New Grad ICU Burnout from COVID

[IcuRN359, BSN]

Hi everyone! I'm a new graduate nurse that has been in the ICU since April. I'm experiencing alot of stress related to COVID. We're in our 2nd wave of COVID now and the amount of death I'm seeing is almost too much for me at this point. We are coding people everyday.

On Thanksgiving, we had 4 COVID patients code during just my shift. Not to mention my hospital is also not allowing visitors anymore so all the communication with family is via the phone. I understand providing emotional support to the family and patient is part of my job, but I am just so overwhelmed with how powerless I feel in this situation.

I love the ICU population in general and I love the critical nature of the care, the critical thinking, the independence, everything, but I do not know how to deal with this much death and suffering. I know this is largely due to the pandemic and in the normal ICU environment, deaths are not quite this frequent, but with no end to this pandemic in sight, I don't know how much longer I can deal with this.

Nurses on my unit are burnt out. Some are leaving the bedside permanently to go into administration/case management, some are just out sick with COVID for weeks at a time. It's not even just caring for these critically sick COVID patients that bothers me, it's also the way my community is treating it.

I am seeing patients die every day at work, but then I go onto social media and see that half of my friends and family are posting that this virus is fake, that we're faking death certificates for financial gain, that nurses should just keep quiet because we "signed up for this". I literally feel like I'm being gaslighted by my community about this pandemic. 

I'm just looking for advice. How are you guys dealing with it? How do you get back into the right headspace after a code? How are you staying healthy and keeping your stress down among all this craziness? How do you prep for a shift dealing with critically ill COVID patients? I would appreciate any advice. I 

[toomuchbaloney]

My prayers are with you. Try to hold on.  Tell your employer that you are needing some support. 

The entire nursing profession will suffer from PTSD after this disaster. 

[macawake, MSN]

13 hours ago, adelina207 said:

Hi everyone! I'm a new graduate nurse that has been in the ICU since April. I'm experiencing alot of stress related to COVID. We're in our 2nd wave of COVID now and the amount of death I'm seeing is almost too much for me at this point. We are coding people everyday. On Thanksgiving, we had 4 COVID patients code during just my shift. Not to mention my hospital is also not allowing visitors anymore so all the communication with family is via the phone. I understand providing emotional support to the family and patient is part of my job, but I am just so overwhelmed with how powerless I feel in this situation. I love the ICU population in general and I love the critical nature of the care, the critical thinking, the independence, everything, but I do not know how to deal with this much death and suffering.

I don’t know if this is any help, but please know that my heart goes out to you. Your words and the feelings you describe are very similar to the things I hear from many of my coworkers. I’m not in the U.S. but we’re fighting the same fight with this blasted pandemic in Europe. I’ve personally been relatively spared since I primarily work traumas and have stayed in my regular position, but many of my coworkers who work more elective surgeries have switched to Covid ICUs as surgeries were cancelled/ postponed. I talk to them on a regular basis and try to provide whatever support I can but I can see how the job takes a heavy emotional toll on them.

The situation we’re in right now is not normal. Far from it. I think you touched on one of the things that makes ICU nursing extra hard right now. Even if an ICU nurse sees death at work even during non-Covid times, the isolation of the patients from their loved ones due to Covid places a heavy emotional burden on the patient’s nurse. 

Another thing that adds to our stress is that under more normal circumstances if we have a difficult shift, we can leave work and recharge our batteries and regain our equilibrium in a myriad of different ways. But the pandemic is with us 24/7 and limits what we can in good conscience  do in our free time. The last year has been and continues to be rough in many different ways.

If you graduated in April then all of your nursing experience has been during the Covid era. The first year of nursing is usually really hard for most new nurses with a steep learning curve. Yours has so far been a trial by fire. I just want you to know that I am impressed by the work you’ve done. Acknowledge your accomplishment. Be kind to yourself and know that you’ve been, and continue to be, a very important person for many patients. 
 

13 hours ago, adelina207 said:

It's not even just caring for these critically sick COVID patients that bothers me, it's also the way my community is treating it. I am seeing patients die every day at work, but then I go onto social media and see that half of my friends and family are posting that this virus is fake, that we're faking death certificates for financial gain, that nurses should just keep quiet because we "signed up for this". I literally feel like I'm being gaslighted by my community about this pandemic.

Do you have any family members or friends who do realize that the pandemic is real and can empathize with what you’re going through?  I hope you do! If you do, turn to them for support.

