am i getting burnt out?? long one!

akcarmean, LPN · Mar 2, 2008

i have never worked in an icu so i can not say i totally understand everything but i do understand a lot my prayers go out to You in hopes that You can find the peace and answers You need Angie

Perpetual Student · Mar 2, 2008

Up front: I'm not an ICU nurse, I just am interested in becoming one later after I become an RN (I'm an LPN now and did do some clinicals in an ICU). That said, I do have some experience dealing with vents, and people whose lives have basically been all but destroyed. I feel some of the same frustrations that you do, but I am able to motivate myself by realizing that I can make the patient's situation at least a little better, even if I cannot cure what is wrong. And sometimes that's enough, even if it's not ideal.

In some cases, your interventions WILL be successful and someone will be able to go on and continue with his/her life. Of course, there are people who, ethically, should just be allowed to die, as there is no fixing what is wrong and they're resuscitated only to suffer further. If my job entailed codes on such people all the time, I'd probably pull out my hair.

Life can really suck sometimes, and you're often seeing people who're in the deep end of the suckage pool. I wish you the best in either coming to terms with the negative nature of certain aspects of your work or in finding a position that suits you better.

Dinith88 · Mar 3, 2008

just wondering if any of you other ICU RN's feel like you walk around with blood on your hands all the time? Been in the SICU almost a year now--night shift. Don't get me wrong, i love my job--love doing all the cares for my patients, love having an amazing team of MDs and other RNs around me, thrive on the challenge of constantly learning new things, and a billion more tiny things that make my job wonderful. but, seeing something as violent as CPR and ACLS, watching people younger than myself dying with questions still in their eyes--it haunts me. it's like a shadow constantly on my shoulder, like the alarm bells that i dream about at night. I've got friends on the tele and medsurg floors that i try to explain it to, but they just don't seem understand me. I love my job! i relish it! but i just don't know how long i can do it--like the violence of it all is wearing me down. I don't know if it's just cause i'm naive, and this is growing up, or if this is me starting to get burnt out or what. I don't want to get burnt out. I just wish i could forget some of the things that i've seen, that i've done to try to help someone. I want to forget the cries of the wife of the man we just coded three times after we finally called it at 1548. I want to forget to way a pt's orifice gapped open from the FMS. I want to forget about the pt with a black right foot due to a clot that happened in a different hospital from a perfed bowel. I want to forget the mom (who happened to be my age) and the fear in her eyes as 4 MDs tried to decide how they could/should fix her aneurysm, while her baby... but i can't. maybe that's just an ICU nurse's burden. but it's a ******* heavy one.
I'm on vacation right now. trying to get away from the shadow that i can't seem to get away from. You know the phrase--do unto others as you would have them do unto you? well--the last thing in the world i want is to be a pt in an ICU, even my own. I know i would get compassionate RNs and MDs, and the best medical and nursing care available, but given the choice, i would much rather just be dead. I think part of my problem is that i feel guilty. Guilty for condemning anyone to something I wouldn't be able to deal with. Guilty for knowing that the definition of 'torture' is too similar to the definition of the ICU (taking away dignity, restraining, no sleep, pain, no ability to speak, ect.). and angry at friends for not understanding why i want them to make their parents in the hospital DNR/DNI. angry at my MD dad and sis for not understanding the burden i carry, despite their understanding of my medical terminology. angry at the public for not seeing what we do, and not discussing things like codes and ventilators and such--for hiding from it. and angry at myself for not being able to grieve for the patients i've lost--for burying it with laughter and jokes and pretending like i'm strong enough to carry them all.
am i the only one who feels like this?

You're so young and just starting on your nursing 'journey'...so i wouldn't jump to any conclusion that you're 'burnt out'...(thats kind-of a vague term anyway)...

But...the vibe i get from your post is that you're a very sensitive person...and these are simply growing pains. These experiences and feelings can either drive nurses away from the ICU...or...they are what gives us our hardened skin...and allow us to deal with this stuff every day. (or drives us to drink :uhoh3: )

I hope these emotions you're dealing with dont drive you away.

If you were new to the ICU and indifferent or un-phased by the 'stuff' you may have other issues...or not have an authentic 'heart' for nursing.

Hang in there!

Dinith88 · Mar 3, 2008

seeing people who're in the deep end of the suckage pool. .

