Running on Empty

There are times in nursing when we begin to run on empty, when our emotional, spiritual and physical resources dry up. This article is a discussion about the importance of continuing to feed our spirits so that we are able to provide the best possible care to our patients. Nurses Announcements Archive Article

"Come to me, all you who are weary and burdened, and I will give you rest." Matthew 11:28

Tears spilled over as I clicked off my cell phone and started the car, instructing my GPS to take me to my next hospice visit thirty miles away. The tears were not, as you might suppose, out of sadness for the dying patient that I was headed to see; they were instead tears of fatigue and self-pity, of overwork and of frustration.

As I drove, I struggled to re-direct my emotions and to achieve control over all these unwanted feelings that seemed to bubble up from murky depths of discouragement. Deep breaths, calming thoughts, a focus on the particular patient that I was about to see, and a silent prayer, all helped me gather myself to continue to offer the best possible care when I arrived at the home.

Being a professional nurse of many years, I know the signs of compassion fatigue or just fatigue in general. But life is not an idealized parade of lovely patients in an orderly pattern, nicely separated by re-energizing breaks where well-balanced meals suddenly appear, consumed while a favorite selection of music plays in the background. Real life as a nurse looks more like concentrated discipline to stay focused on the needs of the patient, while dismissing or delaying the cacophony of missed messages, equipment failures, scheduling snafus, and documentation demands.

With time and experience, we all learn to prioritize and master the art of offering ourselves without becoming completely depleted--that is, unless you look at days like the one I refer to above. If we are to be honest, we all have days like that one: days where we overextend ourselves physically, emotionally and spiritually; days where we give until we are running on empty.

Are you a person that fills up your car's gas tank when it gets half way to empty? Do you wait until the light comes on? Or are you the person who waits until the car sputters a bit before coasting in to the nearest station? As nurses who are also spiritual beings, sometimes we expect to keep running on fumes. We don't take the time we need to in order to fill our spiritual tanks. Instead, we survive on "fast food" of the spirit.

I work as both a Hospice Nurse and as a Parish Nurse. I am usually asked to help with the orientation sessions for the new Parish Nurses. My topic is usually, "Time Management." One of the things I tell the new Parish Nurses is: "Minister out of the overflow." Use your imagination to picture a cup, a chalice. Now pour water into that cup until it runs over, like a fountain. As long as our nursing and care for others comes out of the overflow of our hearts, then we will not run dry. We will continue to be able to give and meet others' needs. But when we stop the in-coming nurture of our own souls and bodies, and begin, instead to dip into the cup itself, then we quickly find ourselves in tears as we ride down the road or the elevator, ready to step out to another shift.

If we keep our lives in balance, then we can be those excellent nurses that we so long to be. It is our work to overcome cynicism, doubt, frustration and to journey on as advocates, compassionate healers who reach forward through the maze of computerized care to see the patient and meet them where they are. We move beyond the chores to the connections, to the real and therapeutic touch.

And we don't give up because it is so hard. Let me tell you something: nursing has always been hard and it always will be. We find reasons to complain--we are human, after all--but truly, we have more technology, more ability to relieve pain and suffering, more treatments and more understanding than ever before. Let's do ourselves and our profession a service by focusing less on what is wrong, and instead maximizing what is good.

Mother Teresa once said, "If you can't feed a hundred, just feed one." The idea that we may not be able to do everything for everybody assaults us daily. But we can make one person's day better. One patient. One co-worker. One environmental services person. Just one.

Being competent and compassionate nurses stems from a balanced life, one that focuses on mind, soul, body--or said another way: if we focus on spiritual nourishment and self-care then our words and deeds will be those of a nurse who is both competent and compassionate. Self-care is not a self-centered, self-absorbed state of mind. It is not the mentality of "I work hard, so I deserve what I take for myself." Instead, it is maintaining a rhythm of giving from the spirit and receiving into the spirit. It is nurturing our whole selves so that we can continue to give.

George Saunders, a contemporary fiction writer, writes, "What I regret most in my life are failures of kindness. Those moments when another human being was there, in front of me, suffering, and I responded...sensibly. Reservedly. Mildly. Err in the direction of kindness. Do those things that incline you toward the big questions, and avoid the things that would reduce you and make you trivial. That luminous part of you that exists beyond personality--your soul, if you will--is as bright and shining as any that has ever been."

