My Burnout Story
I'm a CVICU nurse that recently broke down and quit due to the experiences, death and suffering in particular. I'm a victim of burnout and PTSD. I'm hoping to publish to get my story out so it reaches other nurses or providers in the same situation.
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.Last edit by Joe V on Jun 15, '18
About jk2185, BSN, RN
Im a former CVICU/CCU RN, former LPN that has worked in LTC, Urgent Care, PCU, and ICU.
Joined: Dec '11; Posts: 34; Likes: 116Feb 10, '16My heart goes out to you.
My last EMS call was a 2 y/o that died in his sleep. No abuse, no one blame. I can still hear the mother's scream when we told her he was gone and it was almost 20 years ago.
I quit as soon as we got back to our station. I ended up traveling & healing for a year before deciding to go to LPN school.
Therapy is a good idea. Try to remember a time that you were happy or at least at peace and do what you can to recreate that. Time with friends, family or even by yourself- if that is how you heal. It's the little things that will heal you. And time.
Be good to yourself.Feb 10, '16This is my greatest fear. My goal is to end up in the ICU some day. However, I fear reaching my breaking point as you have. Please take care of yourself.Feb 10, '16So sorry for what you are going through. Time to take care of you. It is ok to be selfish. Get therapy, go on vacation, get a massage etc. Do whatever you need to to feel better.
You are right..you do not have coping skills. That is not your fault. Your coworkers never taught you to do it in a healthy way. 10 to 1, they are not coping any better than you are.
When I was a new grad, my first job was in peds hem/onc. My coworkers told me the same crap yours did. We never had debriefing. We never talked about the incredibly sad things we saw each day. We had some weeks where some poor child died every shift and my coworkers were walking around like it was nothing. There were times I wanted to scream at them, "ummm HELLO, today SUCKED!!!". If you dared to show emotion (appropriately of course, away from pts/families) you were labeled as weak, told to buck up etc. Its just not healthy. You know what happened? Those nurses were clicky, angry, and ate their young. They were amazing nurses and I learned a lot from them. They were just lacking in the interpersonal skills department. I lasted 18 months and left broken, clinically depressed and told I needed to find a different career because there was something wrong with me b/c I had trouble handing the emotions of the job. Luckily I did not believe them. 18 years later I am a damn good APN. Prior to going to grad school, I found a nursing job where I was supported and thrived. It took a lot of years to undo the damage they did, but I got there. OP, you will too. You just need to get back to being you and deal with all the grief you locked away for two years. Once it is gone, you will feel a lot better and have a much different perspective on things.
We do ourselves a big disservice as a profession. We do not have to always put on a brave face and not deal with our emotions. We see horrible things. Its ok to react to it once the patient is taken care of and we are in an appropriate place. I know there are units out there that do this in a healthy way. We need to follow their example.
Best wishes!Feb 10, '16I lasted a year in ICU. I'm working L &D now, hoping to heck that I'm not too jaded to still be a good nurse.
I loved trauma/Icu, I hated the dying, especially the long, drawn out deaths. My last one was the day before I quit.
It still haunts me. A young guy whose family wanted everything done, yet couldn't believe he was sick enough to come be by his side as he died on full support, drugs and ventilator. Ugh. Horrible. I didn't get a debriefing either. I had 6 withdrawal of cares during that year, never did have any thing to support me during those times. It's the nature of the beast I suppose.Feb 11, '16Your message strikes a chord in any nurse who has an iota of compassion left. I have not experienced the same things you have but I have experienced burn out and a strong desire to talk with someone who understands what I am going through.
You did the right thing - walking away is extremely hard but you have to take care of yourself. Whatever that takes - do it! I have quit a job because I just had no more to give. My husband says I care too much - he may be right but I don't know how to be a nurse any other way. It won't always seem this dark but right now you have to nurture yourself before you can think about caring for anyone else. My heart goes out to you and I wish you the very best. Take the time you need to renew yourself.Feb 13, '16So sorry you went through that. I worked oncology, we all cried sometimes because we all got attached to patients/families at times. Unfortunately you did not have co-workers to help you "decompress." It was not you, it was the environment. Breathe - it DOES get better. You sound like you need some help to cope - PLEASE get it!Feb 13, '16My heart is with you. I am so sorry that you have experienced this, especially since it was not a one-time thing but a pattern of stress.
I can't imagine working in a CV unit without some method of debriefing. We had one code in PACU when I was a student, and that is such an incredibly rare occurrence that I wasn't surprised we didn't have a debrief, but that doesn't mean we didn't need one. Just because it's a common occurrence doesn't mean people "should get used to it."
You have a wealth of knowledge, and I hope that you will redirect your knowledge and experience into a different nursing area. You don't have to work critical care; you'd be an asset in any area. Do seek some help, and don't give up on nursing! Heck, you'd be an amazing mentor to new critical care nurses or could help develop programs to support nurses in high-stress specialties. Maybe a longer article for AN? Good luck to you.Feb 13, '16We all need a healthy way of coping, or a unhealthy one will find you.
Sounds like you never developed a professional persona, no one can handle daily personal death and suffering without it breaking you. somethings have to be kept at arms length.
You will have to let go or you will drown from everything you are trying to carry.
good luckFeb 13, '16Effective coping mechanisms are important in high stress units. This year makes 19 years as an RN. 18 of those years in critical care. I have been in a highly acute trauma icu for the past 14 years. Our team has seen our share of death. We have run protocols, pumped large volumes of fluid into critically injured patients in a matter of minutes, hugged families, and have gone to funeral viewings to pay respects to the families. I have found there needs to be some professional distance in these types of areas if you want to remain effective and "right in the head". Some of the things we do on a daily basis would mortify the lay public. Therefore we must find a way to deliver care that is compassionate, evidence-based, deliberate, and effective. Once we began to focus too much on emotions, we become ineffective. I had to learn this about 17 years ago. This doesn't mean you don't care, but it preserves your mental health and promotes clarity. When you start to require "a drink", to deal with emotions, you open the door to a different type of crisis.Feb 14, '16Currently, my nursing program requires us to take a death and dying class which is supposed to prepare us for these type of situations. One of the books we are reading is Compassion Fatigue and Burnout by Vidette Todaro-Franceschi, which happens to be my professor. The book is amazing and my professor is very inspirational! I highly suggest that you read it, she has 30+ years of experience and she's just a great person in general!Feb 14, '16Thank you so much for writing this. I want you to know that I just applied for a research fellowship to study this exact thing. I'm specifically studying burnout and compassion fatigue and how it relates to nursing students/schools of nursing. Is enough being done at that level to address BO/CF and what can change? My ultimate goal is to help prevent BO and CF in all nurses because its effects are devastating. More support of nurses experiencing this is needed. Please don't blame this on yourself--it makes complete sense that you're experiencing this.
I just wanted you to know that I'm working hard for you regarding BO/CF. You are not alone and I'm really sorry you're going through this. <3Feb 14, '16Quote from KCMnurseThis is a great reply! Thanks for saying this.Your message strikes a chord in any nurse who has an iota of compassion left. I have not experienced the same things you have but I have experienced burn out and a strong desire to talk with someone who understands what I am going through.
You did the right thing - walking away is extremely hard but you have to take care of yourself. Whatever that takes - do it! I have quit a job because I just had no more to give. My husband says I care too much - he may be right but I don't know how to be a nurse any other way. It won't always seem this dark but right now you have to nurture yourself before you can think about caring for anyone else. My heart goes out to you and I wish you the very best. Take the time you need to renew yourself.Last edit by InTallGrass on Feb 14, '16