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Nurse burnout/Moral distress/Compassion fatigue

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by Lee238 Lee238 (New Member) New Member

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EMSnut45 works as a Critical Care Transport Nurse and Paramedic.

11,931 Visitors; 178 Posts

Lee,

I could have written your exact post a year ago. I had the same feelings as you, and had the same amount of experience. I ultimately had to leave that position and I couldn't be happier! I'm in the same specialty, but the environment and support system is so much better!

I also agree with the others who say you should talk to your doctor. You'll need every ounce of strength to get through this, and that includes mental strength.

Just remember, you don't have to feel this way!

Feel free to PM me if you'd like!

Best of luck,

EMSnut

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790 Visitors; 25 Posts

I've only been working a few years and am already experiencing signs of burnout/fatigue. There is possibly another word for it that I've recently discovered on here - moral distress (google).

I work on an acute-care floor where the patients cannot do anything for themselves. The management is terrible and extremely uninvolved. I am scared to get into specifics, but i'll just say this: the turnover rate is amazingly high. There are issues with disrespect between the nurses and also across disciplines between nurses and techs. I'm on the nightshift, so it's hard to say if my symptoms are attributed to that, the work environment or a combination of both. I feel it's the latter.

*Compassion fatigue

the thought of a patient outside of work can instantly bring me to tears, thinking of their sickness.

*Troubles with personal/romantic relationships

I find that I am increasingly distant from my boyfriend, who I've lived with for a long time. Often times the things I see at work between the disrespect among coworkers and the degree of sickness my patients have make it impossible for me to open up to him. In other words - the things I see at work are so hard for anyone NOT in the nursing field to relate to that they would find it unimaginable - so I don't even bother getting into it. Instead, I keep it inside, bottled up. I become numb to it myself, like I'm just drifting through life not feeling much. I am even less physically able to be with him - often times freezing up right before we have sex.

*Sad

I don't even get together with friends that often anymore. It's too much effort.

So there you have it, my brutally honest story of the beginning of my nursing career.

Wow! This must really be a tough time for you. Thank you so much for sharing. This will definitely help me better assess a career in nursing before it is too late. Particularly, the things I don't really wish to see. Since I have trouble even pricking someone, this can become a problem in the future.

Try to get professional help the next chance you get.

A bit of silliness based on the bold texts above... after all, silly things can evoke a smile, laugh, guffaw, right?

P.S. Look at the related Burnout in Nursing video as well.

Edited by CareRx

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wishiwereanurse works as a glorified PO IM IV SQ PR pusher.

1 Article; 8,236 Visitors; 265 Posts

you took the words right out of my mouth...

someone mentioned the word 'depressed', and knowing myself, being in very similar situation as yours, and having felt depression before...I don't think I am depressed...I know I have a sad state of life, but depressed....no...depression is worse. I just got back from a 6-wk vacation to 'de-stress' myself, I was fine when I was on break.. but as soon as I was back at work, it was like I never had a vacation... I feel like I have aged significantly in the last 3 years, and even after doing night shift for so long my body is still not used to it, and lately it wants me to sleep at night and stay awake as long as the sun is out.

I've been thinking of Public Health for a long time now, it is something I am interested in just because I am tired of seeing sick people and their comorbities in the hospital, when I know most of the diseases people have in this country can be prevented...I'm tired of the business side of the health care industry, people talking abt who's got what insurance and what's covered by such and such...and hospitals admitting people just so they have a census...

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canesdukegirl has 14 years experience and works as a OR nursing.

2 Likes; 8 Articles; 36,785 Visitors; 2,543 Posts

Oh honey, I totally understand where you are coming from. As several posters have written, I could also have written your post. I worked nightshift for 2 years and I was not myself. I hated to look in the mirror; I couldn't stand myself, much less other people. I would instantly get irritated at the slightest thing. I was, simply put, a person unrecognizable to myself and my close friends. Surly when I used to be bubbly, frowning when I used to smile all the time, short fused when I used to have the patience of Job, and isolated when I used to be social.

Night shift changes your body rhythms, as you know. Depression is part of the risk of working night shift. You don't see daylight, you don't interact with people you know because you are trying to get your "day clock" up and running in order to engage with them (and this seems to be a HUGE effort), and you are constantly being jerked from "night body clock" to "day body clock". All of this leads to insipid isolation.

