help, I have burnout bad!!

eldragon · Jun 21, 2009

If it takes you that long to pass meds to 7 people, you need to manage your time better. Once you are in control, you will feel less hurried and scatter-brained and stressed out.

You are the nurse and helping people to bed over and over, is not your job. You are paid to do other things.

Perhaps sit down and make an outline of what your typical shift is like, and give yourself goals about how to do it in a timely manner. Do not allow yourself to be distracted.

You will drive yourself crazy if others run your schedule. Time management is key, I think.

BTW - I pass meds to 30 very needy residents in 2 hours. If I stood around talking, or even took a break for myself, I would never be done with passing morning meds. Get in there and do your job, and let (or demand) that others do theirs.

netglow, ASN, RN · Jun 21, 2009

These things that she used to do well, she just can't seem to pull off lately. That is what burnout does to you. No matter what kind of planning you have, you just can't seem to swing it.

:icon_hug:

jrbl77, RN · Jun 21, 2009

i have been very organized in the past. unforntunatley, i can't get back to that spot. i know what i need to do and how to do it. i can't get past the fact that i would not want to be laying in a pile of p--p or a wet bed. how do you say to someone, i can't help you. it often takes longer to find someone to help the person than to do the job yourself. several weeks ago, my aid was sent home at 1130 am due to a drop in the census. i was not told for an hour later. none of my patients could get out of bed by them selves, unless they were not supposed to and then they were crawling out of bed. several needed help with feeding. family members stand at the door and look at you and expect you to attend only to their loved one. when i first strted nursing, we were expected to do what ever was needed to be done- no questions asked. it is a hard role to break. i guess i am just tired of being everything to every body.

angel337, MSN, RN · Jun 21, 2009

i have been very organized in the past. unforntunatley, i can't get back to that spot. i know what i need to do and how to do it. i can't get past the fact that i would not want to be laying in a pile of p--p or a wet bed. how do you say to someone, i can't help you. it often takes longer to find someone to help the person than to do the job yourself. several weeks ago, my aid was sent home at 1130 am due to a drop in the census. i was not told for an hour later. none of my patients could get out of bed by them selves, unless they were not supposed to and then they were crawling out of bed. several needed help with feeding. family members stand at the door and look at you and expect you to attend only to their loved one. when i first strted nursing, we were expected to do what ever was needed to be done- no questions asked. it is a hard role to break. i guess i am just tired of being everything to every body.

i feel your pain. you deserve a big hug because i can tell you genuinely care about your pts. the hospital administration doesn't make it easy by cutting and nurses always put he blame on themselves and think that their working conditions are normal. you can only work like that for so long before it burns you out. hang in there.

Virgo_RN, BSN, RN · Jun 21, 2009

You are only one person, and you can only do what you can do. I, too, used to be one of those nurses that did everything for my patients, for many of the reasons you've stated; that it's quicker and easier to just do it myself than it is to find someone else, that there is nobody else around to be found, that the CNAs are busy too, etc. I could not in good conscience allow a patient to wait for anything, knowing that if I waited for the aide to respond to the patient, that the patient would be waiting for a while. I figured I could just do it, since I was right there. But I found myself getting more and more behind, late on my med passes, late on my assessments and documentation, not having time for meal breaks or potty breaks, and staying past the end of my shift to finish my charting.

I don't know when things changed, but they did. I became one of "those" nurses. One of those nurses that delegates to the CNA. This does not mean I never touch a water pitcher or wipe a behind or help a patient back to bed, but it does mean that I do these things when I have time. I prioritize my assessments, my med passes, my sheath pulls, etc., and let the CNAs do their job and assist patients with their ADLs.

Am I less popular with the CNAs now? Absolutely. Do patients have to sometimes wait for things I don't think they should have to wait for? Yes.

But the fact is, one nurse cannot be everything to every patient. You just can't. And if you try, you will burn yourself out FAST.

So, my suggestion is to prioritize your RN level nursing duties and utilize your aides. As I said, that doesn't mean you never fill a water pitcher or ambulate a patient or wipe a behind, but it does mean that when you do those things, it is when you have determined that you are caught up enough on everything else that you can take the time to do it and not put yourself in a bind.

texas_lvn · Jun 21, 2009

Time management is key, I think.
BTW - I pass meds to 30 very needy residents in 2 hours. If I stood around talking, or even took a break for myself, I would never be done with passing morning meds. Get in there and do your job, and let (or demand) that others do theirs.

I agree with you that time management is key. I have worked both med-surg (which sounds like where the op is working now) and LTC (which sounds like you are working now) and you can not compare the two in the amount of time it takes to pass the meds.

OP, it sounds like you have a great heart, and it sounds like your unit needs to be more team oriented. I hope things get better for you soon.

eldragon · Jun 21, 2009

I agree with you that time management is key. I have worked both med-surg (which sounds like where the op is working now) and LTC (which sounds like you are working now) and you can not compare the two in the amount of time it takes to pass the meds.

