Help! I have extreme compassion fatigue

Altra, BSN, RN · Jan 8, 2013

Blue Roses, I'm sorry you're feeling this way.

The first year of nursing is rough. But it is also a period of tremendous personal growth.

I agree with your assessment that your coworkers are probably not the best outlets for listening to these feelings you're experiencing. Please always remember that although you may form some close friendships with those you work with ... work is work and personal life is personal life and the two are not the same. I'm very glad to hear that you've taken steps to see your PCP and utilize the resources available to you through your EAP. Taking those steps demonstrated excellent judgment.

I suspect you realize that at least some of the anxiety you're experiencing is generalized without cause, and is interfering with your normal functioning. Though I agree that meds are rarely the best choice for first line treatment, sometimes short-term meds allow for alleviation of some symptoms such as sleep disturbances and eating problems, and that can go a long way toward strengthening your overall ability to deal with other things.

Please see your PCP and EAP provider as soon as possible. And feel free to post here, or PM me anytime. {{hugs}}

ChristineN, BSN, RN · Jan 8, 2013

I took a Compassion Fatigue assessment and I scored off the the charts for both burnout and compassion fatigue. Im a young new nurse about a year out of nursing school and I haven been on the ob for about 10 months. During the past 4 months or so I have had increasing anxiety to the point of being physically sick and having to call off work, and now I only have one more absence left until they fire me.
My boss is very strict and unsypmathetic. If you try to talk to her she says things like well sometimes life just isnt fair. instead of trying to help you. She holds grudges and has favorites and least favorites, and if you are the latter you know it and feel it in the way she treats you.
About 2 months ago I had two patients pass away on me in a two week period, and since then I have been a complete and total mess. I have been getting dizzy and passing out both at work and at home, I constantly feel like something terrible is about to happen, and I have a constant underlying current of fear and anxiety in my mind and heart. It doesnt help that we have been consistantly understaffed and overworked the past several months (I work on a med surg floor in a huge city hospital). Every night I go in Im terrified of what I might face when I get there. I cry all the time. I cant sleep, I dont eat because I feel nauseated most of the time. Im also facing stress outside of work, confict within my family and trying to plan and pay for my wedding coming up in May mosty by myself.
I know I have bitten off more than I can chew. It came to a head last night when my fiance woke up to me sobbing my eyes out because I stay awake all night to make sure hes still breathing. I have been in denial, I know I have a history of depression and self-mutilation as a teenager, although I was never diagnosed with anything. But now I feel like a train speeding at 100 mph towards a solid concrete wall.
I have appointments this week to see both my PCP and a free counseler service provided through my work. I dont really know what they will be able to do for me, as I am very reluctant to go on any mood altering drugs for fear of side effects and addiction. I am going to try and talk to my boss, but I dont see her doing much to help me. I have tried yoga, excercise, meditating, hobbies, etc etc and I still feel this way. Its like Im trapped inside myself and inside this job that I am so afraid of. I have also applied for several other nursing jobs in the community, but that was just recently and I havent heard back from any of them yet.
I dont really even know if anyone will read this. I just feel like I need to express myself to others who might understand or who might be able to relate and tell me what they did to help themselves. I cant talk to anyone at work because it will come accross as complaining and if my boss gets wind of it we get written up or fired. I am pretty desperate at this point. I barely have the motivation to get out of bed anymore. Normally Im a generally happy person. I want to feel happy again.

I am so sorry to hear you are going through this. One option after talking to your doctor or counselor might be to see if you qualify for FMLA in order to take some time off to take care of yourself.

classicdame, MSN, EdD · Jan 8, 2013

get whatever counseling you can afford. They might be able to help you get time off with pay and should be able to provide you with tools to help you cope with your situation or make appropriate decisions about the future.

Blue Roses · Jan 9, 2013

Thank you to the folks who replied to my message. I just got back from seeing the EAP counselor, who was very sweet and kind. She offically diagnosed me with moderate depression and extreme anxiety/ panic. She gave me some paperwork to take to my PCP with whom I have an appointment tomorrow, and we will go from there. I've known deep down this diagnosis was coming for me, but it scares me still. I don't want to be ruled by it. As for my job, I don't really know what I'm going to do yet. Depends on how any interviews I get go and if my treatment plan my doctors put me on works well for me.