'Deep end of the suckage pool'... :smokin:

(i feel like i'm stuck there sometimes...like when my alarm goes off in the morning...)

hikergurl24 · Mar 4, 2008

You are an ICU nurse. This means you must do things that seem inhumane and not even kind sometimes. And although you may have your demons, there are times that these things you are doing brings a loved one back to life, and back to their family. It is hard to see the injustice of a drug dealer recover and an 18 year old die a death that is unjustified. Our eyes are open to a whole different world, and we are the people that fight that fight, but it also develops a character that hopefully you will come to peace with. A person that can give someone their last bath, can hold a hand, or look into their eyes an see that real person (regardless if the media sees it, or if friends understand it) will give that patient something much more important than medical care. Who else can claim they do that for a living? Take deep breaths and realize you are giving your patients something more important than sometimes even living, which is their last chance at dignity.

VivaRN · Mar 7, 2008

I went through a similar period as a new nurse in Burn ICU. It sounds like you need some support - a good friend or, even better a co-worker or mentor you can talk to who understands. You can't force people to understand or want to understand where you're coming from.

The way I see it, the job can be very wrenching and painful at times. It can be violent, sometimes to an end you don't agree with. As an ICU nurse you get to be there, helping guide patients and families through illness, vulnerability and death. Is it easy? No. But who chose ICU because they thought it would be easy? Even when you can't fix the patient you can help them cope with what they're going through. If you have to do something aggressive to save a person's life, it may be violent but you have to give that person their best shot.

The best advice I ever got came from our unit social worker, who told me "It is what it is. Just do the best you can." That's all you can do, and that's ok.

The haunting feeling gets better with time. I'm not working in the ICU currently but I remember certain situations very vividly. Although these situations were very sad they don't have the same bite 4 months after as they do 4 days after. It's a process, and maybe how you feel right now is one step in that process of moving through. It might help to keep a journal, or even just go for a walk and reflect on how far you've come since you began in the ICU. Try to put it in perspective.

Best of luck, I hope others will come along and offer their thoughts as well.

MommyandRN · Mar 18, 2008

Honey I understand every WORD. I am completely with you. I have always been affected by the "disturbing" aspects of ICU and it has made me completely paranoid these past 8-9 years. I have recently been floating to floors and have realized that the floors are more my style and that ICU may not be for me. I suggest looking into a job change.... med/surg floor, ob, er, anything other than critical care.

sweetsmiles2007 · Mar 19, 2008

that's the crazy thing though--my unit has been going through a time of low census, so i've been floating out to tele. Tele bores me out of my mind. i hate all the charting, i really don't like having 2 hrs or less for each pt and i miss the rush and the teamwork of the ICU. I love where i am, i don't want to be anywhere else. i think i just haven't gotten that hardened ICU skin yet--too sensitive. eh--i guess i'll get it eventually

thanks everyone for your support!

bluefabian · Mar 21, 2008

I've seen bad things and deaths in both of my two fields and it still haunts me. If you think acute is bad, wait until you deal with chronic patients.

I hate the feeling that I make less to no difference in quality of life to patients who are weaker and getting worse by the day. Doing dialysis now, I saw how many of my patients died or deteriorate further. Chronic Renal failure secondary to DM that eventually affects the vision - seeing them getting blind and bumping into things when they weren't. One leg amputated the next week, now wheel chair bound when last month they were up and about. Elderly people bedridden or having to use assistive devices after an incident of fall, related to bone calcium loss (as the effect of renal bone disease). Congestive heart disease that could be fatal anytime.

And all that i did was life support or life sustaining or whatever. Not much different in what I did. Just prolonging life. Maybe add a bit of quality of it. But not much.

That's why I am considering to move field again. I want to see instant or eventual results that shows improvement. i wanna see some of my patients discharged and get better.

WanaBdun · Apr 5, 2008

At least you recognize what it is that is bothering you. You are devloping that black humor that nurses have and you are no longer naive to what is done to people when they are ill and want everything done.

Give yourself time, and more time. If you are particularly affected by something that happens, take time off to deal with it. I know you dont have months on end, but take a day or two to face yourself and your issues. You will prevent the slow burn from taking over if you deal with it. If you shove it and pretend nothing is wrong, you will end up burnt for sure.

It does get worse. I could tell horror... HORROR... stories about things I have seen, and yet that will not make it any better. Use your experiences as chances talk about end of life issues with the living.

