Feeling burnt out. Looking for advice.

[Nurse12390, BSN]

I’ve been a nurse for a little over two years now. One year in medsurg and another in the NICU. I love the NICU but have been feeling overwhelmed and burnt out emotionally for some time now. I’ve had a couple of traumatic patient losses lately and have not felt like myself since. I’ve been having panic attacks before going into work and either feeling really anxious the whole time I am there or completely detached which is not normal for me. I love my patients and families and it hurts me to feel like I’m not really there or in it like I used to be. I’m also required to rotate every two weeks between days and nights. Sometimes I switch between days and nights in the same week a day apart from each other. I’m always tried on this schedule and have a hard time enjoying my days off because I feel like I’m just recovering. I would like to work just days but that’s is not an option and day shifts are only offered based on seniority.

I guess I’m just looking on advice on how others have dealt with feeling burnt out? I miss feeling the way I used to about nursing and just want to work towards getting better.    Thanks!

[Okami_CCRN, BSN, RN]

When I am feeling burned out, I start to actively look for other jobs.

I have also switched to part-time, which has improved my work-life balance and done wonders for my mental health. I know not everyone can afford to go part-time (neither can I), but I supplement with per-diem work in a less stressful area. 

[JBMmom, MSN, NP]

You're dealing with a lot right now between the losses and the difficulty with a shift switching job. I would recommend you reach out to the confidential counseling line through your organization to find someone to talk to for support. I can't tell from your post whether you need a new job, a new exercise program, more social time with friends and family, etc. I don't mean this in a sarcastic way, there are SO MANY aspects that could impact why you're feeling like you are. If you think you like this job then I would do all the work I could to get to the bottom of the issue and treat that first. But if you feel like it all stems from the job, then maybe you work on moving on and hope the other parts fall into place. I wish you the best of luck. 

[Been there,done that, ASN, RN]

You could handle this job...if you  were not forced to rotate from days to nights. That is messing with your mind more than anything else. As an experienced NICU nurse, I am sure you can get a day job.

Best wishes.

[Nurse12390, BSN]

Thank you everyone for your comments and advice! I unfortunately took a sign on bonus so I’m contracted to stay inpatient for 2.5 years. If I break the contract I have to pay all the money back. My husbands is in school and not making money so we really can’t afford loosing that money. The previous hospital I worked at did a 6 week rotating schedule which I was told when I took this position that this floor did as well.

Unfortunately you don’t have much control over your schedule as a rotator and you switch between days and nights in the same week. If I had a consistent rotating schedule I think I would be okay but schedules are made to fill the holes in staffing on the floor so at the end of the day most people don’t get the schedule they signed up for. I really love nicu and feel guilty for not feeling happy there right now . we have had 3 babies pass away in the last week. A baby that I was taking care of was declared brain dead and the parents want to keep him alive for religious reasons. They plan on putting in a gtube and trach next week. I felt horrible the whole shift putting this poor kid through painful procedures to keep him alive when he is already gone. I felt so helpless and felt like I wasn’t making a difference which was really frustrating. I try to separate my feelings as best as I can but some of these kids/families really get to my heart. I think between this and the schedule/the culture on the unit I need a break. 

I talked to HR and have an interview for a pacu day/evening position. I feel really guilty even thinking of leaving nicu because it was my dream job and the reason I went to nursing school. But I’m hoping if I have a more consistent schedule I will have time to work on my mental health and feel better. Thanks again for all the feedback! I really appreciate it!

[SmilingBluEyes]

I applaud your self-awareness and desire to do best by your patients and families. I agree with the others who say a consistent schedule is key. I know I rotate (somewhat) between days and evenings and even that plays with my sleep and my mind. If I had to shift from day to night sleeping and back, I would lose what was left of my mind!  I think you'll feel better and will be able to think more clearly if you are on one shift consistently.

Those losses are heartbreaking as is that situation with the baby with no brain activity. Anyone would take those hard, but someone who is already physically stressed from sleep pattern changes would feel this even more acutely.

You would do well if you can get that other job, even if only for a while. Maybe you could go back to NICU if/when the schedule would be either days or nights.

I wish you well. You can't pour from an empty vessel; take care of yourself as you care for others.

[hppygr8ful, ASN, RN, EMT-I]

As you state that part of your emotional state is due to some traumatic patient losses I would suggest you seek out a mental health professional for a Critical incident stress debriefing. Your employer should do this for you but if not check with your facilities EAP program If you have insurance you can go that route. 

I would not suggest that you  make a change in this state of emotional turmoil. Do you have PTO can you take some time off? Once you are feeling better rested and in a good place emotionally then go out and show them who you are!

[Dafabb, LPN]

As a Nurse you are a baby.  I am an LVN and I have now been a nurse for 45 yrs.  I have seen a lot of Nurses burnout and keep working and I will say when it takes hold it is not pretty to see.  I have P&^^ several nurses off over all these years.  I have also gotten very disgusted with nursing but I was also very fortunate.  I have worked every department in a big hospital there is except PACU.  It was not even invented until much later.  From ICU-OBGYN I have worked.  I have also done agency and traveled I think that is what has saved me in the long run I mix it up.  I still love nursing but in truth I would now like to go remote.  When you feel burned out change to a different dept. for a short time.  Also you must know it takes a very special person to be able to work NICU. I think out of the entire hospital NICU nurses are the smartest and almost angel like along with the Dr who takes care of them.  The reason for saying this is that these babies can not tell/show you anything you have to know or know what to look for.  You have to have that special 6th sense in NICU. And you also have to be able to see those babies die at some point.  Not everyone can do that.  I can not and I am an OX in strength.  Babies and small children are my weakness.  I chose to only do those areas PRN which I did get a  lot of practice over the years but NICU once or twice. If that is a problem with you maybe you need to rethink where you want to go  OB/Babies was great and I had a ball.  I did many yrs PRN/float to these areas.  Burnout in nursing is huge now it use to be 5-7 yrs.  Now who knows.  You can listen to others as I have given you some solutions but in the end do what you need to do.  I forgot also get off the rotations it will kill you much earlier(stats)  Work one shift only and others only if you want to do PRN.  If they have a problem with that find a job/hospital that won't.