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Extreme nurse burn out need help please

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I need help. I have been burnt out for a long time for various reasons. I have come to my end of burn out and I am severely depressed. There's a lot of background to why I feel like this but this is why:

I work on a cardiac tele unit, ratio is 4:1. Always understaffed. I work often as charge nurse with up to 4 patients, no secretary, no aids. I often don't go home until 9 pm because no one wt my job can keep up with all the work and lack of help. We are technically a step down unit and should be 3:1 but they changed our name to "cardiac tele" to place us at 4:1

Friday I was at work taking care of a man with ARDS. He was severely ill and I called an RRT on him. He should have been intubated but he was DNI so they placed him on BIPAP instead. Well this guy was also an a-hole. He was the typical patient that curses you out, presses the call light every second, etc etc. I asked for help multiple times from my supervisor who was also working as the charge nurse that day and she did not help me. She also had 4 other patients of her own and used that excuse to ignore her charge nurse duties.

Well this his guy was on the verge of basically coding all day if it wasn't for me staying at his bedside all day long managing him. I asked for ICU orders which the doctor placed and I told my charge nurse about it. She made no effort to move him and I was too busy with him and my other patients to move him myself. Long story short he threw his bipap at me multiple times, threw his urine at me and soaked my clothes, sexually harassed me, called me a B*tch, showed off his erection multiple times at me and tried to grope me as well. I did everything to defend myself as much as I could but there was only so much I could do because he would exacerbate himself so much when he would do this that I would then have to manage him again to not code.

That at was the last straw for me. I'm so depressed that I put myself out there so much to save this man from coding and he disrespected me this much. I asked for help and got nothing. My management also turns their heads and does nothing. I have been depressed and crying all weekend. I don't know what to do.

some additional background: I made a medication error a while back. Was put on leave for it for 2 weeks then returned to work with a final written warning and I have to be monitored every week for the next 2 months when I pass meds. Not to go into detail but this was definitely not a just cause for the error I did (no harm occurred) so my union has placed a greivance.

i have a new job now working out of bedside but I don't start until Next year. I don't know how I'll make it till then. I don't even know if I can return to work tomorrow. I have been a mess all weekend and have been crying, not eating, etc.

can I please have some advice or words of encouragement? Please help me. I am so depressed.

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Sick days, PTO or whatever your employer calls them can be used for mental health too. Take a day or two off and take care of yourself. That's not going to solve everything, but it can be a start.

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Security for patients with those unacceptable behaviors. You do not have to tolerate being assaulted even by unstable patients.

I'm a bit confused though. With unpleasant or icu patients I'm usually the one wheeling their bed down to the different unit myself? Especially when I'm behind with my other patients?

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I had 3 other patients. I did not have the time to be able to do that. On my unit it's usually our charge nurses that transport the patients.

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Should have, could have, would have. Your nursing partners were not helping you. Then it was time for physician intervention. The patient required sedation, so you could handle him.

Crying and not eating is using energy you need for your new job. Use your PTO, show up on the last day to make it look good.

Carry on.

.

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I am sorry for your current situation! When I left my last hospital job I was to the point that I just couldn't do it one more day so I understand (at least a little) what you are going through. Is it possible to take a leave from work until the new job starts. Sick pay, PTO, short term disability etc. If you are feeling depressed maybe it would help to see a therapist. It doesn't sound like the current job is changeable/fixable so I would just try to keep expectations low and do what you can while you are there. Spend the energy you would have used (wasted!) at work trying to fix the work situation and instead "fix" (take care of) yourself/your well-being. You need to find a way to decompress, find what works for you. Do you have any friends/family you can talk to about this?

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Friday I was at work taking care of a man with ARDS. He was severely ill and I called an RRT on him. He should have been intubated but he was DNI so they placed him on BIPAP instead. Well this guy was also an a-hole. He was the typical patient that curses you out, presses the call light every second, etc etc. I asked for help multiple times from my supervisor who was also working as the charge nurse that day and she did not help me. She also had 4 other patients of her own and used that excuse to ignore her charge nurse duties.

