Burnt out after only 6 months

[gennn19, BSN, RN]

Hi everyone. I've been a nurse for ~2 years. My first ~1.5 years as a new grad nurse were in a very happy laid back specialty, but ultimately I felt like I had no "real nursing skills" and made the switch to a very intense peds ICU where I've been for almost 6 months. Ever since I started in the ICU it has been an emotional rollercoaster of depression and anxiety for me. I had bad anxiety and from the minute I took PALS (pre-req for the position) and got super anxious, I knew it wasn't going to be easy. But I tried to push past the anxiety because I wanted to succeed. Orientation was rough too, I would get so anxious that at one point one of my preceptors suggested I get a new job. I have been on my own for 3 months now and have been doing really well. But nonetheless I am extremely burnt out, I still experience anxiety and depression when thinking about work.

It's not the staff. The staff has been nothing but amazing, everyone from the providers to the educators to fellow nurses have played a role in making sure I am part of the team and that I feel supported. Everyone asks me if I like the job and I feel super bad because I lie and say I love it when I know my heart is just not there. The unit has been extremely high acuity lately (almost all patients are on some sort of device be it ECMO, CRRT, VADs, etc) and extremely short staffed. Management asks people to do overtime almost every day and I feel guilty because I never do. It's not the schedule either--I love night shift and working 3 12's.

Every day before work I get super anxious, and depressed on my days off. People say give it a year for the feeling to go away but I don't know if I can. The thought of a patient coding on me makes me sick to my stomach. I constantly feel overwhelmed on the job with the difficult assignments despite people telling me I'm doing well. Lately we've also had a lot of death and each child's death has been so rough for me to process. I feel like Goldilocks where one unit is too boring and the next is too intense. I also feel guilty because I know so many people would love to have this job. I just genuinely feel like the ICU may not be for me. I feel stupid because what did I expect from a critical care unit? I don't want to be miserable, anxious and depressed every single day for the next 6 months until I make a year. Before transferring to ICU I considered OR (which I've always been super interested in but ultimately went with ICU because I wanted the skills and experience). I don't want to leave my hospital system, but I don't know how feasible it is to transfer to another unit at this point. I am just feeling so burnt out and don't want to give it more time. I don't know what to do with my life and don't want to burn bridges. Any advice would help ? 

[JBMmom, MSN, NP]

ICU isn't for everyone, and there's nothing wrong with you for figuring out that it's not for you. Just because other people might want your job doesn't mean you're wrong to give it up. If your life is being that negatively affected by a job, then there's probably a good reason for you to look for something else.

In two years you found two jobs that weren't exactly what you're looking for. That's totally reasonable. The great thing about nursing is that there ARE so many different places. Ideally you might give the job a year to see if you feel better after you have more comfort, but it sounds like you're doing very well, and the job itself isn't going to change after a year, so if you're not happy with the patients and situations you encounter then it's probably a good idea to find a better fit for you. 

Obviously I don't know how your hospital does transfers and whether you have to stay for a year. I would consider approaching your manager and being honest with him or her about your situation. Hopefully you can find the right fit for you. Good luck!

[TriciaJ, RN]

You never know what you're going to encounter until you're there.  Sounds like you felt restless in your previous position and wanted to go for the gusto.  And to your credit, you're managing well with your patients, but look what it takes from you to do so.

Your current position is making you ill.  It's not for you, at least not at the moment.  I agree with JBMmom that the first thing you need to do is have a heart-to-heart with your manager.  Tell her how eager you were to expand your skills but find yourself struggling mightily to cope with the daily demands.

If your manager is worth her salt, she will understand and not want to lose a good nurse altogether.  Good luck and hang in there.

[Nurse Pompom]

On 4/22/2021 at 5:54 AM, gennn19 said:

I don't want to leave my hospital system, but I don't know how feasible it is to transfer to another unit at this point

My hospital requires a year in a unit, after 30 days have passed, before someone can transfer again (basically they got 30 days to change their mind). See what your hospital policy is. 

I too would give it a whole year. ICU was and still is such a source of anxiety for me when I first started, Id feel the anxiety the day before Id have to return to work. I worked the night shift too. It all got a lot better once I went days. 

