really build relationships with your patients and families and you have so much more time to spend if you are doing home hospice care as it is one on one.

Good luck with whatever you decide to do!!:nuke:

mommy2boysaz · Jul 15, 2008

Thank you so much for your considerate replies.

It is difficult and scary to think of jumping into something brand new after doing one thing for so long, but I suppose I can't ever know if there's something else out there for me if I don't take a chance. I'm not going to do anything too rash. Guess I'll just pray about it some more and see if any new doors open (or old ones close).

Right now I really do love the school I'm in and they do offer a couple of different NP programs as well as the CNM, so I have some other options.

Happy to hear anyone else's opinions, too!

BTW, icyounurse, sounds like you've been through a difficult time, too, with moving and everything. Glad to hear you've found your niche!

And Spidey's mom~ Interesting to hear that you tried ER nursing. I considered that too, but figure it is probably similar to OB, in that I'll still have many pts that are "using" the system and are frequent fliers, etc. I think I would still be too frustrated.

It's very interesting that everyone I've heard from who's tried Hospice has liked it. (I was reading on the Hospice forum, too.) Maybe I'll find out if I can shadow a Hospice nurse sometime.

Thanks again! (I love allnurses!)

FLArn · Jul 15, 2008

I have been working for hospice for almost 5 years now and in addition to lower pt ratios (usu. 1-5pt/nurse) and many fewer abusive/manipulative pts/families; there is an entirely different dynamic in play. Instead of horizontal violence/eating the young being the "rule, it truly is the exception. The whole staff - MD's nurses, CNA's, bereavement counselors, chaplains - everyone supports each other. When there are those occasional "difficult " deaths - the ones where you just can't get the symptoms under control- the staff has the support of bereavment/chaplaincy available to them too (not just to pt's families). That alone makes a world of difference in preventing "burnout".

I wouldn't work anywhere else -- I keep telling my co-workers in the Inpatient unit that "I am never retiring - I'm just moving to the room across the hall form the nurses' station" :lol2:

suespets · Jul 15, 2008

Just about hospice; It sure is the opposite of L&D.Do you have a strong desire to help the dying?I think a nurse would have that be her priority

FLArn · Jul 15, 2008

It surely is a different mindset. You must switch from a "fix it" mode to a comfort focus. We are not trying to cure anything; just provide comfort. So if a symptom isn't bothering the patient physically or emotionally - we don't do invasive or painful interventions (for example - am I wanting to suction the semi-conscious pt. because the trach secretions are interfering in air exchange or because the sound is bothering me-- don't forget suctioning is NOT comfortable!) I watched so many dying patients in the nursing home suffer needlessly from painful and futile interventions that I am grateful to now be able to allow them to transition to whatever they believe comes next in peaceful surroundings w/ those they care for able to be with them for as long as it takes. Death is a part of life and can be a peaceful experience. I was truly amazed at how much we are not taught about dying and the dying process. I look back at the times we complained about (or in the day) restrained those "unco-operative and combative" patients -only to have them die within a few days. I now know I was looking at terminal agitation but I never knew such a thing existed until I started working with hospice. I console myself with the knowledge that 'I didn't know what I didn't know' and now that I know better, I'm able to do better. OOH:spbox: getting down now

Ruby Vee, BSN · Jul 16, 2008

i've been an ob nurse for 11 years. it's really all i've ever done as a rn. (i did med surg and home health as an aide.)
i've always loved it for the most part and am even newly enrolled in school to get my master's degree and become a cnm.
the past few weeks however, i am starting to wonder if i'm getting burnt out on ob. i feel frustrated with almost every aspect of my job. i go to work praying for a quiet shift with no labor patients. i feel dread when a new admit arrives. i'm just tired of frequent fliers that want to be induced at 2 am on friday night because they're 38 weeks and bored with being pregnant. or they're 35 weeks and trying to put themselves in labor because they're sick of being pregnant. or they actually are in labor and deliver a nice healthy baby and aren't all that thrilled but want to know how soon they can go out to smoke.
it just feels like the vast majority of our patients are selfish and completely disinterested in what we have to teach them. they are always trying to take advantage of "the system". mostly medicaid patients who have no problem coming in 10 times before they're in labor for various lame reasons since they don't have to pay the bills.
like i said, i am in school now to eventually become a cnm, so naturally i'm having second thoughts about that, too. one of the cnms i work with just found out she's being sued by a patient in a frivolous suit in which she truly gave the best care she could. "why do i want to do this again??"
i feel like a failure for considering backing out on this venture that i've begun, but i don't know if that is a good enough reason to continue. i still think i'd like to advance my degree, but maybe just a different one...
i don't know. these are all new thoughts and fairly new feelings for me so i don't know if it's just a passing phase or if i'm truly experiencing burn-out. the idea of quitting my job of 15 years and doing something brand new sound enticing...
actually, i keep entertaining the idea of looking into hospice nursing. i highly doubt i'd experience the issues of frequent fliers or people looking to squeeze the system. i imagine these patients (and their families) would be much more grateful and i just think it might be more rewarding.
thoughts? advice? opinions?
thanks in advance!

