Burnout?

ss07 · Nov 9, 2007

Hey Yawl, I'd like to chime in. I'm a prison nurse and I'm tellin' ya. Those guys act like they're at a five star hotel sometimes. It's truly amazing. Entitlement is the precise word that comes to mind. I don't care if they're a mass murderer, they still feel entitled. Geez

CseMgr1, ASN, RN · Nov 9, 2007

Part of the problem with the general public is that they have NO idea what we really do.

Nope, and they don't CARE.

cooblu · Nov 10, 2007

nope, i know what you saying. all you can do is take whatever issues arise at the point of which it has become your problem (can't go back in time) yeah the next patient doesn't care about the next, so i don't waste time explaining. you just have to be self assured that you REALLY did what you could and prioritized properly. i like coffee too but it's way dowwn there on the list. shaving ... well sometimes i miss a day or two myself.

cooblu · Nov 10, 2007

Evidently not.
I think everyone feels this way, at least some of the time. Only you can decide whether you feel this way enough of the time to get out of Dodge for good, or maybe just for a vacation. (Really, I think this problem could be solved very simply: Double--maybe triple--our pay, and give us at least four 2-week vacations per year--with the option to take them back-to-back.)
Eh--back to reality: I recently had a pt who was herself very upset, and whose husband chewed me out first thing on my shift. I did point out that I just got there, but his point was that they'd been there a couple of days and their concerns hadn't been addressed. So I listened, then assured them I'd do everything I could to see that the concerns were adressed, even if it meant calling the attending at home. (A lot of their problems were things only a doctor could fully address--including the ever-popular "I've been here X days and haven't seen a doctor once!")
Happily, a more concerned resident was on call, that shift, and when I advised him of the situation, he got a lot of things moving. One of their big concerns was that she hadn't been getting some of her home meds, and the resident was a bit ticked that it hadn't been taken care of during her admission. He rectified that right away, and saw the patient as soon as he could to let them know what was going on, what the plan was, etc.
Best of all--I got credit for getting the docs on the stick! But I did tell the pt and family where the doc deserved the credit.
There were nursing interventions where I could help, and did my best to do so. Biggest was prn pain meds in a timely manner. Pt had major pain (chronic) and was opioid-tolerant. Didn't make her feel like a junkie for needing 4mg IV MSO4 every hour, but reinforced the view of one of the "bad" doctors that this couldn't be a permanent solution, with more tact. Did a godawful lot of therapeutic listening. Fetched water, pillows, etc., right along with the aide.
Two twelves with this pt, and some other moderately busy ones, was wearing me pretty thin. For my third, she was assigned to another, fresher nurse who was feeling my pain by 2200. She managed things a little differently, but in an equally caring way, and they liked her just fine. So all went well, but I was notified that I couldn't leave in the am without stopping by my former pt's room for a hug.
Pt's husband remarked that I was the first person they'd seen who had treated her like a human being. I'm not sure how fair that was, but there is a satisfaction in turning a patient's negative impression to a positive one. Which isn't to say I don't cherish the ones who are "good" patients from the start. Or that there aren't some who no amount of empathy can satisfy.
As a relatively new nurse, I rarely--well, pretty much never--get to feel like I've gotten a desperately ill patient and had a lot of direct impact in getting them better. I'm delighted when a pt doing poorly starts doing better, but mostly I'm just carrying out doctor's orders, and sometimes getting more experienced nurses involved. I'd be hard pressed to think of a single case where someone is alive today because I was their nurse, though I know nurses who could very well say that.
I do get to say that some of my patients had a better stay because of me, that I've run my butt of and charted in doorways to keep a patient out of restraints, and even that I've let patient's families vent when that was the only thing they could think of to help their loved one.
Golly! If I could do that every time, with every patient, I bet I'd be some kinda saint or something. Alas, I've spent enough time kicking the med cart and cursing to disqualify myself. Sometimes you just give the PITAs the least of your time that's necessary and pray for the shift to end. We pretty regularly get a patient or two that no one is assigned to two nights in a row, to avoid pillow-therapy.

many times a complaint is legit and can be taken care of relatively easy. who cares who gets credit really, you know what you did. take your oportunities.

