Love/hate relationship to my work.

[Anna Flaxis, BSN, RN]

There are things about my work that I absolutely love, and things that just drive me crazy. I know every job is probably like that, but I feel that I have more bad days than I do good days.

Since even before I entered nursing school, I have been pushing myself hard. All but one of my jobs has been incredibly stressful. It's affecting my relationships because I get so burnt out on people and their less than admirable qualities that I become antisocial and don't make efforts to keep up my end of friendships. As a result, I feel socially isolated. When I do get together with friends, I have nothing to talk about. With my spouse, I complain about my job a lot, and it isn't fair for him to have to hear it all the time. I don't like the kind of person I become when I work a few days in a row.

For a while now, I've been feeling like I want a change. But, is this a "grass is greener" sort of thing? Will I regret leaving the ED? Will it be a big mistake?

I love the detective work of the ED. I love the critical care. Trauma, cath alerts, RSIs, conscious sedations, these are all exciting to me, and I like the one on one patient care I get to do in these situations. I like the high level skills I get to practice. I like it when I have good interactions with patients and their family members.

I hate the complaining, the impatient behavior, the demands, and the stat pillow/blanket/snack/water/bedpan requests when I'm in the middle of something critical. I don't seem to have the ability to let this aspect of the work roll off of me like some of my coworkers do.

I've tried to adjust my attitude and focus on the positive, but that only seems to last about halfway through the first shift of my long stretch on.

Don't get me wrong; I am nice to patients and coworkers, and try and treat everyone as I would want to be treated. But sometimes, it takes a lot of energy to keep it up!

I vascillate between dreading going to work and being really excited about getting my CEN and maybe even my CPEN. Yep, I'm an (over?)achiever, and I always push myself and challenge myself. At the same time, I feel like that is taking its toll and maybe I need to give myself a break.

I do participate in hobbies, but I have stopped exercising regularly, and I think that might be part of my problem.

I've been thinking of getting out of the hospital completely and doing something else, like home health or hospice, but I'm afraid I'll miss the hustle and bustle of the ED. I'm afraid I'll miss the critical care and detective work aspects the most.

I know that nobody can tell me what the right choice is for me. I'm not asking for that. But, I'd be happy to read your stories about choices you've made and how they affected you.

[rninmidwest]

I am new to Allnurses....but I couldn't help but respond when I read your thread. I also work in the ER and know how taxing it can be on the mind and body. I got to the point where there were some days I felt invigorated by the ER, and other times...on a particularly rough day... I wondered if I needed to do something different. After a particularly rough shift(s), I often had little left in the way of energy or conversation for my spouse and kids when I got home. I don't think I was decompressing well from my shifts and I knew I needed to make an adjustment somewhere to maintain my sanity. I made some changes: started walking everyday, re-enrolled in school for BSN, and scheduled something fun (movie, playground, picnic, etc..) to do every week with my kiddos. Made a huge difference in how I felt. I am still in the ER and I can't imagine being any place else. I feel like having taken better care of myself outside of works helps prep me for those really rough shifts when it seems you can't please anyone.

I know you will decide what is right for you. Maybe you could job shadow to see what the day of hospice nurse is like. Might give you a better perspective? I have two acquaintenances of mine that both used to work ER and then transistioned out to other areas because they were burnt out and wanted a change. One absolutely loves her job and has never looked back and the other is trying to get back into ER --- she misses the hustle and bustle of it all. Or, maybe you could try to change up your schedule to see if that helps you feel better vs. having all of them in a row?

[brandy1017, ASN, RN]

Maybe you should consider ICU or cath lab where you can be with critical patients and interventions and not be pulled in so many different directions by all the extra stable patients and families in an ER vying for time and attention.

Can you shadow in another department or cross train just to find out if that would be a good fit?

[Medic/Nurse, BSN, RN]

I think I can echo most of what you are experiencing.

I have not worked in the hospital since September 2006 and though I think about going back - I just can't seem to do it. I do have moments where I really miss it and I, too, took a LOT of pride in being very good at what I did and being that "team player". Maybe it's like childbirth (not that I have kids - just what I've been told) or that really great looking guy you loved, but was toxic (not had one of those either - thank God) - you know the kind of situation where you look back and think - it wasn't that bad.... And then you "selectively" pick the good bits to remember and let the pain, tears, frustration, feeling of low self worth or whatever "fall" away.

