I have a confession to make.
I will understand if, after reading my article, you see me in a different, less flattering light. The goal of this article is not for me to make friends though. Instead, I hope to share a part of my life story that might help someone avoid becoming burnt out of our profession like I did.
Please understand, I am by no means proud of the things I am about to tell you and I am not suggesting you do what I did. The most ideal reaction I could receive from you is for you to read the article, roll your eyes and proclaim "I'd never do that."
Now for my confession: I was what people in our profession call a diva nurse. I started being one in nursing school and it continued through the first five years of my career.
Feeling disappointed? Think this confession is somewhat anticlimactic? Let me expand upon what kind of diva nurse I was.
I was the diva nurse who:
- Sat in my school's orientation lecture and listened very closely while the Program Director stated "History shows only one third of you will graduate, no more." At that moment, all but a few fellow students became enemies in my mind. I wasn't going to let them have my graduation spot. I gossiped about everyone and anyone who seemed to struggle at all. I became 'that student' who was obsessed with scoring higher than anyone else on every test and clinical rotation. I refused to associate at all with those who I decided were 'not going to make it, not worthy of being a nurse."
- Had a smooth transition from school to first job. I felt I needed to outperform my peers (other first year nurses) so I dedicated myself to my job in every manner I could. I continued my practice of being dismissive towards my peers who were taking more time to learn their way around the job. It was as if I felt these peers, who I believed 'not going to make it' might rub off on my the wrong way or something.
- Was reliable to a fault. I never did so much overtime that I became unsafe (I thank the heavens for that much at least) but I had many more weeks of doing overtime than not. I was eager to please and saw doing overtime as a chance to be a good team member. By the way, if you're wondering whether or not I've noticed the irony of wanting to be a team member after being dismissive of my peers, the answer is 'yes'. Helping was not a problem in and of itself though. The fact that I was critical of others who didn't follow suit was.
- Was eager to learn and expand my knowledge. I saw joining committees as my bridge to doing this, and it allowed me to network as well. Quality improvement, crisis prevention&preparation, risk management, pain management, information management and many more. I belonged to every one of them at one point or another. Sometimes I was in three at one time. While this seems innocent enough, truth is, I was compromising my personal life. I had less and less time for friends and family as my involvement in committees grew.
- Earned high patient review scores on surveys and never went too long between being told by my manager that someone had written a letter complimenting the care they received. Nothing to be ashamed of here, right? When scoring higher than your peers and winning awards becomes your focus, you are bound to misstep. I became obsessed with high patient review rankings. If I was third best in the hospital last quarter, I'd better be second best next quarter. If I thought there was any chance of my scores slipping, be became anxious. More than anything else though, I resented other members of the care team who didn't share my obsession. If you were doing anything that made me believe my scores might fall, you could count on having some words with me. No room for being human or having a bad day on my watch. By the end of my second year in nursing, I had already lost count of how many times someone was written up because I didn't approve of their approach to things.
- Earned the respect of her manager. Yes, I can admit it. I need to be honest here. I was 'that nurse' now. The manager's pet. The one who exemplified the level of perfection the manager wanted everyone else to emulate. Once my foot was in that door, my being dismissive of others who I thought weren't 'up to snuff' became even more out of control (if that's possible). I didn't need to fear you being offended by me or not liking me telling you what your standing on the unit was. We both knew who the manager would side with. So buck up, or get lost. I know of three people who were fired after the manager asked me if I thought they were doing well or not and I gave a harsh assessment of their performance.
I could go on forever, but I think I've made my point. I was a diva nurse. Ego driven and so concerned with my image you could call me narcissistic (among a few other things).
For the first three years of my career these behaviors, as self serving and evil as they seem, served me well. I continued to receive high patient review scores which led to awards and was already being urged by hospital administration to further my education so I could be considered for a management position.
But no one can keep the pace I had set for myself up for very long. Looking back, I'm not sure how I did it for three years. Reality set in early on in my fourth year. Over the next two years, I slowly but surely began to unravel. Little by little the consequences of my attitude and personality began to take their hold.
Family and friends alike were becoming very concerned with my absence. I missed many family events, and my friends were feeling neglected. More than a handful of times I was approached about being so distant. My friends were lectured with some version of my 'Nursing is a needed and vital community service, not just a job. You'll just have to understand that I can't always come out and play anymore' speech. My family got much kinder treatment though (depending on your point of view). I didn't make them sit through any lectures. I simply made good use of my called ID and didn't answer when they called. No need to listen to their complaints about my not visiting anymore. Don't they understand? The pain management committee is about to implement an idea of mine and I can't let it go off wrong.
It's been over six years now since that time of my life. I still haven't talked to some of the family members I had been dodging back then. Only now, it's because they don't answer the phone.
My personal life become empty. That is the only word, the truest word I can use to describe it: empty. My friends began to tire of being made to feel like they were bothering me and dwindled away. My family, being neglected and feeling they had done something to upset me, also wandered off. I started to notice I wasn't being invited to employee gatherings. Instead, I was being asked to work the day of. Bike riding, going to baseball games, reading and day trips no longer brought me joy. My only escape from work came on my off days when I did movie marathons on Netflix. Some might say I was clinically depressed. At the time, if you had asked me, I'd have said I was 'devoted' to my 'calling as a nurse' and started beating your ear with, yes, another version of the 'Nursing is a necessary community service not..........' speech.
Inevitably, my less than desirable personal life became toxic enough to affect me while I was on the job. I'm sure I didn't need to tell you that.
During my first two years of nursing, I had zero call offs. Yes, you read it right, none what so ever. I had three during the third year. Years four and five, I at some time got to the point where I rarely went a month without one. By the end of year five, my reputation was the only thing holding me back from disciplinary action and that shield was about to end it's life.
I became short with patients and co-workers alike. My patient survey scores suffered, but that mattered to me not one bit. I had at some point decided they didn't mean much to me anymore either. Don't people know I am the winner of the 'Above and Beyond' award? Hadn't I proven myself enough already? Small disagreements with co-workers at times erupted into unprofessional bickering. I was now not only dismissive of some of my peers, but I was outright bullying them now. I was at a point now where I was just as likely to be written up as I was to cause someone else to be.
The week of Christmas, 2009.
My life changed.
I'm willing to bet you think the next thing I'm going to say is that I quit my job and left nursing. That's not the case. I hadn't had enough yet. In fact, I was on a mission to get a fresh start and prove the problems I was having were my employer's fault (or co-workers, or family, or friends, or boss, or......whoever) not mine.
I called my best friend from school. She was the one I contacted at this point because, well, she was one of the few I had kept in touch with. At least I had kept in touch with her well enough that she'd not think me odd for calling. I hoped so anyway.
We got to chatting on the phone. She complained about her boyfriend, I complained about work and it wasn't long before she invited me to come visit. I immediately called off work for the next day and, on a whim, made the long drive to her new home.
Once I arrived, we picked up right where we left off from our days in school. We gossiped about everyone from our class of course. We compared notes on who was out of the profession already and who was doing well. We ordered take out Chinese, because that was what we lived on in school. Her brother, who I dated for a few months before nursing school started, even came over and surprised us. She opened a bottle of wine (as a joke, I always said wine and Chinese food don't mix) and we spent at least three hours chatting. Maybe it was the wine, maybe it was being tired from the long drive but I became a bit of a cry baby about how things had turned out for me. I believe I used the phrase 'I feel broken' a dozen times.
My friend had to excuse herself to run an errand. Someone she needed to get gifts to was about to leave town. So, her brother invited me to his place to see his new home. He was excited to show me his new wall fountain. It was one of those picture frames with water running down it like a fountain. He remembered I had a soft spot for fountains.
I decided some fresh air would help wake me up, I wanted to talk to my friend more when she returned. So I agreed to go.
They say a rapist usually targets someone who knows them. It's also said that when they do find a target, they wait for that person to be in a vulnerable state of mind.
When we entered the house, he removed his jacket and invited me to sit on the couch in the living room. Once the door was closed, he began to give me his assessment of what was wrong with my life.
According to him, I was a [female dog] who just needed a good [intercourse]. I was having all these problems in my life because [female dogs] like me need a good [intercourse] from time to time or we get crazy in our heads with desire. So, you see, he was, in his opinion, doing me a favor by providing me with a good [intercourse]. Whether I wanted it or not was no matter because I was a confused [female dog] and didn't know what I wanted anyway.
I tried to fight the first time he took me. That's probably why the first time seemed to last forever. I was sure that if I injured him, he'd stop. I did not accomplish my goal of injuring him. I did get a sprained right wrist though when he hyperflexed it.
No more details are necessary here other than to say, he was much too strong for me. I also believed, before it was all over, that I was not his first victim of forced sex.
After the first time, he came at me was over, he deposited me on the couch and went in the bedroom. He as in there ten minutes. Many things crossed my mind while he was gone. Running was one of them, but I feared he'd harm me much worse if he noticed and caught me. Going back to my friend's house wasn't an option anyway, I wouldn't know what to say. And driving home was an impossibility. There were no phones, he only used a cell phone that was on him and mine was not in my pocket anymore.
There was no fountain on the wall.
So I stayed, mostly because I couldn't process what was going on around me. He returned twice to make sure the [female dog] had a good enough [intercourse]. Then he disappeared into his bedroom for the night. I passed out for what amounted to about five hours, got up, and left. I drove straight home, didn't go to my friend or talk to anyone the whole ride there.
You would think I'd be distraught over what had transpired, and I was, but that was not what truly broke me. It was what greeted me at home. Emptiness. I meant it when I said my personal life had become empty. I wanted to talk to someone, but there was no one left to talk to. My friends had all drifted away, my family was chronically upset with me and I certainly wasn't going to anyone I knew at work with this. So, I had to settle for crying myself to sleep for a few days.
I then did something I never thought I'd do. I did a 'no call no show'. When the day came I needed to go to work, I wasn't able to but I didn't want to argue with anyone on the phone about it either. So I just didn't go and I turned my phone off. I, in fact, no call no showed three days.
I called my parents on Christmas day, apologized for not being able to make it since I was ill, and then left the phone alone. No one called me that day.
The next day, my phone seemed to be going off every hour on the hour. You could set your watch to it. I looked at who was calling and instantly recognized my manager's personal cell phone number. It seemed to me that I should answer.
I did.
She desperately wanted me to come and have a face to face talk with her before my termination. She begged me to do it.
I did.
I lied to her though. I told her I was depressed, probably because of the holidays, and I slept through the days I was supposed to work. Again, she was begging me to do something. She felt, despite the fact that I told her I had no interest in saving my job, I should go to employee assistance and seek help. She wanted me to go as soon as I left her office.
I did.
During my first meeting with the counselor, I told her the same lies I fed my manager. She was kind, soft spoken, but not convinced. She informed me she felt there was something I was leaving out (I think she suspected drug use actually) and encouraged me to share what it was that was really making me so sad.
I did.
I wasn't fired. I was granted a two month leave of absence. During that time, I was doing two counseling meetings a week. When I did return, it was not to do direct patient care. I did work behind the nurses' station (discharges, documenting vitals, answering phones). I was still being paid my usual nurse's wages though, so finances never became an issue.
Two months later, it came time for me to make a decision. Did I want to return to nursing or no? The counseling had helped put me back together, but they focused on the rape. My being burnt out over my profession came up, but not as much.
If you've been paying attention, you'll notice, I was burnt out and on my way out of the nursing ranks before the rape. Sure, I thought I had something to prove so I was hanging on but, eventually, I'd either have been booted out of the door or I'd have quit.
I was not in a position to be naive though. I knew, without a doubt, if I wanted to return to nursing, my attitude and personality had to be reinvented.
I had to learn to deliver nursing care without ego being my fuel. I could no longer strive to be the perfect nurse and become angry when I felt I didn't achieve this goal. I had to accept that I was joining my peers, the ones I had shunned for years as being unworthy, and would have to treat them all as equals. To go even further, I'd have to accept that some may not consider me an equal anymore. Most of all though, I had to achieve balance in my life and stop using my profession to define myself.
The heroes of this story are, in every sense of the word, many of the peers who I had damned since meeting them. More than anyone else, they supported me. No one ever came at me with resentments from the past. Many went out of their way to check on me and ask me how I was doing no matter how inconvenient doing so was. One in particular, a nurse who was near retirement that I had said very demeaning things to, made extending me kindness her mission. On Valentine's day, she sent me not one, but two dozen white roses. She knew they were my favorite.
It was their support and their kindness that made me feel I not only could return to nursing, but that I should.
I did.
And I did enter my second jaunt through the nursing profession with the new approach I spoke of before. I continued going to counseling, made many changes to my personal habits and slowly but surely reinvented myself.
I've been back for some time now, and I must say the results are more than anything I could have imagined. I owe much of this to what I coined as my new approach to avoiding nurse burn out: The Rubik's Cube approach.
You see, we as individuals are not two dimensional. We are much more complex than that. We are much like the Rubik's cube. Six sides, all a different color, all moving parts.
To solve the Rubik's cube puzzle, you must make all six sides one solid color. You can't achieve this though by focusing solely on the green side. You can work and work to make the green side as perfect as you like, but that does you no good on the red or blue or orange sides. You'll never get the green side done so well that it makes up for the other sides being a mess. The object of the game is to make all the sides match, not just one.
You have to have balance and make all the sides of the cube right. You must give all sides their equal and due attention.
When I was a new nurse, I was not doing that with my life. I was focusing on just the green side. I kept working harder and harder at it, expecting the entire cube to be solved. But, once the bigger picture was looked at and the blue, red, orange and other colors were taken into account, my work gave me nothing but a very messed up cube with a perfect green side.
My professional life was great, for a while. But the other parts of my life suffered so much for it, the puzzle was never going to solved and I was never going to be happy.
So, the summary of the Rubik's cube approach is to take care of all the different sides of yourself so that your professional life can flourish along with them instead of being dragged down by them. If all your self worth comes from just one side or the other, you are in danger. I don't let this happen to me anymore.
I had put too much emphasis on my professional career and neglected everything else for too long. I am back in nursing full time now, and I have some simple rules I follow that I'd have never accepted before.
- I never do overtime two weeks in a row. When I do overtime, I don't go beyond forty five hours total for the week.
- I visit my parents at least once a week. If I can show up for five days of work, I should be able to manage at least one parent visit as well. My father, who is aware of my rape incident, gets two calls a week on days I don't visit even if it's only to say I'm alright and going to bed.
- I do not belong to any committees anymore. My job does not mandate them, so I'm only missing out on a small raise for not participating. Day trips with my nephew and nieces are what took their place. I'm at a point in my life where I'd rather learn what makes loved ones happy than sit around pondering risk management. That's just me though.
- I have a pet now. I'm a cat person. I love him dearly. He serves a very important role for me. As long as I have him, even when no one else is around, I am Ok. I might be alone, but I'm neither lonely nor feeling isolated.
- I have gone back to reading. I might put my book down for a day or two here and there but I have a mandated two hundred page per week minimum requirement. Small steps with small goals.
- I always have at least one active hobby other than reading going. At first, that was just doing marathons on Netflix. But that's graduated to bike riding lately.
- I volunteer twice a month, six hours each time, to the employee assistance hotline of my new company. Someone was there to answer the phone when I called, so why not return the favor?
I did inform my friend of her brother's attack on me. We've not spoken again since that conversation. Unfortunately, a resentment that is going to take me a long while to let go of was born that day when she told me she had already been aware that her brother did this sort of thing "from time to time, if he thinks you'd like it." I'll be alright though.
I still keep in contact with more than a few of the co workers who were so kind to me when I was down and broken. The one who sent me roses is now retired and, I choose to eat my Chinese take out with her these days.
I harbor no shame over my rape, I had no say in that incident. What I can at times still feel shame about is how I let myself become so isolated from everyone around me. My mistakes, and my poor outlook on what really mattered in life contributed to what put me at risk for the attack. Again, I'll be alright.
I've learned how to never allow myself to put myself at risk like that again. I focus on all the sides of the cube now. I never have to be isolated again.
I will end with this: Don't let your professional life swallow you and eat you like I did. Give all the colors of your Rubik's cube their just due attention. As much as we think we're focusing on just on the side for good reasons, in the end, since all the other sides are a mess, you won't accomplish anything.
So do your employer, patients and everyone else a favor. Turn that cube around in your hand once in a while and let red or yellow or orange have your for some time. You might be surprised how, upon returning to the green/professional side, things have gotten better, not worse.