i have no experience with ob and am not even sure what a "cmn" is. clinical nurse manager? but i do have a little experience with burn-out.

if it's burn-out, sometimes the easiest thing to do is change shifts. or change jobs. maybe a different job at a different hospital with different frequent fliers. changing specialties or transferring to another unit within the same hospital is also a possibility. but if you feel a call toward hospice nursing, maybe that's telling you something! good luck with whatever you decide to do!

allnurses Guide · Jul 16, 2008

Thank you so much for your considerate replies.
It is difficult and scary to think of jumping into something brand new after doing one thing for so long, but I suppose I can't ever know if there's something else out there for me if I don't take a chance. I'm not going to do anything too rash. Guess I'll just pray about it some more and see if any new doors open (or old ones close).
Right now I really do love the school I'm in and they do offer a couple of different NP programs as well as the CNM, so I have some other options.
Happy to hear anyone else's opinions, too!
BTW, icyounurse, sounds like you've been through a difficult time, too, with moving and everything. Glad to hear you've found your niche!
And Spidey's mom~ Interesting to hear that you tried ER nursing. I considered that too, but figure it is probably similar to OB, in that I'll still have many pts that are "using" the system and are frequent fliers, etc. I think I would still be too frustrated.
It's very interesting that everyone I've heard from who's tried Hospice has liked it. (I was reading on the Hospice forum, too.) Maybe I'll find out if I can shadow a Hospice nurse sometime.
Thanks again! (I love allnurses!)

Actually, I left out that in the small rural hospital we were expected to learn it all and I did work ER there for 7 years. I did OB, ER, med/surg, wound care, (Initially we all helped out with LTC too), I was the baby nurse during cesareans, etc.

steph

mommy2boysaz · Jul 16, 2008

Thanks everyone for the responses.

At first I thought OB and Hospice were on two extremes of the spectrum, but the more I think about it, and after reading some of your posts, there really are a lot of similarities. I, too, am trying to offer women comfort during a scary, painful time. (If they bypass the epidural) There is a huge amount of time spent educating patients and families about the labor and birth process and about caring for their babies. The family dynamics are insane most of the time! It is a time of transition for everyone in the family, just as the death of a loved one is.

I suppose it's not such a shock that I would be interested in both specialties. Plus, as I said, I have done home health in the past and enjoyed it.

Guess my main desire is to do something worthwhile, knowing that I am making a difference to someone. I've lost the feeling that I matter much to most of my patients now. I am giving some thought to changing departments within the same hospital or something. I'm still thinking... No decisions yet!

mommy2boysaz · Jul 16, 2008

Oh, and RubyVee~ A CNM is a Certified Nurse Midwife.

mom2michael, MSN, RN, NP · Jul 18, 2008

I don't want to be an OB nurse forever that's for sure. I love the experience and I love the patient teaching. What I don't love is the inductions and the sections that are all scheduled for the convenience of the doctor and/or patient. What I don't love is my co-workers getting in a tiz because someone actually is trying to deliver during shift change or the doctor getting mad when their scheduled induction comes in 2 days early actually in labor all by themselves. Or the patient that tours the building and 1/2 way thru the conversation tells you she has her induction scheduled for Sept (this was in June). I really dislike that our c-section rate is about 40% which is just way too high. It makes me crazy when a VBAC comes in and the entire legal department ascends upon them and makes me them feel stupid for wanting to try a VBAC.

But I love my patients as a whole. 99% of my patients, regardless of the family dynamics are truly appreciative of what I do for them and what I can teach them. That is something I very rarely experienced in ER. I love the time I get with them. I love the 1:1 with them. I love bringing a baby into this world and sharing my thoughts, teaching points and life experiences with my patients. I love watching that transition from princess into the delivery room to first time mommy complete with the deer in the headlight look and I love that this once demanding crazed women now turns to me for support and guidance. I love that her husband who was so petrified of his wife during the delivery is now sharing tears of love with her over their new baby. And I simply just love babies. I love to find my snuggle bunnies and have them curl up in my lap while I chart. Reminds me of why I am where I am each time I see a sweet baby angle. Awesome, it really is.

However, we live in a McDonald's fast food paced environment. Everyone wants it done in 3 mins or less and that includes deliveries.

What keeps me sane is the fact that someday I want to be a CNM and I want to do this so I can see birth the way it was designed to be seen and practice the way I feel I should practice. God made women capable of having babies without a million drugs, inductions, IV's and constant monitoring. God made us able to have babies surrounded by 10 people if we desired. God made us able to withstand the long labors and the long pushing all without drugs, vacuums or *gasp* a C-section OR rooms. I want to be able to give women the type of births they desire. I want to be part of a heritage that is so awesome and so real.

I went to OB strictly for the experience in L&D before I became a CNM. I knew long ago that things about it would make me crazy and but I also knew that unless I experienced those crazy things I would not truly appreciate being a CNM. It teaches me all the things I don't want to be when I'm done with school :bugeyes:

I know you'll find the peace you need in your life and the direction you need to turn next. Only you can truly know if this is burnout or just a combo of many things going on right now in your life.

Good luck to you no matter what you decide!!!