When I left nursing in 2006 - I was at the end of what I could tolerate mentally, physically and emotionally. Burnt out - nah, just burnt through and through. I was in a very bad place and not living the life that I had envisioned for myself. I was not a good friend, good wife or even good person - I didn't have compassion fatigue - I was out of compassion for most everyone, including myself. I don't make a lot of discussion about this and DO NOT have any type of a substance abuse issue - but, I found many shifts ending in a blender full of margaritas consumed SOLO post shift. Every shift. It was the ONLY thing that got me though the shift - knowing that I would get to "zone" out and maybe numb it all away for while. Not a road I would be able to travel long. A road with consequences. Bad ones. I had been contracting/traveling and away from my husband (I was in a period of self-exile and punishment, in hindsight) and woke up one day and knew that if I did not quit - I was not going to survive. I would not call it despair - cause you have to feel something to even despair - I was at the end. NOTHING was left to give - I think it is a miracle that I found that scrap of self preservation and enough fortitude to act on it. My husband and I are financially secure (even without my income) and so once that was reinforced by my husband - the real question came down to self destruction and he did not give me anywhere else to run and hide - get out , come home or stay away. "I don't care if you go to work again, go back to nursing someday, go work at WalMart or sell flowers at the airport as long as you get well, get to place to be able to take care of yourself and us - it stops now."

So I left and did NOTHING. That's right - nothing. Now just a rest period - but a full on existential crisis. I knew that old paradigms of life would have to shift and something different would have to happen - but, I had hit the point of no return and my life was in flux. I needed to be able to care for myself as well as I had cared for others.

I ate well. Drank very little (thank God, that path came to an end). Exercised. Spent time with people I needed to reconnect with and mend more than a little neglect. Found solace in nature, quiet and the grace of God. Lot of soul searching. I spoke with a counselor to keep me in a forward motion and get my "self talk" repaired.

Sounds pretty - woowaahootaawoowee - but, not so much. The point was I had lost my "center" and needed to re-center myself. I worked to find that "spark" I had lost and had to realize that I did not want to spend another second doing something, anything that took more from me than it gave. I had been so good at what I did - I forgot that doing it well should be rewarding or fulfilling or heck, even moderately tolerable.

Before - I had been able to "center" myself - I would focus on teaching, preparing and passing multiple certifications and focus on being a GREAT NURSE or PARAMEDIC. Worked hard to be better tomorrow than I am today. And most of the time I could find that "spark" and get back to it. Eventually, I think some burn out is expected and most can work through it - but, you have to look at the "big picture" and be honest with yourself about your capabilities and just as well, to know your limitations.

Like you - I was great with the "sick" or urgent cases. It is a PRIVILEGE to be able to care for someone that is really sick and have them trust you and you be any small part of helping them through (either to wellness or the "good" death - free of suffering as possible and with all the support they deserve). So, that was the last bit of "reward" - but, those cases are draining in their own way and even being good at something does not make it good for you. It was the other 90% of the ER "crap" that got plated up for you to chow on - your own little buffet from hell. Yum...???

I hated the entitled, b*****, whiney, demanding and must have my way set of patients that suck your energy out. The best part is those with the least amount of illness have the biggest demands - demands I could never fulfill - no matter what I did, how I did it, the amount of time I spent or anything. Complain, complain, complain. Call admin and "get that nurse fired" - I loved those most of all. Administrations with the "patient is ALWAYS right" position - is a special kind of employee abuse (most of these are the ones that could not staff their hospitals - wonder why?). I was always respectful, tried to treat folks the way I'd want my loved ones cared for). I never tried to reason when someone wanted to yell at me (just let them finish - apologize for everything and ask "what will it take to make this right sir?). I was courteous and treated folks equally (bum under bridge treated as well as a bank president - actually the bum was often the "better" patient). I did not care about insurance or payment - I did all I could for everyone. RX for motrin so your medical card would pay, cause you spend your single mommy money on cigs, blinged cell phones, the baby daddy and fake nails - no problem - wait here (for the next 15-20 minutes, so I can retrieve your chart, track the doc and hold your d/c, it is so OK - clearly, why should anyone here expect that you would BUY motrin when you can get it for FREE - your right, were stupid to think that a $2 OTC med should come out YOUR pocket like it would ours). I had hit the wall. I was done.

Add the bad behavior patients, with bonehead docs you had to keep from killing patients, administrations that had a new customer service program monthly, service recovery that was exhausting when a patient did not get their correct meal tray, risk management that were the REAL directors of your work and impossible schedules, no staffing for a break/meal much less a vacation, co-workers that were as miserable and even less able to be "team" players and snark, snipping, and downright childish behavior at times - and well, a perfect combination for - I. JUST. CANNOT. WILL NOT. KEEP. DOING. THIS. TO. MYSELF.

So, I left - and had no plan other than to BE STILL.