Try to talk to someone. Talk to your coworkers or a mental health professional. Anxiety doesnt go away on its own, at least not for me. Id also add that OR nursing probably is very stressful as well with high standards. You might work with different types of personalities etc..People die there too.. Surgeons can be difficult.. However, I am not an OR nurse, thats just what I heard. 

I would stick around for a year, because at least you will have the experience under your belt. In the meantime, ask your education department if you can shadow in the OR because..Imagine if you leave ICU and hate the OR? ?

[gennn19, BSN, RN]

Thank you so much everyone for your responses. I have checked with HR and I do in fact need to stay for an entire year before transferring. I am so afraid of making the wrong decision. If I were to leave it may look bad to have left a job after only 6 months and I'm afraid it will close some doors down the line. I love my hospital system and it took me 8 months to get into this hospital as a new grad, I can't help but feel I'm throwing away a great opportunity ?

I feel extremely guilty too because my coworkers and even NPs keep praising me for doing such a good job managing with the high demands of the unit and caring for my patients. It's just the chronically short staffing makes me so anxious, not knowing what kind of insane assignment I'll be walking into, whether a patient is going to decompensate at any given point on top of an already heavy assignment. I'm always on edge. It's not so bad when we have decent staffing. But still bad.

 

I am afraid to talk to my manager. We have check ins every few weeks and I have already sort of expressed how I'm having a hard time coping emotionally. But I didn't go into too much detail. I guess I have some serious thinking to do...I really appreciate everyone's input ❤️ 

[CABGpatch_RN, BSN]

First, I just want to acknowledge your feelings.  How awful.  You seem like a very insightful person who really cares (which can also pile up on your anxieties).

Can you maybe get in touch with your EAP (employee assistance program) if there is one?  You don't have to do your thinking alone.  Talking out your thoughts with someone else really does help.  Just saying how I'm feeling out loud, for me, takes so much power out of my anxiety driven thoughts which help ease my feelings.

Anyway.  I wish you nothing but the best.  I cannot imagine doing what you do.  I worked in an extremely high acuity CVICU for the majority of my nursing career.  But I worked with adults.  I would be a MESS working with a pediatric population and their family.  A MESS.

I hope you can find the support you need to make your decisions. ?

p.s.  OR and even PACU are awesome jobs.  I am in the PACU now and it's the place I will retire from.

[Leader25, ASN, BSN, RN]

On 4/22/2021 at 5:54 AM, gennn19 said:

The thought of a patient coding on me makes me sick to my stomach. I constantly feel overwhelmed on the job with the difficult assignments despite people telling me I'm doing well. Lately we've also had a lot of death and each child's death has been so rough for me to process. I feel like Goldilocks where one unit is too boring and the next is too intense. I also feel guilty because I know so many people would love to have this job. I just genuinely feel like the ICU may not be for me. I feel stupid because what did I expect from a critical care unit? I don't want to be miserable, anxious and depressed every single day for the next 6 months until

My heart goes out to you,feel your pain,but a year is not a magic number that will have you suddenly feeling better.Growth is painful,but you have support,you are not an expert by any means but you have your foot in the door.Seek emotional counseling from an outside source it can really help with your anxiety.it is a tough job but you might learn to embrace its challenges and love the pace and excitement. Best of luck to you.

[TAKOO01, BSN]

HI,

What was the happy, laid - back specialty, and can you go back there?

[speedynurse, ADN, BSN, RN, EMT-P]

I LOVE peds but can’t imagine working in a high acuity peds on a daily basis. I actually did enjoy the high acuity in the ER, but your brain and body eventually have to take a break. I do encourage you to try to stay a year. PICU is invaluable experience. If you like peds, why not try peds OR or peds PACU? Those are lower stress, more controlled environments but still uses a lot of critical thinking.

[JBMmom, MSN, NP]

On 4/26/2021 at 7:30 PM, CABGpatch_RN said:

I am in the PACU now and it's the place I will retire from.

We recently had a number of our ICU nurses head over to the PACU and they all seem to love it. Definitely something to consider for those with ICU experience.

OP, wishing you the best to figure out what will work best for you!