I think the ones that propagate the lie that the virus is fake are actively contributing to and worsening the trauma you’re living every shift. Since they’re family and friends, I assume they don’t mean to, but what they’re doing is in my opinion harmful just the same. If I was in your situation, I would protect myself and avoid social media altogether and only reach out to people who could provide support.

As I mentioned I’m in Europe and I don’t know what kind of support employers are obligated to provide? But you and your coworkers really are the frontline warriors in this battle and you need and deserve support. If your employer doesn’t provide some sort of debriefing/counseling, do you have the means to access it on your own?
 

13 hours ago, adelina207 said:

I'm just looking for advice. How are you guys dealing with it? How do you get back into the right headspace after a code? How are you staying healthy and keeping your stress down among all this craziness? How do you prep for a shift dealing with critically ill COVID patients? I would appreciate any advice. I 

I’ve been fortunate enough to not have my job change all that much in the last year but my previous career involved a decent amount of negative stress and I’ve always relied on nature and exercise combined with a healthy diet to recharge. After a particularly stressful event we would always debrief informally in the group involved in the incident(basically just talk about the experience and our feelings) and sometimes also in a more formal fashion, arranged (mandatory) by our employer. 

How is your unit? Is it supportive? It might not take the entire group, one or a couple of individuals whom you are comfortable confiding in could be enough. Also, if possible I wouldn’t hesitate to take one or several ”mental health days” and call off if things got to be too much. Even in extreme circumstances like the present time, a nurse cannot take care of patients without taking care of her- or himself first. And if you feel that the cost of doing the job you do is too high, there’s no shame in looking for another job that’s less acute in nature/less frontline. You matter. Your health matters. 

Best wishes and take care!! 

 

[CardiTeleRN, BSN]

I completely agree and I chose to leave the bedside. The burnout is too great that it was causing panic attacks and extreme anxiety. I couldn’t sleep. I felt sick to my stomach before every shift. Depression. Regretting nursing overall due to HOW the pandemic is being handled.

is it only American nurses feeling this way?

[BeatsPerMinute, BSN, RN]

Not just Americans. Have friends from Germany who spent some time studying in America. Still talk with them from time to time. They're suffering too. One of the German girl friends ended up getting proposed to by one of my guy friends. They married last year, and they both live in America now. Currently, because of this pandemic, my friend is not allowed to visit family in Germany and doesn't know when she will see them next. 

[subee, MSN, CRNA]

On 12/8/2020 at 10:54 AM, CardiTeleRN said:

I completely agree and I chose to leave the bedside. The burnout is too great that it was causing panic attacks and extreme anxiety. I couldn’t sleep. I felt sick to my stomach before every shift. Depression. Regretting nursing overall due to HOW the pandemic is being handled.

is it only American nurses feeling this way?

This: " Regretting nursing overall due to HOW the pandemic is being handled."  This present situation is much worst than post 9/11 because we have lost our feelings for our fellow citizens and no longer can act cohesively as Americans to fight a common enemy.  No one vilified doctors or nurses at this time.  No one said the attacks weren't real (well, maybe except for the Bat#(%* crazies) or that we would never again have another attack after an election.  We all suffered TOGETHER and that support is what got people to go to their jobs every day.  We have descended to the grammatical phrase "Me and my ____" rather than "_____and I" and, IMHO, that says it all.
 

 

[GS ED RN, MSN, RN]

your words definitely echo through many of us - thank you for all of your hard work -- its unfathomable - I have been a nurse for only 5 years and I swear some days it feels like 50 years (KUDOS to the seasoned nurses out there) I spent a good chunk of my MSN researching burnout - especially in critical care setting and this was before COVID - burnout is VERY real - and if and when we get to the other side of this s**t show we are going to have to deal with the sequelae. All I can say is that I am happy you are using this platform to express your feelings KEEP doing that - healthcare workers are the only one who truly can empathize and understand these feelings. Secondly, HONOR yourself, HONOR your feelings they are 100% valid - do not let anyone ever tell you otherwise. 

I used to do spin workout classes in the studio after work and it helped me decompress - the music would vibrate through my body and all the BS and bad vibes from work would sweat out - well COVID ruined a safe workout space outside of home -- I invested in a home spin bike -- (Im not made of money - many of us arent - but you have to invest in what makes you happy!) I listen to music before work and get myself my fav coffee - (even tho I cant enjoy it at work like I used to) I also stopped picking up extra shifts - I feel guilty for it - but the extra work and stress disturb my inner peace --- point being - do little things for yourself even if it costs money or is fattening - honor yourself! we will get through this! we need to stick together!

