In June, 1971, as a new graduate RN, I was just like all of the rest of you.......proud and pleased with my academic and student clinical accomplishments that would launch me head-long into a career and profession that held much promise.
For those of you who are new grads, or still within the first few years of practicing Nursing in the acute care setting, there is much you can do to prevent this "Battered Nurse Syndrome" - a term I coined for myself when I was ten years down the road working fulltime, as a "bedside Nurse" in the hospital environment.
We all start out with those sharp and well-defined edges of idealistic intentions, which gradually become smoothed and worn as we grow in knowledge, self-confidence, skills, and making judgement calls day after day.
Somewhere along the way, a continuum that is an individual thing, we cross over into that place where we are confident in our skills, and "on the job" experience has taught us much, although we know learning never stops for us. It's at this juncture that Nursing becomes the "work" we do on a daily basis and brings much satisfaction.
Perhaps things have changed a lot since I went to school, but I do know that we never had any courses or "lectures" or seminars designed to teach us how to keep ourselves mentally and emotionally protected from developing "Battered Nurse Syndrome", or "burnout" as we refer to it today.
Over a thirty year span in the profession, battered Nurse syndrome visited me on more than one occasion. So, how do you recognize its insidious onset? And what do you do about it? And what exactly am I talking about when I use the term "battered?"
As Nurses we are on the front-line of human hurt, pain, and losses day in and day out. We are the gatekeepers of negative emotions on display from anyone and everyone in our environment - the patient, the immediate family, interns, residents, staff physicians, surgeons, department heads, disgruntled ancillary staff, and an ever increasing pressure to contain cost while delivering quality care. Then throw in the ever-present reality of unsafe staffing patterns and profiles. For us, the work setting is truly a "battle ground" on many fronts. We are so intent on and consumed with delivering care, we lose sight of our own human needs in all of it.
Signs and symptoms:
a growing "dread" about going to work today
feeling agitated on the job
avoiding at all cost having to deal with the "difficult" patient
"barking" at our peers
bursting into tears often throughout the shift
inability to "shake" a feeling of "just don't care anymore"
hypersensitivity to constructive criticism
a loss of sense of humor
awakening and not feeling rested
calling in "sick", when not really ill
a growing dependence on alcohol to help me "unwind"
doing the minimum required to get through the shift
inability to let things "roll of your back"
taking comments too personally, exaggerating them out of proportion
feeling confused and unable to prioritize
feeling like a "victim"
Prevention, and what can be done:
First, acknowledge that we are only human, and we all have our limitations.
Be honest, don't deny that you "feel troubled."
Find a person who is a safe "sounding board"
Talk about your feelings, don't just "stuff" them
Start journaling on a regular basis
Keep the fun in your life (outside of work)
Learn to defuse highly emotionally charged situations
Learn to "bubble" yourself when you can't walk away
Find a quiet place to "regroup", rethink, before going back into an unpleasant situation
Don't compromise what you know to be true, and right
When you make a mistake, own up to it
When complimented, say "thank-you"
Nurture and pamper yourself when off duty
Take a "mental health" day now and then (use vacation time, etc.)
Consider transferring to another area, less stressful
Cultivate your sense of humor
Ask for help when you know you need it
Contribute the good ideas you have willingly
Instead of a two week vacation, schedule several "shorter" 3 or 4 day mini-vacations
When you punch out.....leave it all there
Have and maintain healthy boundaries for yourself
Contact your EPA (employee assistance) if necessary
Don't "pretend" everything is "ok", when it is not
Develop a new interest or "hobby" outside of work
Know your limitations
Know your strengths
Don't be afraid of change
Cultivate a spirituality that has meaning for you
We work in a "war zone" today as far as health care is concerned, particularly in the acute-care setting. When hospitals went the route of "corporate America" much changed, for all of us.
Our simple, and pure "ideals" of giving good patient care are threatened on every front it seems. We deserve to be treated well, and it can only begin with us.
Bonnie Creighton,RN, MHCA
Mental Health Consumer Advocate
Sep 17, '01
Having a hobby outside you job is very important, as you wrote, Bonnie. One of the greatest misconceptions people have today is that to be happy with your job, turn a hobby into a career. I find this line of thinking dangerous. Yes, it's important to love what you do, to be dedicated and always learning, etc. But if you take a hobby and make it your means of living, it becomes work with all of the ups and downs, and all of the ties and requirements. While it's hard to believe that anyone would have nursing as a "hobby", the idea is the same. Love your job, but don't use it as your escape from daily life.
Also, nowadays, there are seminars and classes about preventing burnout. Make a point of attending. They really do help.
Sep 17, '01
As a student nurse, I really appreciate your insight! I find when I read this that allot of it goes to, not just nursing, but every career path that people take.
Sep 17, '01
some very good advice. thank you.
thats one of the best things about this forum.
i liken working in the hospital to being in a war too. in fact the unit from hell (where i must return to tomorrow) is a lot like working in a mash unit...or so i think having never worked in one.
you know the unit i have been on has been so pleasant. the patients are mostly renal and i dont mind that. the staff is so nice and there is a sense of peace there even in the chaos.
im going back to hell tomorrow...at least until i find another job. ill do what im supposed to. ill watch my back and ill document everything but i will NOT accept harassment from anyone.
i really need to get out of there. too bad cos i do like that hospital.
i can learn to like somewhere else.
burnout is a big issue. i dont want to burn out before i even really begin.
Sep 17, '01
Good article. I told my husband when we got engaged that because I was going to be a nurse, he would need to help 'put back' what work and my patients would 'take away.' He understands that I need to be 'taken care of' too, and need encouragement to take care of myself. When we bought our first house, we did a $5,000 modification (it was under construction when we made the offer) to install a jacuzzi tub JUST FOR ME
in the master bath. The builder kind of balked at first and said that no one really used jacuzzi tubs and that we were wasting our time. My husband said, 'you don't know my wife. She needs this. She's a nurse.'
What a good man. I think I'll keep him.
Sep 17, '01
Been there - done that! Essarge was right when he/she?? said these signs and symptoms are present in every career. Once you get to the point of experiencing these symptoms, it's very hard to come back to a normal life with family and friends (and people in general). We must allow ourselves to be pampered and not feel that it's our lot in life to take care of everyone else all the time
. Our career shouldn't engulf us. It should be a small part of the many things in life that make us happy. Now, let's see if I can actually heed this advice after I graduate.
Sep 17, '01
THANK YOU, THANK YOU, THANK YOU. My first encounter with a mental health patient on my psych rotation in school was a nurse. That was a valuable lesson. I worry so much about nurses. We take care of everybody but ourselves. I've seen the horrors of what you described.