Feeling extremely burned out.

When I moved to Tennessee, I accepted a position in a large (32 bed) medical/surgical intensive care unit in an approximately 700 bed hospital. I loved the unit, the acuity was high, and the staff was great. Staffing, however, was a nightmare. It was nothing to have a paralyzed therapeutic hypothermia, an unstable balloon pump, and a septic CRRT as one assignment. We sometimes ran the entire 32 bed unit with 8-9 nurses. The unit was constantly short staffed (imagine that), and I frequently offered to pick up overtime. I felt that I owed it to my coworkers to try and lessen the burden.

In the end, I lasted around two years in that unit before I burnt myself out completely. I dreaded going to work, came home feeling beyond exhausted, spent much of my time sleeping, beat myself up over the caliber of patient care I provided, and often worried about the safety of my nursing license. Despite my love for the staff on the unit, I left that hospital, and took my practice elsewhere.

I can't say that I loved the staff in the next hospital I went to work at, and I can't claim that it was the best job that I've ever had. What I can confidently say is that my stress levels went down, I never worried about my nursing license, I felt that I delivered much better patient care, and the feelings of being burnt out slowly began to recede.

You may not have to leave the ICU completely, but it may be time to leave THAT ICU.

Thank you so much for replying :) That patient load is insane! We are always doubled with CRRT and balloon pump, but never together in the same assignment. My stress level over the last 2 years has literally tripled. I don't even remember what it's like to feel "normal" anymore... whatever that is right. I can't even sleep the night before I have to come to work. My heart just pounds and skips beats all night. When I am at work, I am fine. When I get to my car at the end of my shift, it hits me how mentally and physically exhausted I really am. I then proceed to crash on my first day off and feel hungover on my other days off. It's just this over and over again and I know it's from work. My home life is fantastic! I don't know what I would do without my family. I'm definitely on the prowl for something new.

Units like that aren't safe, and they certainly aren't conducive to healthy staff. There will always be bad nights in any ICU we work in, that's just the nature of the job. But in units like yours, every night is exhausting simply because of poor staffing/high acuity patients. I made really good money, and I loved my coworkers, but, in the end, the pay/unit environment wasn't worth it. Nursing is my passion, but it's just a job when everything is said and done. I refuse to sacrifice my mental and physical health and well-being just because a unit isn't properly staffed.

At my hospital, it was a management problem, and the staffing issue needed to be fixed at the level of CEO/CNO, but no one was willing to address the problems. At some point, you just have to know when to look out for yourself, and realize when it is time to walk away.

I've been burned out before. Sometimes a simple change of shift will fix it. Or stopping or starting rotating. Sometimes you need a change of scenery -- ICU at a different hospital, a different ICU at your hospital. Maybe try PACU or GI clinic or something totally different. My husband burned out in CTICU and found his bliss in critical care transport. I, on the other hand, got angry and threw a big ole tantrum. My manager announced before half of her staff, 60% of whom had been there more than a decade, that "anyone who stays in the ICU for ten years is strictly mediocre." I came home from the staff meeting and called a realtor, put my house on the market and quit my job (last day was December 22) and moved to the opposite side of the country without a job or a place to live. It fixed the burnout, but I wouldn't recommend it as a strategy.

You probably know all about good self care and it's role in the prevention of burnout. I had a VERY burned out friend who looked at her job with fresh eyes and more appreciation after getting rid of 200 pounds of abusive husband. (She divorced him; didn't kill him, although the latter would have been safer and probably made more sense.). I got a dog in the midst of an episode of burnout, and walked him without fail after every shift. All the love and attention I lavished on the dog, I forgot I was burned out, and by the time I remembered I was over it.

Good luck with your case.