My Burnout Story

[jk2185]

I've been crying all morning coming from a pain so deeply repressed and locked inside me. I watched my last patient die three days ago and leave in his wake a broken family truly taken to the depths of misery and suffering. It was unexpected as most seem to be in an Intensive Care Unit. A hopeful wife of 20 years who claimed to have found her soulmate blindsided by her husband's death.

I remember the daughter's face when she came to the bedside while I was performing futile CPR, a gasp of horror unknown to most people. Empty eyes and an instantly drained soul. They both, the wife and daughter, threw themselves on his body begging him to return from the dead.

How many times have I seen this? Too many to count. Each time, I myself have felt the distinct pain of death and sorrow and stuffed in a vault deep in my psyche hoping to never release it. How many times have I been bestowed the "privilege" to give people the worst news of their lives.

"Hi, I'm so and so, we've done everything we can, I'm sorry."

"Hi, I'm so and so, your husband's stroke was catastrophic and unrecoverable. He may not make it through today."

"Hi, I'm so and so, you are going to die and I'll be here to help you and make it as smooth as possible."

Ever had a day where you got sent home because both of your patients died?

Ever cleaned a dead body for the morgue, then gone to your 30-minute lunch break (and you only get 30 minutes, no more)?

Several deaths I pin on myself. I lost two patients last year which I "know" I had a hand in. I should have known this, I should have done that. Of course, people tell me it wasn't my fault. Does that help? No....it's a deep knowing and a horde of permanent memories I will take to my grave.

Then there's the clinical stress.

Am I doing the right thing? Do I know what I'm doing? Ever looked at a med vial 5 or 6 times because you keep second-guessing what you're giving? I used to go home after a shift and read up on things I encountered during a shift that I was unsure of. I used to read textbooks for leisure. I've got ACLS forwards and backwards. Pretty sure I can interpret rhythms better than some of the residents. I'm not trying to toot my own horn; just pointing out that this drive (which according to popular belief is a good thing) has driven me off the cliff into a world of immense suffering.

Maybe I just don't know how to cope.

I thought having a couple beers or glasses of wine was the way to do it. Laughing with your coworkers about how messed up your day was or just venting to your innocent spouse. OR MAYBE, there's a better way to do this so that able people like myself aren't lost in this dark forest of despair. I've heard of certain facilities offering post-death huddles or post-major event huddles. Now I understand that's not plausible on a unit where 2-4 people die or have a major event a day, but something has to give. You're supposed to "buck up," or my favorite I've been told is "this is a sink or swim place." HA!!! What a joke. No wonder I'm where I'm at today. People aren't meant to be able to handle these kinds of stresses at their full-time job. I do remember a clinical instructor I had (a critical care guru) telling me that ICU nurses typically have a two-year shelf-life before changing disciplines. I remember thinking, "what weaklings, two years is nothing; I can do it."

It's torn a hole in me. I quit my job yesterday. I don't sleep. The formerly strong, I can do anything, level one center, highest acuity, give me the sickest of the sick gunslinging cowboy has changed. I'm having trouble leaving my apartment. Time to get a good psychologist. I don't know if I'll be able to ever touch a patient again. This is hands-down the hardest thing I've ever done. I hope I can heal. I hope this reaches someone else out there experiencing something similar. Burnout and PTSD are real. Don't let them steal your life.

my-burnout-story.pdf

[InTallGrass, BSN]

Your message strikes a chord in any nurse who has an iota of compassion left. I have not experienced the same things you have but I have experienced burn out and a strong desire to talk with someone who understands what I am going through.

You did the right thing - walking away is extremely hard but you have to take care of yourself. Whatever that takes - do it! I have quit a job because I just had no more to give. My husband says I care too much - he may be right but I don't know how to be a nurse any other way. It won't always seem this dark but right now you have to nurture yourself before you can think about caring for anyone else. My heart goes out to you and I wish you the very best. Take the time you need to renew yourself.

This is a great reply! Thanks for saying this.

[PAISITACOL]

Thank you for sharing your story. Although I am not a new nurse to ICU, I am new to CVICU. Thank you for your story and hope things get better for you. I cannot imagine the wealth of knowledge you have on the field maybe you can use it to help other nurses who are starting out. thank you for you service.

[Bchapm01]

My heart goes out to you because I experienced the same difficult decision to leave nursing after 19 1/2 years.

[Popoagie, ADN, EMT-P]

It's sad that in medicine we are weak if we have emotion for our patients. Please know not all of us are without them. I've cried with many families, patients and coworkers. Find your peace, and please don't give up on life, laughter or people....walking away from nursing needs only be a Segway to a new, greater chapter in your life.

[riblets63]

I'm so sorry for all the bad that has happened. The pain is probably because you care.

Hugs.

[O9eleven]

Your message strikes a chord in any nurse who has an iota of compassion left. I have not experienced the same things you have but I have experienced burn out and a strong desire to talk with someone who understands what I am going through.