Part of me feels ashamed of my diagnosis, like it makes me weak or flawed. Another part of me is somewhat relieved that I can probably put a name to my problem now. It doesn't make it less scary though.

Kareylea · Jan 9, 2013

Blue Roses,

THere is a time to soldier on and there is a time to stop and take a breath. If even half of what you report is true, you are far past the soldiering on part. Your HEALTH is at a stake here and it sounds if it is in jeopardy. Part of being a nurse or even a responsible person is knowing that you have to take care of yourself before you can take care of others. We laugh and joke about big bladders and no breaks but I've never heard a nurse praised because she had a gaping bleeding wound and still decided to go into work. And mental health can be, just as any other medical condition, a gaping bleeding wound.

Lives are in your hands but not the least is YOUR OWN.

Take a breath and put things into prespective. You do no one any service by going past your breaking point. YOur boss, your job, your career...they can all wait and be fixed later. Twenty years from now your bosses opinion will make little difference. Getting yourself healthy now could be.

Best of luck and good health to you.

HouTx, BSN, MSN, EdD · Jan 9, 2013

Yikes!! Sounds like PTSD to me. Classicdame is 100% correct. Job-induced stress is actually a reason for temporary disability under workers compensation. You also need to go 'up the chain of command' and let your employer know how pitiful/incompetent your manager is. That sort of behavior is inexcusable. I can almost guarantee that your organization will be very interested in correcting her attitude, particularly if she is causing dissatisfaction & turnover....that is a huge expense to the organization.

Your reactions are understandable, especially to patient deaths so early in your career. In my organization, telling a nurse to 'suck it up' is a career-limiting event for a manager. We offer 'critical incident stress debriefing' to staff who are involved in any sort of traumatic or stressful event.

Please take care of yourself.

Orion81RN · Jan 10, 2013

You are not weak or flawed. You suffer from a chemical imbalance which is a MEDICAL problem. I'm in a very very similar situation. I had been starting to have panic attacks about my job, which led to a meltdown. I did one of the worst things you can do. Right before a shift, I had an extreme panic attack with sobbing, hyperventilating, and vomiting. I immediately called my work and quit. I personally am on medication, but had not taken it in a month. SO STUPID of me. Now I'm out a job, and how the heck am I supposed to explain THAT situation in an interview and expect to get hired. Don't buy into the grass is greener on the other side. If you decide to switch jobs, don't impulsively quit d/t anxiety before you have one secured. And if you take another job, your personality comes with you. I'm glad you're doing counseling and seeing a doctor, because that's how you're going to get better and learn coping skills. Also, and this is not medical advice, but if you're Dr.thinks meds may be a good idea, TALK to him/her about your concerns before immediately ruling it out. There is a difference between being emotionally immature, unable to cope without trying, and having an actual chemical imbalance that needs to be medically treated. Best of luck.

Blue Roses · Jan 10, 2013

Thank you all. I'm scheduled work to work again tonight, but I'm still feeling dizzy and I feel I am on the verge on a panic attack on and off, so if I still feel this way in the next few hours I plan to call in sick and have my fiance drive me to the ER. I know my health and my safety should come first, and any boss who doesn't see it that way isn't someone I would want to work for anyway.

It's just hard, I cried most of the day today and I don't see the light at the end of the tunnel right now but at least I am getting help

Blue Roses · Jan 11, 2013

I did end up going to the ER. They didn't find anything and sent me home with a 48 hour Holter monitor. I still have my PCP appointment tomorrow so further follow up will be done.

Wave Watcher · Jan 11, 2013

Think of it this way.....your mood is already altered and you are already having major side effects both physically and mentally.

It's time for help. Hang in there.

Orion81RN · Jan 11, 2013

We sound so similar. The panic is unbearable and most people, even nurses don't understand. My own husband didn't understand til he saw me in the midst of an attack. I couldn't get through certain situations without xanax, and people are so judgmental about it. Its not garden variety anxiety (which I of course do get and handle without my xanax) that most people can get through. Its sheer panic. I hope all goes well with your appointment. :)