I have been pondering this very thing with in myself as of late. Or something similar. I have been in healthcare for 12-13 years and been an RN for 7 of those and I have been feeling burnt out the last 2 years. I think burn out is what you are sensing, especially, among hospital and nursing home nurses.
It is hard to see death an increasing violence over and over again and maintain the same level of empathy. Especially if the nurse is not taking care of herself outside of work (because of family obligations or working long hours etc). Lets face it after working 13 hours we are tired and dont have time to take care of ourselves. The number one piece of advice I get from nurses after a hard day is to "Have a glass of wine.. Or two" with a smile. I do not know any drug addicts on my unit but I do know a lot of my colleagues indulge in legal substances such as ETOH to cope with stressful days. Not that I would know if they were doing other drugs like pills.. Some smoke pot but not many.
I have felt increasingly worn out and I believe there are two paths you can take at this point. Disassociate more from your pts that are dying etc (seem cold and tough) or work less and take care of yourself more and consider a change. Not a total 180 but realize in nursing you have option. I have decided to go back to school and get my NP so I will not be on the front lines killing my back and my emotional well being. It is hard to keep that level of empathy when you graduate nursing for years. It wears on you. I have always given a lot to my pts and I think it is why i am so worn out now. For some the change might be to try another nursing field because school is not realistic.
Where i work I would say the bunt out and not is about in half. I know who I can go to for a sympathetic ear and who will brush it off saying," Welcome to nursing." Or, "Welcome to (insert name of unit here) ." I do not regret becoming a nurse. It was the best thing I could have done for myself. I wish my back didnt hurt as much and I wish the system worked more fore nurses and our pts but I do not regret it. You have to take care of yourself and know who you can go to for support. You need support as a nurse you can not suffer silently like so many do because they want to appear tough. For fear if they do not appear like they can handle it then they are bad nurses. When nursing is emotionally charged almost 100% of the time.
Get you RN and love it but pay attn to when you start to have feelings of bun out and talk to someone and take care of yourself. Step back and work less and then regroup and see if you need a change. That is my advice.
A Vermont RN