ICU nurses/former ICU nurses, please advise... :)

  1. Hello fellow ICU nurses, and former ICU nurses!

    I've read some articles regarding burn-out, specifically related to ICU burn-out. One such article stated that some ICU nurses get burn-out since they start to feel their efforts are futile, etc. This is exactly why I am starting to feel burnt-out. I love my job, I really do, and this patient population is a great fit for me, as far as being able to comfort patients/families through a most difficult time, getting to be anal, detail-oriented, help guide residents in patient treatment, etc.

    I have been working in the ICU for a year now, full time on night shift. I'm not stressed out at all in critical, unstable situations. I'm comfortable in my own skin, and am not nervous about work, etc, so it's not the stress of the job that gets to me. I am looking to start studying for my CCRN since I enjoy studying anyway, and have decided against applying for FNP school since I want to start a family. If the ICU has taught me anything, it's that life is transient.

    I always advocate for my patients, especially when I see that it's time for a discussion with the family. I ensure that a discussion has been initiated, but as you all know, it sometimes takes families a week, sometimes a few weeks to make their decision, and sometimes they make the decision that we don't agree with, but we have to continue on anyway. I understand it's natural for a family to take some time regarding decision making since it's not easy, but it is difficult to see a patient suffer through unnecessary treatment in the meantime.

    Logically, I know my job is rewarding because I'm still providing quality care for people who need it, even those that won't make it out of the hospital, but I still feel for the patient and the family through their pain/suffering.

    Any tips from experienced ICU/former ICU nurses? (One told me to put a wall up, which I thought I was doing well, but apparently not lol; I find that I am taking work home more now than I did months ago. Is this just the ebb/flow nature of the job?). Is this just something I can expect time and again? Also, I've been doing nights as a nurse for 2 years now, and never got used to it. I think a large part of my feelings also stem from not having much quality time away from work. I mean, I really miss the sunshine, and don't get to see it much; I even got sun rash when I went to the beach this past summer, and one of the risk factors is night shift apparently lol. I'm probably going to go part-time once we can afford it since we want to start a family anyway, and this would allow me to have enough days off in a row where I can actually be up during the day, and enjoy the outdoors!

    Sorry this is long. Thanks for reading! I'm assuming my feelings aren't uncommon as ICU burn-out is not atypical. I still find my work rewarding, so I'm not a crispy critter lol, and no OT recently, and I took a few vacation days, which were awesome. What's the point of PTO time if we don't use it, right?
  2. Visit Good Morning, Gil profile page

    About Good Morning, Gil

    Joined: Jul '11; Posts: 626; Likes: 596
    MICU; from US
    Specialty: 3 year(s) of experience in Rehab, critical care


  3. by   nurseprnRN
    Been there, done that. And swore I would never, never do it again. And I haven't. It had less to do with futility than with empathy. Some may think that's an issue with borders, but I saw, and see, it more with my tendency to try to see things as others see them...and in the ICU that can be so painful.

    Please, please, please take your PTO, early and often. One of the reasons for (and hallmarks of) burnout is sacrificing yourself/your privacy/your self-care/your enjoyable out of work time because you feel guilty for leaving the job where it belongs. This does not belong in your living room, desk, earned days off ... or in your head.

    Do not let yourself get so far burnt that you compound how bad it makes you feel by discovering exactly how indispensable you are when you really have to leave, because you will be hurt to discover that you are not. Do not ask me how well I know this.

    You are the only you there is-- and your prime responsibility to yourself is to take care of yourself. You must do that or you will be no use to anyone at all.
    Last edit by nurseprnRN on Oct 24, '12 : Reason: missed something
  4. by   Anna Flaxis
    I'm sorry, I have never worked in the ICU, but I do understand burnout. I'm unsure from your post what makes you feel that you are experiencing this. It sounds more like you don't like working night shift and you'd like to work less. Everything else sounds like a nurse who is very engaged in their work.

    I'm not hearing you say that you dread going to work, that your patients irritate you, that you're tired of doing things for everybody else while forgoing your own needs, that you go into autopilot at work and just go through the motions but don't really care, or that you daydream about mopping floors or flipping burgers.

    Maybe you are having those feelings and feel afraid to express them, as if that would make you a bad nurse or a bad person.

    Maybe you know that's where you're headed if you don't do the things you know you need to do to take care of yourself. You're right; and that is not a place you want to be.

    My advice is listen to your gut and make the changes that you know you need to make now rather than waiting until you truly are burnt out. Believe me, you do not want to go there.
    Last edit by Anna Flaxis on Oct 24, '12
  5. by   Good Morning, Gil
    Thank you! GrnTea, you eloquently stated how I feel, and it is more empathy than anything, and I really feel for the patients who do not have a fighting chance, but the family has not accepted that yet, so we continue with treatment; I feel for the patient who is being kept alive, and I feel for the family who hasn't yet accepted their loved one is gone or has poor insight no matter how we as nurses, and physicians explain it. And, Stargazer, I am starting to feel burnt out, namely due to working nights, but I do feel somewhat guilty for feeling this way since I know how good I have it compared to the patients in those beds, so you hit it spot on. I still find my job rewarding, but not having any quality free time doesn't really help me get away from work. I know I could schedule my nights all in a row so I could have 6 days off, but I know that would lead to burn-out faster (as far as having to be there 6 nights in a row).

    Working day shift would be the ticket, but that's not an option for a few years, and I really don't know that I want to continue working nights for a few more years since 2 years has been long enough. I have to keep a consistent nights schedule since I don't have enough days off in a row to flip/flop, and being awake all night on days off really isn't that awesome lol.

    So, I won't be making any changes right now since we can't afford it yet (hubby just finished grad school), but we should be able to afford for me to go part-time within the next few months, which would allow me to enjoy life again outside of work, and have time to raise the kiddos when we have them. I make the best of it right now, of course, but life is short, and I really don't want to look back on life, and say, "I made the best of it." I want to enjoy daylight hours with my hubby (and future kiddos), and visit my parents/family often.
  6. by   MomRN0913
    I wrote a whole post and lost it. I'm a former icu nurse and kind of want to go back. It was pretty much where I started as a new grad with the exception of floating for the first 4 months. I loved it, and felt pretty comfortable in my role, although never too comfortable.I got burnt out trying to save the unsavable patients. Patients have no hope, are suffering are in pain, but their loved ones won't let them go. It got very hard for me to watch. To code these patients when they should be given the opportunity to die a peaceful death with dignity.So guess where I am now. Hospice. I do miss critical care, but it is rewarding to help a patient die a peaceful death at home.You do t really sound burnt out. But when you start to take some of this home, like others have said, take those PTO you've earned and check out totally. Something I'm not really able to do in home hospice which kind of stinks
  7. by   Anna Flaxis
    At least you are still feeling. This is good. Sounds like going part time is in your future, as soon as you can swing it. I hope that's enough of a change to keep you engaged with your work! Best wishes and good luck to you!