[igtgrnokbye]

After a long day....A long day.  I’ll go to the chapel and kneel down and pray for every soul. The souls we fight for to stay with us and those that have passed.  I pray for the endurance and intelligence to have Gods will work through me no matter the outcome. 
I will study my specialty especially if there is weakness in my practice. Sharpening every nook of knowledge till I can write the protocols myself. 
If I am floated to the lower acuity units I’ll find a lonely patient and sit with them hold their hand and just talk to hopefully have a conversation  that ends in a smile

[LibraNurse27, BSN, RN]

I can't imagine starting your nursing career right when this pandemic started, and in ICU no less. Thank you for your hard work. I agree with avoiding social media. I quit facebook and I'm so much happier. And it's OK to distance yourself from people who are saying covid is fake and going around spreading it. Better to be distant than resentful and depressed. After work I hug my partner and my pets, but sometimes need some time to decompress before interacting with anyone. Sometimes I just need to cry on my way home, release some of the stress and sadness.

Exercise helps if you have the energy. And venting with coworkers plus encouraging each other. I hope you're working with a good team who support you. And if it affects your mental health too severely it's OK to take some time off if your work allows it, or look for a different job. No shame in that; we're not obligated to work with covid, and you have already played a huge part in the fight. I hope things get better, hang in there!

[speedynurse, ADN, BSN, RN, EMT-P]

On 12/17/2020 at 11:20 PM, LibraNurse27 said:

I can't imagine starting your nursing career right when this pandemic started, and in ICU no less. Thank you for your hard work. I agree with avoiding social media. I quit facebook and I'm so much happier. And it's OK to distance yourself from people who are saying covid is fake and going around spreading it. Better to be distant than resentful and depressed. After work I hug my partner and my pets, but sometimes need some time to decompress before interacting with anyone. Sometimes I just need to cry on my way home, release some of the stress and sadness.

Exercise helps if you have the energy. And venting with coworkers plus encouraging each other. I hope you're working with a good team who support you. And if it affects your mental health too severely it's OK to take some time off if your work allows it, or look for a different job. No shame in that; we're not obligated to work with covid, and you have already played a huge part in the fight. I hope things get better, hang in there!

I have seen both sides.....people that just go on and on and on about covid and won’t talk about anything else....and then there are people in my family (my parents and other relatives) that keep acting like the whole thing is made up and won’t stop talking about that either and it’s exhausting. I have to say I have become closer to a few nurse friends this year simply because we can find a good middle ground where we can discuss this seriously but don’t overwhelm each other with too much negative talk. This may sound super silly but I also have found comfort in my little dog and watching some tv, reading, hiking, and decorating my home. That keeps me sane and going on!

I am so sorry that you had to start nursing though during the pandemic. I know nursing was stressful enough for me as a new grad way before the pandemic and that was during normal stress times! I can’t imagine my new grad journey starting during covid times. Counseling or EAP may be something to consider - you are dealing with heavy stress and death and dying at a very abnormal level and it’s completely natural that you feel emotions and sadness from it - it would be much worse to not be able to feel anything from it.

I left the ER this year because of multiple reasons but the constant death along with many other outside factors just got to me. There is still some abnormal factors in surgical services but not nearly to the point that critical care nursing is dealing with.

[scrabblern, RN]

I can't imagine the stress you're going through and seeing people who deliberately choose to harm themselves and endanger their environment only to end up in a situation beyond salvation, leaving you as a witness. 

There's little I can say to ease your pain. This is an abnormal time, similar to war effort nursing. The people who will understand you best are your peers. Turn to them, and try to collaborate to have a space for healing, whether online or outdoors. Look for a counselor/therapist now as they are hard to come by even when things are normal... I would expect this entire cohort of COVID nurses to be treated for PTSD, to be honest. So while you're away from the floor, just do your best right now to take care of yourself, indulge yourself however you can, whether it be bath bombs or ice cream, extra snuggles with your pet, whatever works, so that you can mentally survive the stress of being a COVID ICU nurse. 

Even when COVID passes, you will still have patients who harmed themselves, who are beyond salvation with ignorant families. You will still have a code on your floor at least weekly. You will see it all, just less frequently as long as you're an ICU nurse. 

As a fellow nurse, I admire you, and thank you for your service.