My Burnout Story

[jk2185]

I've been crying all morning coming from a pain so deeply repressed and locked inside me. I watched my last patient die three days ago and leave in his wake a broken family truly taken to the depths of misery and suffering. It was unexpected as most seem to be in an Intensive Care Unit. A hopeful wife of 20 years who claimed to have found her soulmate blindsided by her husband's death.

I remember the daughter's face when she came to the bedside while I was performing futile CPR, a gasp of horror unknown to most people. Empty eyes and an instantly drained soul. They both, the wife and daughter, threw themselves on his body begging him to return from the dead.

How many times have I seen this? Too many to count. Each time, I myself have felt the distinct pain of death and sorrow and stuffed in a vault deep in my psyche hoping to never release it. How many times have I been bestowed the "privilege" to give people the worst news of their lives.

"Hi, I'm so and so, we've done everything we can, I'm sorry."

"Hi, I'm so and so, your husband's stroke was catastrophic and unrecoverable. He may not make it through today."

"Hi, I'm so and so, you are going to die and I'll be here to help you and make it as smooth as possible."

Ever had a day where you got sent home because both of your patients died?

Ever cleaned a dead body for the morgue, then gone to your 30-minute lunch break (and you only get 30 minutes, no more)?

Several deaths I pin on myself. I lost two patients last year which I "know" I had a hand in. I should have known this, I should have done that. Of course, people tell me it wasn't my fault. Does that help? No....it's a deep knowing and a horde of permanent memories I will take to my grave.

Then there's the clinical stress.

Am I doing the right thing? Do I know what I'm doing? Ever looked at a med vial 5 or 6 times because you keep second-guessing what you're giving? I used to go home after a shift and read up on things I encountered during a shift that I was unsure of. I used to read textbooks for leisure. I've got ACLS forwards and backwards. Pretty sure I can interpret rhythms better than some of the residents. I'm not trying to toot my own horn; just pointing out that this drive (which according to popular belief is a good thing) has driven me off the cliff into a world of immense suffering.

Maybe I just don't know how to cope.

I thought having a couple beers or glasses of wine was the way to do it. Laughing with your coworkers about how messed up your day was or just venting to your innocent spouse. OR MAYBE, there's a better way to do this so that able people like myself aren't lost in this dark forest of despair. I've heard of certain facilities offering post-death huddles or post-major event huddles. Now I understand that's not plausible on a unit where 2-4 people die or have a major event a day, but something has to give. You're supposed to "buck up," or my favorite I've been told is "this is a sink or swim place." HA!!! What a joke. No wonder I'm where I'm at today. People aren't meant to be able to handle these kinds of stresses at their full-time job. I do remember a clinical instructor I had (a critical care guru) telling me that ICU nurses typically have a two-year shelf-life before changing disciplines. I remember thinking, "what weaklings, two years is nothing; I can do it."

It's torn a hole in me. I quit my job yesterday. I don't sleep. The formerly strong, I can do anything, level one center, highest acuity, give me the sickest of the sick gunslinging cowboy has changed. I'm having trouble leaving my apartment. Time to get a good psychologist. I don't know if I'll be able to ever touch a patient again. This is hands-down the hardest thing I've ever done. I hope I can heal. I hope this reaches someone else out there experiencing something similar. Burnout and PTSD are real. Don't let them steal your life.

my-burnout-story.pdf

[freesia29, ASN, RN]

I too have compassion fatigue and anxiety. I have only been an LPN for 3 years. I think constantly running short staffed is burning out a lot of nurses. I am also quitting my job and am grateful I can take some time off to heal myself and take care of me. Last year I contracted EBV and I have been struggling ever since.

[Sensibility, BSN, RN]

There is a balance in what I have to say. On the one hand, our job as medical professionals must be to preserve life; but on the other hand, we have to accept death as a possibility. We are often not in control of that outcome. We do what we can and that is all we can do. Death is not in our hands and we cannot stop that process if it is going to happen. None of us will be here forever and all of us at some time will experience death. I have seen babies die. I have experienced death in family and friends. The longer I live, the more people that die. My mother, my best friend, passed away 3 years ago. My father passed away a year and a half later.

I believe our society is not prepared for death as a part of life. We think that death is abnormal. It's not. So many people today have unfortunately embraced atheism; and even if some don't believe they are atheists, they wonder if this is all there is? Judging from the lifestyles and ideologies of many medical professionals, I don't believe many of them make God a priority or know Him. Is it just about being here, being married and then leaving the planet? I know there is a heaven. I know that being prepared for this eventuality is probably the most important aspect of a person's life that they can do for themselves. I know that I will see my mom again for all of eternity. My mom had faith in Jesus Christ and I know that I know that she is there as is my dad and so many of my friends who have gone before me. I believe in Jesus Christ and have been changed by His grace. That's all that matters.

We can't expect that the pain of death will go away. Nobody will ever be able to replace that person who died. Some deaths are very tragic. Other deaths are so desired due to the pain and suffering the person is experiencing. We who are left though miss that person. I believe that it is unrealistic not to embrace that pain and shed some tears of sorrow. I am crying for myself because of that loss and how much I will miss that person. That is what should happen. We live in a world that does not embrace pain and sorrow. We are expected to bounce back and be our jovial selves again instantly. Nobody can accomplish this and so there is the frustration of wanting to be happy but feeling that intense sorrow inside. People say things trying to make us feel better but really can anything take that pain away? I don't think it can. The hardest part of losing someone is not that moment of death but the moment six months down the road when we wish they were here to talk to and share a moment with. As medical professionals, we too experience that loss. We meet these people and they become a part of us to a certain extent. Mourning the loss of a patient is a real aspect of being a nurse. It is normal.

