I think that your mind and body are telling you something and its important to listen. I was in a similar situation not to long ago, where it felt like I was completely burnt out. I was constantly depleted, putting my energy into something that demanded my full attention and I had to make a ton of sacrifices. In order to get everything done, I had to sacrifice MY own needs. I saw a therapist for being overwhelmed and if you can make the time to see one and have the resources, it might be the first step in sitting down with yourself and making some adjustments for your own happiness. What I learned throughout the therapy sessions was something I didn't fully understand before: you simply can't accomplish the rigourous achievements you have set out to without at every step of the way, being able to nurture yourself and meet your own needs. Think of it like a fight in a rink. The fighter always has a station and a group of people that he goes to when the fight becomes too much, when he gets hurt, when he needs water ect. Without that station to recover at, without those people to bandage his wounds, without water to drink when he has sweat everything out- he can't win the fight. The burnout you are feeling is letting you know that you need to take care of you, so that you have the strength and energy to do what you need to. Nursing is very demanding, school is demanding, being a wife and a mother AND growing another human inside you is demanding. I think a good start is write out all YOUR needs. From what you wrote, it seems like it would be 1. More time with husband 2. More time with daughter 3. More rest 4. More fulfilling/ less physically demanding work (shift wise, at least while still pregnant). I think if your current situation isn't working and its burning you out, try to tweak it with little adjustments like you have a time/ place carved out for studying, like at a coffeehouse during a weekend day, but then at night your husband, daughter and you can go out to dinner and have family time. It sounds like you have the guilt when your studying/working for not being with your family but then when you are with them you have guilt for not studying. I think setting up a schedule for this would be super helpful with the rule you aren't allowed to feel guilty about one thing when you are doing another. Also, talk to you husband and let him know how you feel. Whether its helping out with your daughter more, doing the dishes, giving you a foot rub at the end of a long shift- he isn't going to know you need a little TLC if you don't tell him. If the tiny tweaks don't help, a bigger change will have to be made whether its switching jobs, taking a lighter academic load, or something else that can lighten your load. Sometimes, we just have too many demands placed on us and it's ok to find a balancing act. Just remember to look out for yourself and that your health/ happiness is the most important thing.