Well this his guy was on the verge of basically coding all day if it wasn't for me staying at his bedside all day long managing him. I asked for ICU orders which the doctor placed and I told my charge nurse about it. She made no effort to move him and I was too busy with him and my other patients to move him myself. Long story short he threw his bipap at me multiple times, threw his urine at me and soaked my clothes, sexually harassed me, called me a B*tch, showed off his erection multiple times at me and tried to grope me as well. I did everything to defend myself as much as I could but there was only so much I could do because he would exacerbate himself so much when he would do this that I would then have to manage him again to not code.

That at was the last straw for me. I'm so depressed that I put myself out there so much to save this man from coding and he disrespected me this much. I asked for help and got nothing. My management also turns their heads and does nothing. I have been depressed and crying all weekend. I don't know what to do.

Obviously I don't know you so feel free to disregard if I'm off the mark:

Do you think you constantly just put up with a bit too much, maybe?

There's just absolutely no way I would've put up with this day you're describing. There's no reason you should've had to - but at some point you might have to throw a bit of a fit! Professionally, of course. Start calling people. The manager, the supervisor/admin on duty, security, the physician (requesting bedside presence), the ICU...whoever. All of them. Call a RR/RAT for someone supposedly in such poor condition who needs to move to a higher level of care!!

If you are someone who continually just allows everything to be heaped on without a willingness to appropriately demand anything in return - - - that makes for a rough existence. :(

If a friend of mine was telling me this, I would suggest 1) a vacation 2) possibly a new job 3) counseling and/or empowerment/assertiveness training.

Take care of yourself ~

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I would have called the cops and done everything in my power to get him indicted for assault likely to cause great bodily injury. I would have attempted to move Heaven and earth to get those charges to stick if it meant being the DA's #1 pest.

I'd also sue him in civil court, if hospital did not back me up I'd sue them. I'd do this after contacting security at the facility leaving a paper trail of his actions. For someone who is in that bad a shape he sure sounds as if he can dish out abuse. Glad I work in state prison, custody does an excellent job of protecting us!

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How long have you been working at Bottom End of Hell General? From this point you go into survival mode. Use up every nanosecond of time off coming to you. Put in your 2 week notice and no more. Can you afford to take a couple of weeks off between jobs to decompress? Do you really need uninterrupted paycheques? A short term bank loan? (Don't do a payday loan.) Pay the rent and utilities but use the food bank? (Repay by donating handsomely when you're back in the chips.) Short term retail work over the holidays?

I really hope you can give yourself a Christmas present of getting out of there ASAP. Trying to keep abusive jerks alive with no backup, punitive approach to med errors..... ! I'm sending you good thoughts and wishing you a happy New Year.

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Sick days, PTO or whatever your employer calls them can be used for mental health too. Take a day or two off and take care of yourself. That's not going to solve everything, but it can be a start.

Don't tell them it's for mental health. Just call off sick. An employer does NOT have the legal right to know what sickness you are having. To keep the peace if they ask, just say fever, diarrhea, achey - better to not say anything, though.

Edited by Kooky Korky

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Did you at least change into clean, dry clothing?

Honestly, grow a backbone and never let anyone treat you like that again. Yeah, I know, easier said than done. But you have to do it.

I know you felt it was your job to keep the nasty patient alive. but if he's throwing urine on you and throwing other things at you and being totally violent and evil, you should be getting him sedation, MD consult, and/or transfer, not just focusing on his breathing. And if your Charge wasn't arranging the transfer, do it yourself.

A nurse is not required to get hurt on the job.

Maybe the old guy wanted to die, or was scared to die, or was just out of his mind due to the illness. Even so, you do not have to tolerate violence. Never do that again.

Use up your leave time. And don't let anyone make you feel guilty about using it. As others have said, you can pick up a little job until your new one starts. Fast food, retail, temp agency - you can be a receptionist, clerk, customer service, dog walker, whatever.

Take care of yourself. The job is using and abusing you and will not cry if you get hurt physically or are depressed. So you start putting yourself first and start toughening up. You can do it. God bless.

Edited by Kooky Korky

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