Evaluate what drives you to work the night shift. Is it the extra money? Is it because you seem to be more productive during the night? Do you enjoy the absence of the BS from administration? Really look for the things that you get out of working this shift. Write it down.

Now try to remember what it was like to work day shift. Did getting up at O'Dark 30 seem like a mountain to climb? Did you hate the rough and tumble pace of day shift? Write down what you liked/hated about working day shift.

To expand, write down the symptoms that you are feeling. You did a great job outlining the feelings and sx you were having in your post. I implore you to expand on these points. Take what you have written down and look at the big picture that is in front of you. Talk to your boyfriend about it. He wants to see you happy as well.

Before you go to your doctor to discuss your sx, do some soul searching. Take a few days off-you MUST do this to clear your mind. You sound like you have some sx of anxiety. I can relate. It takes me days to unwind when I am on vacation because I can't let go of the notion that I must be in control at all times or the world will end. See?!? This is lunacy on my part, and I have finally learned to recognize it and LET IT GO.

If you feel that you don't have the energy to do anything, then I would make an appt with your doc to discuss the possibility of chronic fatigue syndrome. I used to think this was a BS dx, but it is real, and the treatments are helpful (i.e., exercise, meds, eating things other than junk, having more than Diet Mt. Dew being my main source of fluids, journaling).

Take small steps. You are at a point now in your life where the smallest step seems like you are climbing the stairs of the Mt. Tai Staircase in China. Be gentle with yourself, but at the same time, show yourself some tough love. YOU are the only person that can change your circumstances. Remember that excited, empathetic and energetic chick you once were? DON'T LET THIS JOB ROB YOU OF WHO YOU ARE. Take back your identity with a vengeance.

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Chin up has 26 years experience and works as a Employment Law.

1 Like; 5,534 Visitors; 694 Posts

I've only been working a few years and am already experiencing signs of burnout/fatigue. There is possibly another word for it that I've recently discovered on here - moral distress (google).

Hi lee,

Thanks for mentioning moral distress. Had never heard of it. Just googles and interesting. Will research more.

I work on an acute-care floor where the patients cannot do anything for themselves. The management is terrible and extremely uninvolved. I am scared to get into specifics, but i'll just say this: the turnover rate is amazingly high. There are issues with disrespect between the nurses and also across disciplines between nurses and techs. I'm on the nightshift, so it's hard to say if my symptoms are attributed to that, the work environment or a combination of both. I feel it's the latter.

It is probably a culmination of many things. Where you have terrible management, staff bullying and needy patients, you run the risk of shutting down. Mentally, physically and emotionally. Add in night shift, lack of sleep and isolation, your coping skills are quickly diminishing. Roll them all together, this extremely toxic, unhealthy environment, and the door to depression is wide open. You need not only to remove yourself from this environment, you need professional help for support so as not to become, "clinically" depressed. A very serious condition, that when untreated is debilitating and can lead to death. Not saying, you are near this, but you need err on the side of caution. You need the help right now. You are in the storm and cannot see a way out. Your judgement, is off.

My symptoms:

*Physical exhaustion/fatigue mixed, ironically, with insomnia.

I am constantly tired and lacking energy, yet cannot seem to sleep more than 3-4 hours in a row. I've worked many a 12 hour shifts off 3 hours of sleep, and being on night shifts makes it seem impossible to ever catch up. I lay in bed literally for hours and hours unable to fall asleep and "turn off" my brain and my thoughts, which always, no matter how hard I fight it, go back to work scenarios that fill me with bad feelings that make my stomach turn. Even when I enter the half awake/half asleep phase - I catch myself thinking nonsensical thoughts about work and it wakes me right back up.

You are suffering from depression. This can be helped with a change in milieu and behavior modification. Get help before it reaches disorder status.

*Compassion fatigue

This is so difficult to admit, but if I don't I'll never know if anyone else experiences this. I find my attitude towards patients increasingly negative. I am often times angry inside at them for requesting something from me that I find unnecessary and feel more like a servant than a caregiver. My interactions are brief and impersonal and I get antsy when a lengthy conversation is initiated, all the while thinking about the 7 other patients I have yet to see and the hours of documentation I have yet to do related to being short-staffed. This is scary for me because I am an extremely empathetic person - the thought of a patient outside of work can instantly bring me to tears, thinking of their sickness.

Yep, you have nothing left to give. When you think about it, it makes sense, you are hurting and beat down, your body is in survival mode and can only protect itself. The amazing body will do for us, when we can't or won't.