[Kris1969]

I can't imagine working in an ICU setting - and to still feel each death means you have compassion and that is so necessary and yet it beats us down . I work in a small city ER - we see everything. Suicides hit me the hardest. Some days I feel like I can't cope with someone dying and then a person screaming at you that they need a prescription filled .

Take time to heal - you've given and given and now it's your time to take.

Thanks for sharing !

Krista Manitoba Canada

[dec2007]

Sometimes it's the suffering and death that is unbearable. Other times, it's the waste of a young life, with all its potential now gone. Sometimes it's that the management (who still write RN after their names), who have been away from the bedside so long that they have no clue why you are devastated. Sometimes I can't put it into words, and I just look at my coworkers and say "Nobody really knows what we do, do they? Even if they want to, they just don't get it."

[Dixie girl]

I hear your pain! I knew for at least the last 10 yrs of my 38 yr career that I was burning out but thought I was tough enough to handle it. I tried working different types of nursing trying to find something that was less stressful but it didn't work. I left with the guilt knowing I had failed my career, my family, and mostly myself!

Now I'm 60 yrs old, living on my pension and what's left of my 401k. My family and husband don't really understand and only see the financial burden I have put us in.

I have Fibromyalgia, chronic migraines, osteoarthritis, IBS, and type 2 diabetes. Have been trying for disability for the last four years and right now my life sucks!

When I am asked if I would go into nursing again, I say not only no, but hell no! I was a really good nurse and helped a lot of people but the price ended up being too high.

[wyoRN0987]

First let me say, your post prompted me to join allnurses (instead of just lurking to read the articles, ha!) just so I could comment. It really struck a chord--my heart goes out to you. I totally understand everything you said and just reading it and the other comments has helped me cope with my own critical care encounters. You sound like a brilliant, dedicated nurse and I hope you are able to get back to a mental space where you can practice again. That being said--take some time off! Start living again, travel, go to therapy, talk with other nurses/EMS/MDs, people who know what you're going through. Try lots of different things, there is no one way or right answer in dealing with death, sorrow and burnout. Someone mentioned a book they'd read in school, so I hope you don't mind my suggesting one too--"Man's Search for Meaning" by Viktor Frankl. He was a psychologist and Holocaust survivor and it's about what gets people, from a psychological perspective, through the worst experiences life has to offer. It's a little book but very, very good.

Again, let me say thank you for sharing your story, you have helped me more than you can know.

[CURLY56]

I've been a nurse 28 years. Hospice, AIDS, Cancer, ICU, Tele. I can't tell you how many pts I've seen pass away. I've held a hundred people in my arms as they die. I'm still haunted by deaths I've seen 20 years ago. I've had to tell children they are going to die. I've had to call mothers in the middle of the night with the bad news. But I counterbalance this by thinking of the lives I've saved, hundreds at least. Nurses are like soldiers in a battlefield. We have to go on no matter how bad it gets. If we don't the war is lost.

[power%away]

Nurses have compassion for everyone but themselves. We need some concrete ideas to come forward. There is real battle fatigue here. We need mental health days. We need support of doctors, chaplains, grief counselors and administration. We don't want token help of pizza, etc.. Nursing needs administrators to show up and step up with flexibility and compassion for those that keep their doors open

Nursing needs to demand a place at the table.

What about changing units, rotating in and out of intensive care units? What about recognition being vacations or extra time off? Ideas please.

[Jlangford1]

I also am in the same boat. I was a STICU nurse forn2 years. I am now seeking help for agoraphobia with panic disorder. I would rather stay in my house with my dogs than go out into "the real world" every aspect of my life has changed. I was a RN for 13 years but now I don't even know if I ever want to be a nurse again. I used to feel good about myself and what I did. Now.....not so much. Good luck to you

[Luckymut]

My breaking point was when my dad arrested in the back seat of our car.,we were 10 miles from the nearest hospital, and at least 15" from the nearest ACLS rig. It was agonizing realizing that CPR was fruitless and the medics telling me they could not stop because I did not have is wishes on me. I had to watch them flog him on the side of the road for 20 minutes while begging them to load him and go. I never again want to do CPR on another living being. After 33 years at the bedside, I have walked away. It's been 3 years.

[dec2007]

Nurses have compassion for everyone but themselves. We need some concrete ideas to come forward. There is real battle fatigue here. We need mental health days. We need support of doctors, chaplains, grief counselors and administration. We don't want token help of pizza, etc.. Nursing needs administrators to show up and step up with flexibility and compassion for those that keep their doors open

Nursing needs to demand a place at the table.

What about changing units, rotating in and out of intensive care units? What about recognition being vacations or extra time off? Ideas please.

Our vacation days are also our sick days, so I think extra time off (i.e.:mental health days) would be the greatest perk ever!!! One year our manager had a message therapist rotate through all the Units doing chair messages. That was really nice for the folks who were able to step away from their patients for 20 minutes. Most recognition comes in the form of food or candy, which I could really live without.

[PancakeSaturdays]

So, so sorry Another Broken Healer.

Good for you for knowing your limits.

I wish your facility would have practiced a post-death huddle. Seems like the only chance a person could have of surviving in ICU for very long would be to have that type of support.