cooblu · Nov 10, 2007

Ahhh...let me think about the last facility I worked in!
* a FOUNTAIN (3 stories high!) at work.
* NICE ART. Lots of MARBLE.
* Elegant sheer drapes that were nicer (and more expensive) than what I've ever had in my house. (Windows are so cold and impersonal)
* Music piped in the entry during the day that sounds like BIRDS (at night it's a FROG medley).
* Add VALET parking.
* Don't forget the BABY GRAND PIANO and the musician (haven't had lessons in a long time - I tried and disappointed patients - again!) to play it all weekend.
Nah - this is NOT my current work. But this one was at my LAST position (ED RN). I think that the niceties were a PART of my reason to FLEE. Actually, the BIRDS and FROGS are what pushed me over the top! (I did NOT know they were piped in for several weeks. I'd spend some time looking for all the birds - but, since I could NEVER find bird poo, I was SUSPICIOUS :eek )
Okay...maybe in wasn't the facilities as I sit here typing. Maybe it was the fact that 9 nurses had quit in 11 weeks. Both the Administrative and Clinical Managers had given notice. The MD's had declared "Jihad, on the nurses. You guys will do things our way or else." And the 30 minute guarantee (your treatment will be started and you will be seen by a doc in 30 or FREE MOVIE TICKETS). Add the fella that blew his head off at the WR doors and well, I was desperate to GO.
Anyway, GO I DID. And I have NEVER looked back.
I took almost 4 months off. I have been out of hospital nursing for almost 15 months and I will NEVER go back unless it is out of extreme financial necessity. Never say never! I do love my job now. I love my co-workers. Heck, for the most part I even love the patients. So, there is hope out there - just work to find something you love. I know that I could "make more" per hour in the hospital, but even now I'm making approx 60K and it is humane. (Your money or your life!) I do have to maintain high levels of educational offerings and competency verifications. Yes, some days it is difficult - multiple flights, take-offs/landings, in and out of the helicopter, heat/cold, working in small spaces, limited help, lots of heavy lifting - but, it is overall a great job. But, the main thing that makes it great is the RESPECT factor. When we show up, I am always a little astonished at how well we are treated. I am actually asked for my findings and my opinion by attendings - it is great. But, I am a bit bothered at times - I AM THE SAME NURSE I WAS LAST WEEK/YEAR. Hmmm...wonder what that means?
My main advice. Find something that you LOVE to do. If you are not "ready" now - work toward that end. My husband (although he did at one time threaten divorce if I got on a helicopter) is supportive - actually, he insists that I NEVER go back to the way I was when I worked in the ED. The person I was scares him - I think! He notes that he has no anxiety about my job. He is thrilled to have a happy, focused wife that sleeps well, eats well, is not tearful at all times, very rarely has a drink and is PLEASANT.
I believe there is something out there for everyone.
Good LUCK
Practice SAFE!

sounds like you did right by "getting th' hell outa dodge". i 've seen this affluent crap used for recruiting and if you have any capacity of reality you know this is not reality. up in those rooms & halls is a different world indeed. i work now only by contract and this kind of "marketing" does not impress me. what impresses me is a civilized work load, adequate help, and a paycheck i'm okay with.

cooblu · Nov 10, 2007

This is why I work Travel and per diem. With travel I am gone right around the time I am ready to pimp slap someone and with local agency I just say "don't send me back there, it sucks" once the agency nurses put the word out on a place they can't get coverage and they straighten out their issue real fast.

exactly! and so it goes for some of those agencies

cooblu · Nov 10, 2007

frustration and loads of it. what i'm reading is certainly true of bedside nursing. still i early on was climbing the ladder of the business/marketing part of hospital healthcare and i understand (kind of) why. i come to terms with myself (to yourself be true) and returned to bedside for several years now. i'm concerned about the near future of nursing, the numbers of us aging old farts are overwhelming. i see nursing students or new grads and i don't know where to start escept to prepare themselves. if i were to in position to be hiring nurse in a facility i would put a sound sense of humor and ethics up with clinical skills and education. my goal is five more years, if thats possible.

