Extreme nurse burn out need help please

[NURSEJSS]

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.

[Persephone Paige, ADN]

FMLA applies for you too. Get a doctor to write you for the short term disability. I don't fool around with that crap. There's more than one way to skin a cat.

[adventure_rn, MSN, NP]

Wow, I am so sorry you are having this experience. In addition to the suggestions above, here are a few ideas that I don't think have been mentioned.

First, see if your job has some kind of Employee Assistance Program. Most large corporations (especially hospitals) have some kind of benefit that allows you to have 3-6 appointments with a counselor for free. They are in place precisely for the reasons you described, and they're totally confidential (i.e. the counselors aren't affiliated with the institution and can't legally tell your employer what you say, just like seeing a regular therapist or psychiatrist). They may be able to help you work on some strategies to get by until you can start your new job. The EAP counselors may even be able to help you navigate the Short Term Disability process; in addition the counseling they also help employees navigate their behavioral health resources (like finding a long-term therapist/psychiatrist, helping you understand your behavioral health benefits, etc.) You can usually find info on your hospital's EAP (it may have a different name depending on where you work) through your hospital's HR site, usually under a tab or section about 'Employee Wellness.'

Second, you mention that you're part of a union--definitely let your union know what's going on and see if they can back you up! One of the main reasons we even have unions is to protect us from unsafe work conditions like the ones you've described. I completely understand if you just want to keep your head down and not rock the boat; however, before you leave, please report these conditions to your union so that they can attempt to address them. That all sounds terribly unsafe for both patients and staff.

Again, I'm so sorry that you're going through this. It is entirely unacceptable. I'm glad you have a new job lined up!

[RNperdiem, RN]

I am glad to have a new job lined up. Hopefully once you put this job behind you, things will get so much better. I am with the others who suggest that you use up any and all PTO.

[NuGuyNurse2b]

Sounds like my old med surg floor where I would get 7 to 8 patients because of staffing issues. I would hang in there until the new job. At least you're getting out, so there is a light at the end of the tunnel.

[Neats, BSN]

Oh hugs to you.

First off what you did for that patient was above and beyond duty. I would have gotten a sitter (maybe not available where you are), I would have talked to the provider about this patient emotional outburst and perhaps gotten something to relax him. It is over and done with . You sound like you have PTSD from this experience. It is real and you need to get assistance with this. I would file a workman comp so you can get counseling, no harm in that.

Sorry you could not count on your supervisors assistance, it sounds like the unit is not cohesive.

Good luck with your next job. You know what we do after the code has been completed, we talk about it, we come up with all sorts of scenarios we should of, could of done. This is helpful in that you are better mentally prepared next time. I would practice this with co-workers you trust just to get a peer to listen.

[Golden_RN, MSN]

I'm so happy for you that you got a job that will hopefully have much less stress! I would try to take vacation or sick days in the meantime.

[FolksBtrippin, BSN, RN]

I recommend that you don't go back to work there. I agree that this is a workmen's comp situation.

Also, please call OSHA and make a report about the workplace violence you suffered.

I'm very sorry for what you have been through. It is NOT your fault.

[amzyRN]

Stress leave or medical leave might be in order. Security is your friend. Patients are still accountable to the law. Sexual battery is a crime. It was appropriate to put him on BiPap if he's a DNI. I think I would have told her that you feel unsafe with the patient and will need to call the police and file a grievance with HR if she doesn't help alleviate the situation. I'd contact an attorney, no way I would put up with sexual battery by a patient. Either security would be at the bedside or I'd file a police report and contact the compliance hotline with my employer. I have a zero tolerance policy for abuse of that caliber. I'd also be looking for a new job too, while I took my leave.

[Kooky Korky, BSN, RN]

I'm so happy for you that you got a job that will hopefully have much less stress! I would try to take vacation or sick days in the meantime.

Not TRY. She must not ask permission, as it will not be granted. She must make the decision that "I need some time off" and TELL her boss that she is not coming in today or however many days she NEEDS.

[buttercup9, ASN, BSN, MSN]

So much empathy here.

Please remember, you are NOT a martyr.

And don't let the med error make you fearful of standing up for yourself.

[TriciaJ, RN]

Not TRY. She must not ask permission, as it will not be granted. She must make the decision that "I need some time off" and TELL her boss that she is not coming in today or however many days she NEEDS.

Exactly. What are they going to do, fire her? Fine. They can deal with wrongful dismissal along with their grievance. Then OP can collect retro pay for days she would have taken off anyway. Win-win.

[jessymae1989]

Your situation is eerily similar to mine.

I, too, am working on a cardiac tele floor with a ratio of 4:1.

I'm sick with depression and anxiety, and loathe going to work every single day. The other RNs make it look so easy, and CNAs do nothing to help.

I'm drowning in sadness. I don't have a solution for you or myself...but just know you aren't alone and we will find a way out of this. Enjoy your new job next year and keep your head up.