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.

[kbrn2002, ADN, RN]

Wow, what a day! So sorry. At least you have another job lined up already so you know there's a light at the end of the tunnel. Have you already put in your notice? If not, call in sick. Do whatever you need to do to use up any PTO or sick time you have accumulated, preferably before you officially put in your notice. I don't know your employers policy but I do know it's not uncommon for employers to stop allowing PTO use after a notice has been submitted and it's also not common for employer's to pay out unused PTO/sick time when you leave anymore.

[Workitinurfava, BSN, RN]

If you have sick leave use it. It is better than going to work with a mind that is somewhat in the clouds due to your depressed feeling. That sets you up for failure. Nursing can be draining and I feel it is not always a long term position for some. I also feel that some positions don't mesh with a nurse (not everyone can work certain positions). That is okay. You fought a good fight and helped save lives, now it is time for you to save your own life. I am looking at other options outside of nursing so I can work less hours or no hours. I am not saying you should leave it all together. Work a position that works for you. Do what you an handle. I worked step-down for some time but all of the machines noises drove me crazy. I would always have a severe migraine and I was a good nurse. I was always tired, and it didn't matter how much I slept. I fared better when I worked oncology-medsurg in the city. My boss didn't want me to leave. I was threatened by someone in upper management, told I would never be able to work for the hospital again if I left. I went to human resources and made sure my record was not marked so I could come back if I wanted to.

[Kooky Korky, BSN, RN]

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.

Are the other nurses more experienced?

Are they actually doing all of their work? I ask because I once had a job where I never really could take a break or seem to finish on time. I was always needing more time at shift's end to chart. I would be checking to see that VS and I/O's were all charted, weights, etc., which took a little time for 8 or so patients. Not a million hours, but about 15 minutes. I would be tired, hungry, and worn down from no breaks, too,so was dragging by shift's end.

I saw that all of the other nurses got off on time, plus had taken dinner breaks, smoke breaks.

I came to see, though, that they were not checking to see if aides' charting of the aforementioned items were charted. Plus, they weren't always doing their own charting! Well no wonder their work was always "done". Their med carts and Tx carts were stocked, their trash emptied, no meds ungiven, all of their refused meds trashed and accounted for. Anything that could have caused a fuss from their relief nurse was done. but they didn't even always chart a note of their own, they never called a doc for a c/o - sleep Rx, cough Rx, BM or other needs. All calling was left for whoever followed them.

How do I know? Paper charts back then. They were trying to prove a point - namely that the workload was too heavy and we needed to unionize.

You must find a way to get the aides to do their fair share of work. Make the patients' needs known to them. Like: Susie, Mrs. Smith needs a UA next time she pees, please. Thanks. Or George, give me a hand with cleaning Mr. Poop Bum, will you? Thanks. Let's grab the linens and wash him up so he can go to sleep. Thanks, George.

They aides will get in line if you are courteous but firm. It's a new approach, but they will come around if you treat them with courtesy.

Realized

[anewsns]

Ugh I am so angry for you and I can feel your burnout. That would NOT have gone down that way on my unit!! It would have been a sitter and 4 point restraints and zyprexa if possible. Can you give 2 week notice and work in an office for a bit? When will it be "next year?" Like a year from now ? Or like next month ? Try asking for PTO in advance- as much as you can! If they decline then just call out frequently- don't deal with bull from anyone. Make yourself Number 1 right now and don't worry about what anyone else has to say about it.

I don't know if all this is possible but my post is so emphatic because I feel your pain! I felt that way at long term care

[NurseAmyG]

That sounds absoluty horrible. I can't imagine how you must feel after having all those things done to you.

I've read some of the other comments here. I wonder how new you are to nursing? And I only wo der tht, because from what I'm reading in your post, it sou ds like something I would've put up with, just like you did, back when I was a new nurse. I've given away my sense of humor for crap like that now. So if you ARE new, or just a non-confrontational person, please know that you do NOT have to tolerate any type of abuse or harassment and if you struggle to be mouthy and stand up for yourself, may I suggest seeking some sort of "life coach".....someone who can help you learn how to be outspoken? .....just a thought.

I wish you all the best and hope things change for you soon

[By-a-thred, RN, ADN]

You are not safe to work in your current mental condition. Do what ever you can to take care of yourself as to NOT get worse before you start your new position. Take your PTO, get a doctors note for time off or just quit. You are at a greater risk for an even worse error that may put your license in jeopardy.