*Troubles with personal/romantic relationships

I find that I am increasingly distant from my boyfriend, who I've lived with for a long time. Often times the things I see at work between the disrespect among coworkers and the degree of sickness my patients have make it impossible for me to open up to him. In other words - the things I see at work are so hard for anyone NOT in the nursing field to relate to that they would find it unimaginable - so I don't even bother getting into it. Instead, I keep it inside, bottled up. I become numb to it myself, like I'm just drifting through life not feeling much. I am even less physically able to be with him - often times freezing up right before we have sex.

Again, signs of severe depression. Until you listen to yourself and body, you will continue to isolate yourself and push him out. You have nothing to give anyone right now. An empty vessel is empty. A broken cistern leaks what little is put in it. His love and support can't be received right now, you need to fix your leaks and only then, will you be able to receive enough to share again.

*Easily irritable (Basically, a constant state of the worst PMS imaginable).

Anything and everything irritates me and my anger is unproportionate to the "offense". I have zero tolerance for people now (new, I was never like this before). Someone messing up my order at a deli could throw me off for an entire morning. I'm usually a passive aggressive person, but I've found myself so irritable lately that I'm unnecessarily rude.

*Sad

I feel sad - which for me manifests as lazy. I don't want to do anything. I'd rather watch television and tune out than go to the gym and be active and interact with people. I don't even get together with friends that often anymore. It's too much effort.

So there you have it, my brutally honest story of the beginning of my nursing career. It's obvious I am experiencing ALL of those things (burnout, compassion fatigue, and moral distress). Please tell me someone out there relates on this level and help me figure out what steps to take.

I understand everything you are experiencing and written. I have been through all of this. Everything I said to you is from my personal experience. It may not be the norm, I am not a shrink, this is not my speciality. All I bring, I bring with empathy and care for you, based on my own sickness with this very affliction. It is a sickness and has to be treated as such and why I suggest, going to a professional as well as leaving your employment. You are crying out for help and deserve to receive it. You do not deserve your sad state, which has broken you down and keeping you from abundant life. All ADL have been impacted greatly and thus,you need to act, right away. You have my prayers and support and I sincerely hope, you will give what I wrote some thought. Please email anytime if you need to talk. Life is vulnerable, yet precious and worth fighting for. Peace!

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Ruby Vee has 40 years experience as a BSN.

941 Likes; 11 Followers; 64 Articles; 168,844 Visitors; 13,727 Posts

add me to the list of those who could have written your post at one time or another. you've been brutally honest about your feelings with us . . . now go tell your doctor.

as a guess, you could be suffering from depression. or it could be a toxic work environment getting you down. in this economy, i wouldn't recommend changing jobs unless you have another all lined up. but changing shifts (or rotating or stopping the rotating) could help. so could more exercise, eating better and getting more sleep. (i know, you said you try to sleep but you just can't.) i had to get a prescription for ambien so i could sleep. when i paid back my sleep debt, life looked surprisingly better.

if you don't feel as though your boyfriend can understand your work life, journal. journalling helps to clarify your feelings and actually has been found to reduce stress. it could be that once you've done some journalling, you'll have a clearer idea of what to say to your boyfriend, how to express yourself and he will get it. then again, maybe not. but it's worth a try.

please get some help. you can't deal with this on your own. good luck!

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17,263 Visitors; 542 Posts

Ditto what everyone else said. Please go talk to a psychiatrist or psychologist about all of this. Life is too short to be miserable!

Also, just about you finding it difficult to talk to your boyfriend about issues in nursing because he's not in the field:

- While it may be more difficult for your boyfriend to RELATE to what you are saying, I still think that you should try to talk to him about your work related (and any for that matter) problems.

I have found that my non-nursing/aide/wanna-be-nurse friends CAN help me work through my work problems, either as a sounding board, advice or just allowing me to vent. I have found that I have to tweak the way I talk to them compared to my friends in the field.

Just because your boyfriend isn't in the field doesn't mean that he can't emphatize with your feelings or make you feel better in some way. After all, your boyfriend's line of work is different than yours. When he has a work related problem, can't you emphatize even if your not in the field? If he can't then he's either not a very good boyfriend or that is something that you both can work on.....

I sincerely hope you feel better. Please talk to a professional.