It's a skilled unit and the meds change almost daily. And even our LTC patients take many prn narcotics, usually twice every shift.

When you think of long-term-care, you may think of people who take the same 3 pills every morning, but that's not the case where I work. Our doctors are pill-happy and most patients take around 10 pills in the morning, and another 6 throughout the day, spread throughout the day. And many, many of them have eyedrops, inhalers, patches and narcotics to deal with, both prn and scheduled. And then the supplements that are offered, meds that are crushed on well over 50% of our patients, and numerous peg tubes, etc. Plus I have to take my own vitals for every single patient who takes bp or heart medications.

So what happens in a hospital setting that takes longer?

jrbl77, RN · Jun 22, 2009

i work in a small med surg unit that has 13 swing beds- so it is ltc mixed in with a few surgery pts. yes most of the pts need their meds crushed and have multiple drops, lotions and potions to apply to all body parts. i may seem angry, i am trying not to, but i do not stand around and chat for any legnth of time. i have been organized in the past. i was the charge nurse on a large 40 plus bed unit and could multi task with the best of them.

allnurses Guide · Jun 22, 2009

eldragon, I do not think it's helpful to tell the OP to manage her time better when she is clearly overwhelmed and asking for help.

OP, can you take some time off? Sounds like you need to have a rest and look after yourself. Are you depressed? May be worth talking to your doctor if so..?

Or can you talk to your nurse manager about the workload issues and needing people to back you up? I am sure they would rather work with you to improve the situation than to lose a great nurse.

Valerie Salva, BSN, RN · Jun 22, 2009

i have been very organized in the past. unforntunatley, i can't get back to that spot. i know what i need to do and how to do it. i can't get past the fact that i would not want to be laying in a pile of p--p or a wet bed. how do you say to someone, i can't help you. it often takes longer to find someone to help the person than to do the job yourself. several weeks ago, my aid was sent home at 1130 am due to a drop in the census. i was not told for an hour later. none of my patients could get out of bed by them selves, unless they were not supposed to and then they were crawling out of bed. several needed help with feeding. family members stand at the door and look at you and expect you to attend only to their loved one. when i first strted nursing, we were expected to do what ever was needed to be done- no questions asked. it is a hard role to break. i guess i am just tired of being everything to every body.

Your facility obviously has very poor working conditions and purposely understaffs, but that more and more, that is standard in nursing. With the situations I have seen in some hospitals/nursing homes, I don't even think Flo Nightingale herself could do a good job.

Is your job ones of those jobs where it is the night before you have to go to work, but you already feel behind?

I know the feeling. It is Sunday night and my shift starts tomorrow morning @ 0600, and I already feel behind. Thank goodness it's a travel contract, and I only have 7 weeks to go. At least there is a light at the end of this tunnel.

Every time you hear a pt say "Nurse?" does your heart sink because you know that whatever it is they want, you don't have time to do it, and you know you will get even further behind if you do and feel like crap if you don't?

I don't know of anything that can help other than maybe another and another and another job- and most of the time, that does not even help. When we wander from job to job as nurses we are simultaneously running away and desperately trying to run towards something which may not even exist.

I don't know what we can do, but you have my empathy and understanding.:redbeathe

Riseupandnurse · Jun 22, 2009

Your facility obviously has very poor working conditions and purposely understaffs, but that more and more, that is standard in nursing. With the situations I have seen in some hospitals/nursing homes, I don't even think Flo Nightingale herself could do a good job.
Is your job ones of those jobs where it is the night before you have to go to work, but you already feel behind?
I know the feeling. It is Sunday night and my shift starts tomorrow morning @ 0600, and I already feel behind. Thank goodness it's a travel contract, and I only have 7 weeks to go. At least there is a light at the end of this tunnel.
Every time you hear a pt say "Nurse?" does your heart sink because you know that whatever it is they want, you don't have time to do it, and you know you will get even further behind if you do and feel like crap if you don't?
I don't know of anything that can help other than maybe another and another and another job- and most of the time, that does not even help. When we wander from job to job as nurses we are simultaneously running away and desperately trying to run towards something which may not even exist.
I don't know what we can do, but you have my empathy and understanding.:redbeathe

Wow! You have really captured bedside nursing in America today. It's a total no-win situation. There may be some hospitals or LTCs where you can actually be a nurse, give the patients what they need, and keep up a human pace and a real smile on your face most of the time (not an enforced Press-Ganey leer). I don't know where they might be. And so often on these posts when people write in like the OP, well-intentioned people advise to try another floor or another facility or improve our time managment or toughen up and walk away---all of which we've done. These are all individual coping maneuvers that really don't get at the cancer that is choking the life and the soul out of our bedside nurses. No matter what you think of Obama or the ANA or the AMA or JCAHO or anything else, somehow and some way it really does have to stop.