I agree with @maxthecat with regard to the narrowed scope of vision we often have when working acute inpatient psych. You're looking at a snapshot -- a single episode in a lifetime of many -- and it's often quite "unpretty." I too work inpatient psych, but my facility is designed (unintentionally) in such a way that I frequently encounter past patients waiting in the outpatient clinics. This often results in big smiles, fist-bumps, and even some boundary-breaking hugs. Seeing a patient who has reclaimed at least some of their resilience, however temporarily in the grand scheme, is actually one of the most fulfilling parts of my life. It can be very energizing.
Yes, there is no shortage of struggles, headaches, and heartaches. I learned very early that if you don't amplify the significance of victories and accomplishments -- small they may seem -- the negatives can be stifling.
While I do work with adults, my primary area of specialty is child and adolescent psychiatry. If you want countless opportunities to make a positive impact, this is the place to do it. Don't get me wrong, it is heart-wrenching work. And interacting with damaging parents/families, guardians ad litem, social service agencies, magistrates, etc. can be taxing. But when a patient is being discharged with some new coping skills, hopefully strengthened resilience, maybe some new medicine, etc., and you get the side-hug, handshake, or even just the "that was my awesome nurse!" comment on their way out the door, you feel like a million bucks. And even if the situation is not ideal, you know you were a positive force for some period of time. And that's a privilege.
OK, so this post took a slight turn (smile). But my point is... try to find an area of passion, if you're not already there. It can make all the difference in helping to keep burnout at bay.
One last thought. The burned-out RNs/MDs you mentioned... they can definitely influence the culture. But you can work against that. Being the smiling and at-times-slightly-annoying-but-always-likable RN on the unit makes people feel better at work, even if they snark. And research shows that the physical act of smiling, even falsely, actually improves mood. So fake it! (big smile)