Let us remember that between the twin hills of competency and compassion lies the mountaintop of the true art of nursing. It is a place we all long to do more than just visit. We desire to live there, day in and day out, creating art through our work and making a difference one person at a time.

Joy Eastridge, RN, BSN, CHPN

May 13, 2015

After working as a hospital RN, the compassion fatigue hit me and I noticed I was still doing my job, by giving meds, dressing changes, etc. but I started really to step back and not have compassion. What I believe has made this issue in nursing worse, is the amount of documentation going on. The computer has become the patient too often and getting those clicks done becomes more important by management. I decided it was time to leave and I gave notice. I loved nursing but I did not love the corporate nursing that really does not give time to the patient. I miss the job, the people, the challenges, and the patients. Now it is time for me, my husband, my family, and my friends.

Specializes in Faith Community Nurse (FCN).
After working as a hospital RN, the compassion fatigue hit me and I noticed I was still doing my job, by giving meds, dressing changes, etc. but I started really to step back and not have compassion. What I believe has made this issue in nursing worse, is the amount of documentation going on. The computer has become the patient too often and getting those clicks done becomes more important by management. I decided it was time to leave and I gave notice. I loved nursing but I did not love the corporate nursing that really does not give time to the patient. I miss the job, the people, the challenges, and the patients. Now it is time for me, my husband, my family, and my friends.

Thank you for sharing from your personal experience. I thought your statement about the computer becoming the patient was an interesting perspective. I wonder how we can work to continue to document without allowing the computer to become the focus of what we do...That is an ongoing dilemma, don't you think? I hope that you find peace and renewal and then find another way to connect with nursing and patient care.

Jean, in my opinion, the documentation will always be what is most important in nursing in the hospital setting. It is all about liability now. At the hospital I worked at, patient satisfaction was most important and a nurse would get called into the office when a patient filled out a form with a complaint, even if this patient ran every nurse into the ground. The manager "had" to call the nurse in. I call this sort of "nurse bashing, getting control of the nurse". And I loved my manager, she was and is a wonderful manager and person but she also is part of the chain ladder up to the CEO. Next, everything was/is about "budget". There is enough in the "budget" for manager meetings, and then meetings about the meetings" but not enough in the budget for patient care. What would help tremendously would be for more aides. Our aides had too many patients and few would get the care they really need. Since the RN is dealing with clicking on the computer, documenting to avoid a legal issue, and seldom has time to do what an aide is trained for, then if we had more aides, patients would be happier, the RN would have time for all those tasks, and a good assessment of the patient but I am afraid, at least where I worked, that this is not in the cards. Don't get my message wrong; I truly loved the job.

Specializes in vascular, med surg, home health , rehab,.

I am a Rn with almost 30 years in; a couple of weeks ago I floated to another unit, leaving my floor short. Got a crappy assignment of course. Spent the day running, no time to chart, demanding families, the whole shebang. I was giving meds to a patient who was talking to his son. He was 84, came in with osteomyelitis, put on vanco, sent to a SNF. Back in Acute Renal Failure. Needed "temporary" HD, except his kidneys were not responding. As I'm busy scanning meds, racing to move on, I hear fragments of the conversation. This man was telling his son, he had had enough. He was bone tired, he was ready to "go home". His son was agreeing. I had to take a deep breath. Stop what I was doing, accept this was going to be another 14 hour day. I talked to him, told him that this was his choice. HD was his decision. He was doing it for his kids. I asked his son to call the family, called the doc and cancelled his HD for the morning, got a palliative care consult. I believe he went home with Hospice two days later. But holding this mans hand while he was crying. A man who thought he had no options but to accept all the invasive treatments. It was a massive wake up call to me. I'm not there to perform tasks. I was there for just this. I left late, tired, thirsty, hungry that night. But I did knowing I did something for a man who really needed my help. It made it worthwhile.

Specializes in hospice.
I am a Rn with almost 30 years in; a couple of weeks ago I floated to another unit, leaving my floor short. Got a crappy assignment of course. Spent the day running, no time to chart, demanding families, the whole shebang. I was giving meds to a patient who was talking to his son. He was 84, came in with osteomyelitis, put on vanco, sent to a SNF. Back in Acute Renal Failure. Needed "temporary" HD, except his kidneys were not responding. As I'm busy scanning meds, racing to move on, I hear fragments of the conversation. This man was telling his son, he had had enough. He was bone tired, he was ready to "go home". His son was agreeing. I had to take a deep breath. Stop what I was doing, accept this was going to be another 14 hour day. I talked to him, told him that this was his choice. HD was his decision. He was doing it for his kids. I asked his son to call the family, called the doc and cancelled his HD for the morning, got a palliative care consult. I believe he went home with Hospice two days later. But holding this mans hand while he was crying. A man who thought he had no options but to accept all the invasive treatments. It was a massive wake up call to me. I'm not there to perform tasks. I was there for just this. I left late, tired, thirsty, hungry that night. But I did knowing I did something for a man who really needed my help. It made it worthwhile.