You did the right thing - walking away is extremely hard but you have to take care of yourself. Whatever that takes - do it! I have quit a job because I just had no more to give. My husband says I care too much - he may be right but I don't know how to be a nurse any other way. It won't always seem this dark but right now you have to nurture yourself before you can think about caring for anyone else. My heart goes out to you and I wish you the very best. Take the time you need to renew yourself.

You can never care too much IMO. As a nurse I believe we should be compassionate. The day my job becomes an automatic,non feeling job will be the day I will quit nursing.

[Quilterbeth]

OMG, find a therapist now. I don't know how you dealt with this for so long, but please find some one soon. You are too important to your loved ones.

[pswan79]

Wow, I am married to an 18 year ICU nurse and my daughter is also an ICU nurse. They both love their jobs, and I am fortunate to have a wife that is so great (I don't deserve) and a daughter that is equally as wonderful.

I am truly blessed! My wife married me and Airline Guy, so when she needs it we take off and fly somewhere. I have a medical background (10 years Army Medical department) and we can talk about her bad days! She has been there for the Cancer Death of my sister and the Murder of my 29 year old son, couldn't ask for someone that cares more about my children and family than her. I have been truly God Blessed with us finding each other over 10 years ago!

Take a break, travel, have a life seeing great places and realize the Nurses help change the world! Now that I am married to one, I reflect and wish I would have be a wonderful Nurse like her - Love with tears and emotions! LOVE YOU K.S. you're a GREAT ICU RN.

[calivianya, BSN, RN]

"Ever had a day where you got sent home because both of your patients died?"

I have, actually, and that's a crappy feeling. It feels like you're getting blamed, like the charge is saying, "Well, you killed them off, so go home before you kill anybody else today!" It's hard not to take it personally.

Most of the time they'll still have us stay because that means two empty rooms and I could just get two admissions instead, but I have been sent home when patients die if I am on overtime.

It all just sucks. I am sorry you are going through this.

[xoemmylouox, ASN, RN]

Everyone has different coping skills. Some good (moderate exercise, painting, family time, etc) others not so much (smoking, drinking, ignoring their stress/anguish). Sadly most of us are not taught how to handle things well and few of us are supported by our employers either. I lean on my family and friends, chocolate, and peaceful walks. I also try to keep a boundary between my patients and myself. I'm not perfect at this, that doesn't mean I don't care or provide compassionate care, that just means I try to leave work at work. I've attended plenty of funerals and have cried with family members ( those I have gotten to know over years). You can care without breaking down. I'm not at all implying that is what the OP did. Most of us simply aren't equipped to deal with death day in and day out, especially the traumatic and heinous deaths that we as nurses see.

For everyone who read this story, learn from the OP. Don't wait until you can't take it anymore. Get the help you need when you need it.

[cdgoldilocks]

Been there. I feel for you. I think we are nurses are so traumatized we are now numb.

I am in my 3rd nursing career change. I did 4 years in CV/Tele/Stepdown. Saw it all. I saw a lady's butt had grown in to her rocker chair from neglect, watched the surgeon gag one day as he came in to repack the black hole tunneling wound, and will never forget the odor that came out. I remember when her "caregiver" was arrested at the bedside. I remember when this woman died of overwhelming sepsis. And that is just ONE story.

I did 14 years in Public Health doing home visits with my supergirl cape, wanting to change the world with prevention. Totally opposite end of the spectrum from death and CABG's, right? Managerial ******** is what made me run screaming from that job. I mean, who needs a raise EVER right? Public Health nurses don't have safety fears in drug homes right? But probation officers do, and they were often in the same room with me.

I am now in school nursing. I am hoping this will be my last adventure in nursing.

Hang in there.

[Bat Lady]

This might be one reason for a phenomenon I saw quite a bit in the 90s....the movement back and forth from ICU to home health. Many ICU nurses (not all, by any means, for reasons which I will mention a bit later) in my area took a year or two off from ICU and worked home health, or even worked occasional weekends or divided their time between the two. I was one who took time off, partly due to the stress and partly because my kids were going through high school and I needed the flexibility so I could go to soccer games, cross country meets, choir concerts, etc. In home health we really valued the assessment skills of the ICU nurses, and in turn, they appreciated the more relaxed atmosphere and the time between patients (we were in a rural area, so there was driving time which gave you time to unwind a bit) as well as the opportunity to relate to the patients more fully.

There were some ICU nurses who felt that home health was somehow "beneath" them. I heard that when I went back into hospital nursing. They were afraid they'd "lose their skills" or something like that, at least that was what I heard them say. Some burned out types became agency nurses and went from ICU to ICU and hospital to hospital, but it didn't seem to help them. Others became travelers; I met quite a few during my brief travel career. That did seem to help them as a change of scenery often does, besides which there is a certain detachment that comes with traveling. You don't have to become involved in the politics of a place and you can just take care of your patients and go home, and after 13 weeks you go somewhere else.