LTC nurse manager burnout? Midlife crisis? Psychosis??!!

[Cxy13]

I've been a nurse manager for many years now. I don't even know where to begin with my frustrations. I almost feel guilty having read what other nurses have gone through. Just read about a nurse with an HIV positive pt who stabbed her the the needle she used for the Pts injection.

im starting to lose my passion and commitment...worked my way up from a CNA to LPN to RN then RN Manager....all within a decade with a great organization who has put their trust and faith in me to manage my units and help maintain the excellent reputation and high quality care we provide the residents of our community. We are far from the "dingy, urine smelling, gross" nursing home/senior community that everyone thinks of when they think "nursing home." Our employees take great care of our residents and are cared for by management and senior leadership. Everything looks good from the outside, even from the inside....a lot of people would give to be where I am. I've worked hard to get here...now I'm here and I don't know if I should stay.

i am 30 and have spent 1/3 of my life dedicated to one organization. I just thought it was the blues....but I'm tired. I'm also afraid. I don't know if I could ever leave because I'm afraid the grass is not going to be greener on the other side. All of my healthcare experience has been LTC and I'm great at what I do. I'm afraid I may not be cut out for the acute world...nor would anyone hired me knowing I don't have any other experience besides LTC and management. I regret that I never took the chance to go through a couple different jobs and gain experience...then again...I've learned so much on this path as well.

I'm tired of the staff...I do more HR work than nursing. No one knows how to get along nor do they try when it comes to new generation CNAs and nurses. So much coaching and teaching and coaching and headaches.

Living with anxiety thinking about that one difficult family that may call state for something a little as missing pair of socks...even after you offer to replace the socks and weave it with gold and diamonds.

Working on processes and procedures to keep it all going in the right direction. I've also got what I jokingly call undiagnosed OCD...im a perfectionist, I cant rest until I perfect it.

I don't get much hands on as what i do consists of paperwork and administrative like duties. I miss the residents and the hands on/face to face interaction.

where do I go from here? Am I in too deep to leave? Got my PTO built up, no weekends or holidays, flexibility...but then looking at the long hours, headaches with the glorified babysitting role of new breed of staff. I worry about my work life balance and my young children. Would they want a mom that can provide them with material things and college opportunities or do they simply want a mom that is present and able to give them the undivided attention? As long as there is food on the table and a roof over our heads...that should be enough right? They would want a mom who was present, both physically and mentally.

I feel like I should turn a few leaf and branch out. If I turn a new leaf, I will be starting from the bare bones...swing shifts, no flexibility...just another name on a spreadsheet amongst the other nurses names. Would have to be trained like a new grad if going into a different specialty.

Has anyone been in these shoes before? Am I just being crazy? Has anyone been in LTC nurse management then left and never looked back? Is it just the blues--and how do I get over it? What would you do? I'm just trying to rule out a midlife crisis!

[VivaLasViejas, ASN, RN]

Well, I'd say you're a little young to be having a midlife crisis, but you're not too young to have a little wanderlust after having worked for one company for ten years. Burnout among management staff is quite common, and sometimes trying another field is a good thing---it gives you a new perspective even if it doesn't turn out well.

I've gone back and forth between management and the floor several times, as well as from LTC to acute care and back to LTC again. I never stayed with any one job longer than 2 1/2 years, so I may not be the best person to advise you. However, I suggest that you take a vacation, even if you don't go anywhere, and weigh your options. Write down on a piece of paper the pluses and minuses of staying where you are vs. taking a leap of faith into another specialty. Then make your decision based on your instincts.

Hope this is somewhat helpful to you. Best of luck in whatever you do.

[KCMnurse, BSN, MSN, RN]

Two years ago I walked away from a nice fat paycheck, and took a pay cut to do something completely different in the nursing field. Do I miss it? Yes. Would I go back? Not in a million years, the grass wasn't greener, it was different. I have an excellent work-life balance now, stress is minimal and I feel healthier. In the end only YOU can decide what is best, weigh your options, and trust your instincts. Good Luck!

[bluegeegoo2, LPN]

I, too, am dealing with very similar feelings/emotions.

I'm not a nurse manager, but a staff nurse in LTC. I recently became so stressed out (burned out) that I have made the decision to actively seek employment outside of nursing and here's why:

I hold myself to an impossibly high standard of performance and work ethic and will nearly kill myself to get it all done before I leave. I loathe to leave anything undone or not addressed.

I, too, am OCD. I have a difficult time with the concept of "good enough." What is that, anyway?

However, due to recent events and management changes at my facility, I have suddenly found that we are frequently short-staffed. If, by some miracle, all of my unit staff show up someone will have invariably called-off on another unit and we get pulled. Voila! Short. Again.

Being short-staffed most of the time has forced me into a "good enough" performance, which is unacceptable to me.

I have grown to resent management for the change in working conditions, resent families and residents for "frivolous" requests (read: drains on my time), resent staff that call-off that further drains what precious little time I have, the list goes on.

In a nutshell, the problem is me and how I'm unable to adequately adjust to the increased demands on my time in which I'm unable to perform at the standard I expect of myself. Therefore, I must go.

I had to decide what is important to me. My overall sense of well-being and emotional availability to my family or "hanging in there" hoping it will get better.

I choose to take action. I will maintain my current job while continuing to apply elsewhere. I feel better already.

[canter1221]

Oh I feel your pain! I was a LTC unit manager in the past-- loved many parts of the job, even care planning, working the cart *sometimes* even bathe a resident or three first off in the am if short z cna (great to do for staff morale!)... But also hated many parts of the job especially 24/7 on all to cover call outs, which affected my child as it became more frequent. That was the final straw for me as a manager.

also, was finally at job 10+ years do lots of seniority & vaca time .....But eventually those didn't make up for the negatives, so I jumped ship to a less stressful role elsewhere.

Happier, Free to pursue further education, but still miss the perks :)

you might consider asking your place if there's another told you can take for a 3-4 month block ... They could use it to train up a potential manager ....does your place have a home care arm it sister agency you can swap out to for a bit? Is there a local hospital you could shadow at, maybe sell it to your bosses as a chance to better understand the experience of your residents when they are at the hospital?

Good luck & take a vacation soon :)