Cyber hugs and back pats for you. This post is awesome. :)

Going to stop opening up these messages as this nurse board is letting spam on and not catching it in time. It is a waste of time for continued opening up and finding "start working at home with this or that and make $".

Specializes in hospice.
Going to stop opening up these messages as this nurse board is letting spam on and not catching it in time. It is a waste of time for continued opening up and finding "start working at home with this or that and make $".

They actually delete them pretty quickly. Why don't you help out and report the posts? It helps the mods find them faster.

I didn't know I could report but now I do thank you. Now if they could get rid of the ad that pop up as I was scrolling, some dude with a horse, a cowboy type looking for love.

Specializes in hospice.
I didn't know I could report but now I do thank you. Now if they could get rid of the ad that pop up as I was scrolling, some dude with a horse, a cowboy type looking for love.

Well, if you want to be able to use this board for free, you'll have to put up with some ads. They have to pay the costs of running it somehow.

Specializes in Gastrointestinal Nursing.

Well written, which is lacking in so many other articles. You touched on a subject that all nurses can relate to, spirituality is so important as well as supporting each other. Thank you for your insight!

Specializes in Faith Community Nurse (FCN).
Jean, in my opinion, the documentation will always be what is most important in nursing in the hospital setting. It is all about liability now. At the hospital I worked at, patient satisfaction was most important and a nurse would get called into the office when a patient filled out a form with a complaint, even if this patient ran every nurse into the ground. The manager "had" to call the nurse in. I call this sort of "nurse bashing, getting control of the nurse". And I loved my manager, she was and is a wonderful manager and person but she also is part of the chain ladder up to the CEO. Next, everything was/is about "budget". There is enough in the "budget" for manager meetings, and then meetings about the meetings" but not enough in the budget for patient care. What would help tremendously would be for more aides. Our aides had too many patients and few would get the care they really need. Since the RN is dealing with clicking on the computer, documenting to avoid a legal issue, and seldom has time to do what an aide is trained for, then if we had more aides, patients would be happier, the RN would have time for all those tasks, and a good assessment of the patient but I am afraid, at least where I worked, that this is not in the cards. Don't get my message wrong; I truly loved the job.

I appreciate your comments. It is so hard to focus on the important instead of the urgent, isn't it? The urgent looms large in our lives and often obstructs the view of what really matters. Also, you offer some helpful suggestions about possible changes.

Specializes in Faith Community Nurse (FCN).
I am a Rn with almost 30 years in; a couple of weeks ago I floated to another unit, leaving my floor short. Got a crappy assignment of course. Spent the day running, no time to chart, demanding families, the whole shebang. I was giving meds to a patient who was talking to his son. He was 84, came in with osteomyelitis, put on vanco, sent to a SNF. Back in Acute Renal Failure. Needed "temporary" HD, except his kidneys were not responding. As I'm busy scanning meds, racing to move on, I hear fragments of the conversation. This man was telling his son, he had had enough. He was bone tired, he was ready to "go home". His son was agreeing. I had to take a deep breath. Stop what I was doing, accept this was going to be another 14 hour day. I talked to him, told him that this was his choice. HD was his decision. He was doing it for his kids. I asked his son to call the family, called the doc and cancelled his HD for the morning, got a palliative care consult. I believe he went home with Hospice two days later. But holding this mans hand while he was crying. A man who thought he had no options but to accept all the invasive treatments. It was a massive wake up call to me. I'm not there to perform tasks. I was there for just this. I left late, tired, thirsty, hungry that night. But I did knowing I did something for a man who really needed my help. It made it worthwhile.

Thank you for telling us about your experience. Thank you for being there for this patient and his family. Thank you for taking the time to stop and focus and listen. Having the mental, emotional and physical resources to be able to pause and re-direct is what it is all about. As we would say down here in the South, "You done good!" (No offense, please to our southern readers. Just a tiny bit of humor!)