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1,393 Visitors; 55 Posts

Wowww! I thought I was the only one. I have not even made it to being a nurse four years yet and I am a wreck. I find myself crying off and on and its insane. I am honestly thinking about seeing a therapist to help me through it. I had NO IDEA that this job would do this to me.

I hope I don't offend you by saying that I think that it will be a good idea for you to see a therapist. If push comes to shove, PLEASE look for another job. I believe this will help with your mental state.

Take care.

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19,555 Visitors; 1,735 Posts

I've only been working a few years and am already experiencing signs of burnout/fatigue. There is possibly another word for it that I've recently discovered on here - moral distress (google).

I work on an acute-care floor where the patients cannot do anything for themselves. The management is terrible and extremely uninvolved. I am scared to get into specifics, but i'll just say this: the turnover rate is amazingly high. There are issues with disrespect between the nurses and also across disciplines between nurses and techs. I'm on the nightshift, so it's hard to say if my symptoms are attributed to that, the work environment or a combination of both. I feel it's the latter.

My symptoms:

*Physical exhaustion/fatigue mixed, ironically, with insomnia.

I am constantly tired and lacking energy, yet cannot seem to sleep more than 3-4 hours in a row. I've worked many a 12 hour shifts off 3 hours of sleep, and being on night shifts makes it seem impossible to ever catch up. I lay in bed literally for hours and hours unable to fall asleep and "turn off" my brain and my thoughts, which always, no matter how hard I fight it, go back to work scenarios that fill me with bad feelings that make my stomach turn. Even when I enter the half awake/half asleep phase - I catch myself thinking nonsensical thoughts about work and it wakes me right back up.

*Compassion fatigue

This is so difficult to admit, but if I don't I'll never know if anyone else experiences this. I find my attitude towards patients increasingly negative. I am often times angry inside at them for requesting something from me that I find unnecessary and feel more like a servant than a caregiver. My interactions are brief and impersonal and I get antsy when a lengthy conversation is initiated, all the while thinking about the 7 other patients I have yet to see and the hours of documentation I have yet to do related to being short-staffed. This is scary for me because I am an extremely empathetic person - the thought of a patient outside of work can instantly bring me to tears, thinking of their sickness.

*Troubles with personal/romantic relationships

I find that I am increasingly distant from my boyfriend, who I've lived with for a long time. Often times the things I see at work between the disrespect among coworkers and the degree of sickness my patients have make it impossible for me to open up to him. In other words - the things I see at work are so hard for anyone NOT in the nursing field to relate to that they would find it unimaginable - so I don't even bother getting into it. Instead, I keep it inside, bottled up. I become numb to it myself, like I'm just drifting through life not feeling much. I am even less physically able to be with him - often times freezing up right before we have sex.

*Easily irritable (Basically, a constant state of the worst PMS imaginable).

Anything and everything irritates me and my anger is unproportionate to the "offense". I have zero tolerance for people now (new, I was never like this before). Someone messing up my order at a deli could throw me off for an entire morning. I'm usually a passive aggressive person, but I've found myself so irritable lately that I'm unnecessarily rude.

*Sad

I feel sad - which for me manifests as lazy. I don't want to do anything. I'd rather watch television and tune out than go to the gym and be active and interact with people. I don't even get together with friends that often anymore. It's too much effort.

So there you have it, my brutally honest story of the beginning of my nursing career. It's obvious I am experiencing ALL of those things (burnout, compassion fatigue, and moral distress). Please tell me someone out there relates on this level and help me figure out what steps to take.

I can say I am a new nurse and have experienced almost everything you wrote about- compassion fatigue, trouble with personal relationships which can be attributed directly or indirectly with my job, physical exhaustion.

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19,555 Visitors; 1,735 Posts

It's called depression. Go see a doctor. Will reply later, after work. Peace!

I don't have a source, but remember when this topic was vaguely covered in school they mentioned "compassion fatigue" and the article specifically stated it was not depression or even burnout. It was something different. (yes i know how helpful this is .lol)

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tewdles has 31 years experience.

30,580 Visitors; 3,156 Posts

depression would be a medical diagnosis, which most of us are not qualified to make...

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RNCMSN has 22 years experience and works as a RN Traveler.

1,957 Visitors; 36 Posts

I see no other posts from you. I hope you are well and not regretting your openness on this forum.

My thoughts are to take a break, remove yourself from the situation and do some soul searching. Get back in touch with you and what makes you happy. It sounds like you do need to seek another position.

Let us know how you are doing.

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