Nurse burnout/Moral distress/Compassion fatigue

Nurses General Nursing

Published

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.

"Accept conditions as they exist, or accept the responsibility for changing them."

Specializes in Med-Surg, Psych.

I have experienced all of these more than once in my career. I always go back to the idea of being an executive secretary, but then knowing my luck I think I will have a big jerk as a boss and that ends that thought.

I am currently taking a break from nursing, I will probably go back and a couple months or so but I need time to re-evaluate why I became a nurse and where have I worked before that made me somewhat happy and content. There is an old saying,"Life is like a merry go round and sometimes you just have to get off."

Nursing can be a brutal career choice even though we are never informed of it when we are training for it. It will suck the life out of you. I will return to nursing just part time and maybe if you can afford it think about doing the same. I am a firm believer that every good nurse has been where you are and you can recover. Take time for yourself and don't lose faith in the profession of nursing.

Specializes in Med Surg, Parish Nurse, Hospice.

I truly hope that you are feeling better. I could have and did write your letter - or something similar a few years ago. I finally got to the point where I just could no longer do day to day pt care. I had just started a new job and didn't know what would happen to me and the job. I was what I called tired of caring on demand. I announced my problem to my boss and sought help through the employee assist program. I was started on meds by a psych md and sought 1-1 counseling. I was able to return to work after 7 weeks. This was 2 years ago. Today I feel better than I have felt in years. I don't work much, but money isn't always the answer. I have been a nurse longer than you and look forward to the day I can finally quit. Hang in there, its not easy but if you need help get it! About working nights, I can't imagine working full time nights, but my husband does, has for 10 years and loves it. He works in a hospital but is not a nurse. He has a routine that he pretty much sticks with as far as sleeping. Good Luck!

I have only been a nurse almost 4 years and I am seriously burned out. I am not happy with this profession like I used to be. I am still trying to hold on because I need a paycheck. But I would like to take another major break from it. I went to school for something else and was not successful. I plan to go to school to become a NP or a PA because I noticed that they don't have the grief we have. They also seem a whole lot happier.

I hope things work out for everyone here. It is a trying journey.

Specializes in ER.

One thing the OP said which seems to have gotten lost was the difference between being a servant and a caregiver.

I can relate to that.

There are days when I think I just cannot give out another bedpan, nor retrieve it and check its contents.

I guess I just worked 25 years too long in this game.

But more difficult are the days when you get a 'trigger-happy' patient who uses the call bell every five minutes, usually just for "Can you pass me that newpaper?", or "When is the doctor coming to see me?", which I've already answered at least a dozen times to her in the past two hours.

"Can you call my family and tell them I'm seriously ill?", when thy have a cellphone right next to them.

Days when perfectly capable patients assume the 'patient' role and start wanting help with things they can do themselves.

"Pass me my shoes so I can walk to the bathroom", is to me the dumbest thing I hear : )

That to me is being a servant, its not healthcare, and it doesnt help them gain independance for when they go home. But try telling them to reach the newspaper for themselves, its a good stretching exercise and all you get is a complaint about being a nasty nurse.

Teling them that no drinking a bottle of coke will not alleviate their nausea gets you a complaint of being uncaring.

Telling them that if they can down a whole packet of M&Ms in two minutes then they can swallow their tablets, and not I am not going to crush them gets a report of negligence.

Point out that if they are able to walk then surely they can manage their own shoes, and you gets families complaining that you don't care.

Am I going to be there with them at home? Ummm, no.

So isnt is better for me to see that they CAN manage for themselves, and are safe to do so, rather than maintaining the false "I'm a patient" scenario that is totally unrealistic when preparing them for the home environment?

Until the time folk get out of this "I'm a patient therefore I am helpless" mindset, I am still looking to leave nursing at the earliest opportunity.

That is what demoralizes nurses, not a genuine workload.

The team I work with loses about one quarter of its staff every year, and sickness levels are higher than others hospitals in this area.

Does that tell you anything about the support we have?

You must have been looking in the window of my nursing life. WE get in trouble for EVERYTHING. And the patients take advantage of the nurse-patient relationship and try to make us servants.

Specializes in Mostly ETC, very interested in wounds.

I know it's been almost a year since anyone commented on this but this is a place that I often find myself. I believe I am refered to as middle mangement. I get to know what all the big wigs are talking about and sometimes put in my opinion but I also work along side the floor nurses and techs. My job is just to keep peace is a crazy, crazy place but after a while. Peace makers can feel like they are going crazy.

A few things that help I do that can help:

-Remember that you did the best job that you can do with the resources that you have. No woulda or couldas, here. They don't help so try to stop.

-When you go home with it all bottled up and you can't talk to your family about it write it down. I don't mean HIPPA violations. I mean just get your thougthts together and write it out. I help you organize your thoughts and deal with them instead of bottling them in that just makes you numb.

-Also find a co-worker that you can talk to who will listen and help you brainstorm for a solution to your problems without adding their problems to yours.

-Also most work places offer vacation and sick time, for God's sake take them. Even if it's just an extended weekend, it's something to look forward to.

Specializes in Med Surg, Hospice, Home Health.

original poster------you hit the nail on the HEAD! Thank you for starting this thread. i have shared it with my whole office---we are all experiencing levels of your symptoms. Some days are bettter than others. I don't want to go back on antidepressants. Hospice is a roller coaster, and just when you think you have a handle on things, everything changes. I do my best to fill my emotional tank with church, friends, healthy relationships---things that will fill my tank. On bad days, it seems everyone takes a "piece" of me.

Wow, ditto, the OP described how I'm feeling exactly, thanks for everyone who wrote something! Was starting to feel like I was a failure at being a nurse, since intellectually I "know" all of this but can't seem to get unstuck. It's like on airplanes when they tell you to apply your own oxygen mask before helping the child because what good will you be to someone that actually needs your help if you're passed out and depleted.

+ Add a Comment