Ruby Vee, BSN · Nov 10, 2007

i can't say that i hate them, but i sure do hate their behavior. our society has permitted bad behavior for so long and made excuses of all types for why those people should be allowed to continue as they have before. now they are being enabled to continue on, by our self-same society. wrong is still wrong, it doesn't matter who does it. making excuses for bad behavior makes it no less wrong! the right to act as an a$$hole ends where my rights begin. the 'hated' people are the ones that don't realize that nurses (and other members of society) have rights!

people have become a lot more boorish, entitled and rude over the 30 years i've been working as a nurse. and some nurses continue to make excuses for their bad behavior. "they're stressed because their loved one is ill," or "how would you feel if you were visiting your father in the hospital and he hadn't been shaved?"

i've been in the hospital as have my parents and dh and i've gone out of my way to be polite and respectful of the staff and of their time. i can understand that a small percentage of the population doesn't know how to behave because their parents never taught them but that percentage seems to be growing pretty danged fast! we as nurses need to stop making excuses for bad behavior and instruct people on how to act if they don't already know. it's unfortunate that people didn't learn this when they were still little and cute, but there you are.

a simple "please don't talk to me that way" may be all it takes. on the other hand, you could whack some folks with a 2x4 and not make an impression!

maconnurse · Nov 10, 2007

Personal hygiene is very important to families. Especially having daddy shave is one of them. You look sicker to me when your hair is unkept and you have a beard. Unfortunately, the staff to patient ration now does now allow these little extras. I as a nurse provided much of the personal hygiene for my father when he was in the hospital because I knew the situation. The average public does not understand this and probably never will.

It is easy to get burned out when you fill you are just treading water and never swimming. Hang in there.

KJB_65 · Nov 11, 2007

My family and friends have a running joke about how long I stay at a job. My record in the same spot is 2 1/2 years. My answer to them is always the same. "you try doing this crap".

lindarn · Nov 11, 2007

Personal hygiene is very important to families. Especially having daddy shave is one of them. You look sicker to me when your hair is unkept and you have a beard. Unfortunately, the staff to patient ration now does now allow these little extras. I as a nurse provided much of the personal hygiene for my father when he was in the hospital because I knew the situation. The average public does not understand this and probably never will.
It is easy to get burned out when you fill you are just treading water and never swimming. Hang in there.

But isn't it about time that we informed the public of the charade that is their health care? That we spend more time documenting what we are supposed to do, but never really have the time to do it? That more and more professional nursing care is being provided by unlicensed assistive personnel, not the educated, registered nurse they though they were paying for? That we have 100% of the responsibility, and accountability, but none of the control.

We have become enablers of the hospital admistration who have allowed this to progress to the point that it has. Rather than saying, " this is impossible to do, and we refuse", we say, "we will just work harder, and not take breaks, get out an hour late, and not even put in for overtime for our missed breaks, and the late exit out of work. And oh, I can come in on my day off!

Why do we do this? Some one put an end to this madness!! Stop playing the "martyr mary", and make the changes that are needed. Support the nurse who speaks up and the staff meetings. Inform the patients what the nurse patient ratio is. Tell them how many patients you are responsible for. If the hospital complains, call the news and TV stations, and go public. It is about time.

Lindarn, RN, BSN, CCRN

Spokane, Washington

registerednut1221 · Nov 11, 2007

But isn't it about time that we informed the public of the charade that is their health care? That we spend more time documenting what we are supposed to do, but never really have the time to do it? That more and more professional nursing care is being provided by unlicensed assistive personnel, not the educated, registered nurse they though they were paying for? That we have 100% of the responsibility, and accountability, but none of the control.
We have become enablers of the hospital admistration who have allowed this to progress to the point that it has. Rather than saying, " this is impossible to do, and we refuse", we say, "we will just work harder, and not take breaks, get out an hour late, and not even put in for overtime for our missed breaks, and the late exit out of work. And oh, I can come in on my day off!
Why do we do this? Some one put an end to this madness!! Stop playing the "martyr mary", and make the changes that are needed. Support the nurse who speaks up and the staff meetings. Inform the patients what the nurse patient ratio is. Tell them how many patients you are responsible for. If the hospital complains, call the news and TV stations, and go public. It is about time.
Lindarn, RN, BSN, CCRN
Spokane, Washington

Amen! By some estimations, the US alone is expected to be some 1 million nurses short by the year 2020. Yes, that's 1 MILLION! At the rate things are going, I think that estimate may be way too low. For all of the patient's and patient's families who expect someone to come charging into their room full speed ahead every time Daddy needs a cup of coffee, they need to stop and consider that there will come a time when Daddy is lying there in cardiac arrest and there will be NO ONE to come to his aid. Why? Because nurses are so abused at this point that they're leaving the profession as quickly as they came into it and they are NOT recommending that anyone else chose this as a career. I am sick and tired of being expected to do the impossible on a daily basis with limited resources and limited time. I had one patient who actually told me "that's what you get paid the big bucks for!" Big bucks my @$$!