And just be open to possibility and see what comes your way.

I found (or it found me) a transport job in December of 2006 and was hired on a resume alone. I could do my first love (paramedic) and yet, be a nurse. Sounds good. Did it - loved most of it and worked into flight over the next year. I did 3 and due to travel involved, the fact that a bad day at work on a helicopter will get you DEAD and the fact that finances were very comfortable - my husband preferred that I stop. So I did. I was tired and while it was not a "perfect" job by any measure - I got out of it what I needed. I had been getting anxious about the crash thing. While I was relieved to be "safe" - after about 6 months I considered going back PT - I did and do miss it. But, I have a hard time saying NO - and before long I'd be everywhere again. So, now I teach some - am finishing an educational program focusing on new nurses - I also do some antique and repurposing of furniture and textiles and while, I "miss" it at times - I have the life I want.

So, if you can financially - just stop or go PRN with the understanding that you need a few months to "cool down" at a minimum. Make self care your #1 task. Be quiet. Reflect - maybe seek counseling. Learn to be present and still and work through your options. Best case/worst case - you can always get another job - but, there is only one you. Make YOU the PRIORITY and you may find your peace. I did.

Good Luck - keep up posted. I cheering for you.

:angel:

[joanna73, BSN, RN]

I'm feeling the same way right now. I really enjoy certain aspects of my job, but I HATE the politics there, the unfairness, and constant requests to pick up shifts. Even when we say no, the guilt trips are there. I don't live to work....a job is a job.

I resent when my free time is demanded by anyone, especially an employer. After another year, I plan to find something else. If I can't have a balance, it just isn't worth it.

[Altra, BSN, RN]

Stargazer, are you feeling better? Can you schedule any time off?

[Anna Flaxis, BSN, RN]

A little better today, but not much. It helps to have had a clinically interesting day yesterday; makes the thought of being there today less painful. I do have some time off coming up next month, which I am looking forward to.

[Ruby Vee, BSN]

sounds to me like you're headed for, if not actually experiencing early burn-out. take care of yourself. walk, or do some sort of exercise regularly, eat healthily and do something fun every day -- even if it's just reading a chapter of the latest romance novel. a bath takes a bit longer than a shower, but nourishes your soul a bit. maybe changing shifts will help, take a few "mental health days" off and go sit on the beach for the weekend. or in the mountains, or just curled up in front of a fireplace with a book you're reading -- or writing.

if it progresses to later stages of burnout, you have to make bigger changes. change jobs -- go to the er across town. or specialties. icu, cath lab, interventional radiology -- or maybe go all the way to med/surg. travel. float. do something completely different.

good luck with whatever you decide to do!

[sirendip]

Stargazer- I know where your coming from! I too am stuck in a ER job in a high intensity inner city trauma center. Jumping ship is not much of an option for me. I'm 50+ and have tried alot of the fields out there. My financial situation is dismal. I am the breadwinner in the family. I've been burnt for quite a while. I've been waiting for the time when my financial situation improves to just cut back on my hours. I have to say that it is such a disappointment to me that skilled clinicians such as ourselves have to make such choices. Our employers our obviously not taking care of us. We hear these stories time and time again. No rest for the weary.

I love ER nursing, I can deal with all of it, but not without support from administration, access to breaks, ability to use vacation time, cooperative support staff etc etc etc....

All the other posters are right, we must take care of ourselves no matter what.

What i'm about to do is cut back my hours to 3 12's per week even though it's a financial hit. I'm also transferring to a smaller satellite er associated with the hospital that is much kinder and gentler. I know from past experience that if I don't take care of myself now, my body will find a way to stop me in my tracks later.

I'm also on here reading what my colleagues are talking about. Knowing I'm not in it by myself helps. Just gotta keep the good fight going for me and my family and the patients that I care for!!!!

[VICEDRN, BSN, RN]

Stargazer, I hear a lot of what you are saying and feel the same way about a lot of the same things. And I also hear NREMT as well. I too have been thinking about graduate school or flight in the future.

In the meantime, use your PTO time. I find it helps me a lot to take time away from the unit.

[Lunah, MSN, RN]

OMG, maybe I'm PMSing (TMI, whatever), but this thread made me teary-eyed. Stargazer, you are amazingly smart, and I know you'll end up doing the right thing for yourself. NREMT-P/RN, you rock, plain and simple.

Loving allnurses very much right now.

[joanna73, BSN, RN]

I just had 4 days off and 3 calls from work. I didn't go in, but the fact that my phone constantly has messages is very annoying. It's as though you can't escape. From now on, I need to start writing NA on every single blank day where I don't want a call. That's pathetic.