And there is nothing wrong with feeling this way. You probably identified something that many have a hard time dealing with because they don't know what it is they are feeling.

bollweevil · Apr 11, 2008

just wondering if any of you other ICU RN's feel like you walk around with blood on your hands all the time? Been in the SICU almost a year now--night shift. Don't get me wrong, i love my job--love doing all the cares for my patients, love having an amazing team of MDs and other RNs around me, thrive on the challenge of constantly learning new things, and a billion more tiny things that make my job wonderful. but, seeing something as violent as CPR and ACLS, watching people younger than myself dying with questions still in their eyes--it haunts me. it's like a shadow constantly on my shoulder, like the alarm bells that i dream about at night. I've got friends on the tele and medsurg floors that i try to explain it to, but they just don't seem understand me. I love my job! i relish it! but i just don't know how long i can do it--like the violence of it all is wearing me down. I don't know if it's just cause i'm naive, and this is growing up, or if this is me starting to get burnt out or what. I don't want to get burnt out. I just wish i could forget some of the things that i've seen, that i've done to try to help someone. I want to forget the cries of the wife of the man we just coded three times after we finally called it at 1548. I want to forget to way a pt's orifice gapped open from the FMS. I want to forget about the pt with a black right foot due to a clot that happened in a different hospital from a perfed bowel. I want to forget the mom (who happened to be my age) and the fear in her eyes as 4 MDs tried to decide how they could/should fix her aneurysm, while her baby... but i can't. maybe that's just an ICU nurse's burden. but it's a ******* heavy one.
I'm on vacation right now. trying to get away from the shadow that i can't seem to get away from. You know the phrase--do unto others as you would have them do unto you? well--the last thing in the world i want is to be a pt in an ICU, even my own. I know i would get compassionate RNs and MDs, and the best medical and nursing care available, but given the choice, i would much rather just be dead. I think part of my problem is that i feel guilty. Guilty for condemning anyone to something I wouldn't be able to deal with. Guilty for knowing that the definition of 'torture' is too similar to the definition of the ICU (taking away dignity, restraining, no sleep, pain, no ability to speak, ect.). and angry at friends for not understanding why i want them to make their parents in the hospital DNR/DNI. angry at my MD dad and sis for not understanding the burden i carry, despite their understanding of my medical terminology. angry at the public for not seeing what we do, and not discussing things like codes and ventilators and such--for hiding from it. and angry at myself for not being able to grieve for the patients i've lost--for burying it with laughter and jokes and pretending like i'm strong enough to carry them all.
am i the only one who feels like this?

Ah, my dear new friend, I wish I could be with you right now. I'd give you a hug, I'd hand you a drink of your choice, and we would sit together on the porch swing, overlooking the tranquil garden. We'd watch the butterflies and the birds, we'd admire the brook and the newly flowering trees. And we would talk of life.

We would watch the children play and know that this life is not of our choosing. Our hearts would nearly burst with joy as we stroked the wonderful fur of the kitty cats asleep on our laps. We would strengthen each other by coming to realize that all of this beauty, this sun-filled perfect day, the passing clouds, all of this is meant to be enjoyed and stored away in our hearts so we can call on it for sustenance when things are not so pretty - when people pass over to the next phase of their lives, when we have to do painful things to patients, when we must try to comfort the newly widowed, the suddenly motherless.

I believe your feelings are so normal because I know of no nurse or doctor I've ever worked with who hasn't experienced them. We all want to help our patients and their loved ones, none of us want to EVER be in ICU or a nursing home. Who in their right mind would choose to be so sick, so helpless, dependent? No one.

There are just some things in life that we cannot know. It is not given for us to avoid all pain or to have all the answers. For me, it is enough that God is in control. He has given me tears to cry when I'm sad and I do let them flow. I used to journal and that helped me to get my feelings expressed. I used to go with coworkers for coffee or a drink after work and we'd let our hair down and get out all our frustrations, helping each other to cope with the suffering we'd seen that day. I hope you have those outlets. You have this forum.

When I was younger, I tried to get answers, just as you are doing. When I finally realized there just aren't always explanations, I was angry with God. Gradually, that phase passed, too. And I came to accept that "I don't know" is so often the answer with which we must be content. Often, words are not the best thing. Sometimes, we just have to give people time to be horrified and in shock. We have to let them cry, scream, throw things, hit the wall. As they calm down, we can offer them the Kleenex and a hug and get the Chaplain or a volunteer to sit with them if we just can't stay. We can go to funerals of patients of whom we were particularly fond or send sympathy cards to their survivors. And we can always pray. My prayers are not eloquent. They are usually "God, help!" or, "God, why?" or "God, please comfort whoever it is." Quickly, I turn to praising and thanking God.

It is important to remember that when we praise God, when we offer the sacrifice of praise when what we really want to do is be angry with God or circumstances, that is when He can move to comfort us.

Also, as our trust in Him grows, we become steadier, more stable. We learn to not look for answers beyond the simple fact that there are no real answers except that He is in charge and He is love. For me, He is Jesus. I know other people worship in other ways and that is what works for them. You probably will find gret help from your loving, good Higher Power, too.

I hope, dear one, that you have found some moments of peace and strength in our beautiful garden. Be at peace. Somehow, all is right with the world. :heartbeat:redbeathe:nurse: