We are constantly exposed to the heights of human emotion every day. Sadness, tragedy, extreme joy, fear-every emotion finds its way in to patient care. But after so much exposure, many of us become numb to it all. At what point does ‘burn out’ make you a monster?
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I grew up on a steady diet of Coke, pasta, and medical dramas. Shows like House, Grey's Anatomy, and Nurse Jackie were a weekly binge treat that fueled fantasies of working in a well-lit hospital, looking adorable in my scrubs, and making lifelong bonds with my coworkers (while also finding true love, rapidly climbing the professional ladder, and performing a cricothyroidotomy with a pen, yada yada yada). Cut to the here and now, and I'm a frizzy, greasy, stressed out ER nurse who sweats through a 13 hour shift long enough to eventually crawl home and stress eat my weight in carbs.
Even though I know how ridiculously untrue most medical TV shows are (sure, let's shock the asystole, and why yes, it's quite common for 3 doctors to ambulate one patient after placing the IV themselves, and hell yeah! I've had sex in an on-call room several hundred times), one thing always resonated with me, episode to episode: how the patients struck a chord within their providers. Obviously it makes for better TV when a patient gifts a nurse/doctor with pearls of wisdom prior to passing away dramatically. Poignant music pairs much better with a scene of a nurse sinking to his/her knees in the hallway, weeping while thinking about how that patient that changed their life. But regardless of the drama of it all, there was something to be said about the connections formed with the patients, and the way the patients inspired the providers, be it positive or negative. They FELT something. And in reality we all know that not every patient is like that, not every shift is like that, and hell, not every month is like that.
But it still inspired the type of nurse I wanted to be.
When I started my career, I hoped to be the nurse who was affected by all her patients. The nurse that felt the visceral pain of a grieving family member in her stomach, the nurse who felt true joy with the birth of a baby, the nurse who held her patient's hand and really meant it. And I'm not saying that I don't have my moments, but the more I work and the more I endure the common use and abuse nurses face all day, all around the world (from patients, from patient's families, and from other staff alike), the more I find myself feeling nothing in the face of tragedy, or even joy.
I'm scared that becoming a more experienced nurse is also turning me into a monster.
I recently had a patient with a miscarriage, who sat in the overcrowded ER, wailing at the top of her lungs as the OB/GYN at the bedside explained to her what was happening to her baby. All I did was pull the curtain closed. I cleaned up the body of a young man who was my age, who had jumped off a building and killed himself. I closed his eyes myself, and while his mother wailed over him, hugging his face to her chest, I filled out paperwork. And during a code where we pounded into a guy's chest over and over and over again until at least three of his ribs were broken, and his family cried audibly outside, I felt nothing at all.
When I voice my concerns that I am becoming burned out, and/or a bad person, the majority of people say: "but you have to separate yourself like that, otherwise you couldn't do your job". But does that make it okay? What does it say about me, that I feel detached even about burning out? Have so many violent or emotionally abusive or demanding or truly needy patients broken something within me, within other nurses like me?
To be in healthcare implicitly means that we are exposed to death each day, because it is always there. It is the enemy, but it is also lurking in the corner of every patient room, its long fingers waiting to reach out. Death is the person no one invited to the party, yet he found his way in. And with that constant exposure, there becomes a familiarity, and possibly even more, an acceptance.
So, I ask you, at what point should my work badge say 'Monster, RN'?
