Time to hang up my tourniquet????

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Specializes in A and E, Medicine, Surgery.

When will I know that I have crossed that fine line and become burnt out as opposed to tired, experienced and realistically cynical? How do nurses know when it is time to go???

Taking hand over today I realised I could not raise an ounce of enthusiasm to deal with the group of patients sat in minors. The chronic back pain who had not taken any analgesia, the very intoxicated guy who refused to vomit on a bowl preferring the floor, the alledged self poisoning who,s bloods came back clear but kept "trying" to hang herself but only when someone was looking and the angry patient who deliberately kept targetting his verbal rage at the youngest smallest nurse and I thought I don't know that I can do this today. I don't know that I can stay calm and non-judgemental when all I really wanted to do is say "your all a waste of space, please go home then we can deal with someone who is really sick". How unfair - they were all patients in my care and deserved more than that.

I worry about the physical toll this job takes. Thirteen hours, in charge, and on the go is physically exhausting. At night my feet and back ache so much I could cry. I have been on every manual handling course known to nursekind but when a patient needs resuscitating or is about to launch themselves off the trolley that all goes out of the window. Some days I will be lucky to get a drink (yes, I do belong to a Union!) and the expectation is that you work late and get called in on your days off at short notice as unsurprisingly our sickness rates are through the roof. I wonder sometimes if I will hit retirement age and have a body that is quite simply too knackered to be of any use.

I worry about the emotional cost of this job. Every day we see and hear things that break a little piece of your heart. We deal with desperate grieving relatives, terrified patients facing death and see things that most people can only imagine. We listen to the tales of tragedy that force someone to try to take their own life and on a daily basis support when someone is told there life will be ending shortly. We deal with death, dying and loss every single working day. We look after elderly relatives that have lost there life partners of 60 plus years and parents who's children have died before them. I wonder how much capacity any one nurse has for seeing, hearing and dealing with these things. I know that these days if I get a cardiac arrest in I will deal with it professionally and to the best of my abilities but within an hour the truth is unless the circumstances are exceptional I will have pretty much forgotten about it. I wonder sometimes if we get given a set quota of compassion, kindness and empathy and once that has gone then thats it - no popping down to the emotion shops for a quick top up. I sometimes come home from work and feel emotionally it has sucked me dry and there is nothing left for my family and friends. They could have a limb hanging off and I am sure my response would be "have you taken any analgesia - no - well in that case don't come crying to me, and make sure you don't get blood on the carpet on your way out!!" How long is it acceptable for my family to stand second in the queue.

I know that I am tired. Tired of unrealistic targets set by people that wouldn't know a bedpan if it bashed them on the nose. I am tired of working in a blame led culture where management are quick to point the finger but slow to lift a hand. Tired of never having enough - enough time, nurses, resouces, beds - in fact the only thing I ever have too much of is patients!!!

But as soon as I think of moving on or up the following stops me.......

The patients - the desperately sick ones who you clinically turn around, the frightened one that you make feel safer, the older ones who still believe that nurses are angels and are grateful for every little thing you do, the children that are scared or in pain that you make laugh just by being daft. If I am being honest some of my patients drive me to distraction but ultimately they are the reward of the job.

My team - I l love being able to share my experience with new or junior members of staff. One of the big rewards is seeing someone newly qualified go from being terrified and utterly inexperienced to confident and capable. Quite a few nurses that I have mentored have gone on to far outstrip me in the career stakes and I take delight in knowing that I precepted all my direct managers!

So how will I know??????

I love being a nurse and am so proud of what I do but at times I question "at what cost". I know that I don't want to be a grouchy burnt out nurse that sees the patients as an inconvenience rather than the reason we do what we do. I see some nurses so emotionally burnt out that the only delight they seem to get is in making their junior nurses and students lives an absolute misey and don't ever want to be that nurse.

For me being a nurse has always been an absolute gift but I think maybe the time will come fairly soon when I need to be part traded for a newer, fitter, more modern model......

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Specializes in multispecialty ICU, SICU including CV.

You're cooked. Read your own post. You said it best yourself.

You still love parts of your job -- but it sounds to me like you are at the point where the bad may outweigh the good. Look into other venues. Go back to school, find a different specialty, something.

We do a hard thing for a living. Give yourself a break. You're not a quitter to recognize that this is happening to you and you want out (if that is indeed what you want.)

Do some soul searching. Hopefully you will find what is right for you.

Best wishes.

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Specializes in CVICU, Obs/Gyn, Derm, NICU.
When will I know that I have crossed that fine line and become burnt out as opposed to tired, experienced and realistically cynical? How do nurses know when it is time to go???

Taking hand over today I realised I could not raise an ounce of enthusiasm to deal with the group of patients sat in minors. The chronic back pain who had not taken any analgesia, the very intoxicated guy who refused to vomit on a bowl preferring the floor, the alledged self poisoning who,s bloods came back clear but kept "trying" to hang herself but only when someone was looking and the angry patient who deliberately kept targetting his verbal rage at the youngest smallest nurse and I thought I don't know that I can do this today. I don't know that I can stay calm and non-judgemental when all I really wanted to do is say "your all a waste of space, please go home then we can deal with someone who is really sick". How unfair - they were all patients in my care and deserved more than that.

- Maybe try to view this group of p'ts differently? I don't think feeling like this about them means you are burnt-out, finished and must leave.

It's quite alright to provide these p'ts with empathy and the best nursing care you can manage ....don't feel bad about that. You don't have to give anymore. Their lack of responsibility will continue to be an issue for them until they see the light.

Nursing education and ethos doesn't place much emphasis on the impact of lack of p't responsibility ....think about how this can really screw with a nurses mind.

I don't think you should apply these feeling to your whole nursing experience....keep it in perspective.

It's ok to acknowledge that lots of people lack the helpful life framework that serve others so well .... no work ethic, no aversion to mind-altering substances, no innate 'right and wrong' and so on. That's why you have a bunch of them in your minors.

Say a silent thanks to your ancestors for passing these things on to you.

Why not try a new job? An urgent care clinic in an area where these p'ts are less represented? A different culture within your geographical area? A new speciality?

You sound like a fantastic nurse ... I would think very carefully before throwing so much away :yeah:

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:yeah:This is me clapping for you to say thanks for all that you do,because above everything else it is obvious you have a huge heart and a nurse's soul. I know what I am gonna say will sound ludicrous in reality,but you need to set some boundaries. You are tired and burnt,but I don't think burnt out. I worked tele for 3 years and I do understand that as nurses,even with unions,a break or even 30 seconds to pee can be a luxury. I gave everything I had at work,and yes I left drained,but I always came in when called,and did my best I thought for patients.

BUT WHAT ABOUT YOU??????

When you leave work,LEAVE WORK !!! If they try to call you in screen your calls. You may have to go so far as to speak directly with mgmt and say I don't want to lose my position,but we need to set ground rules about how much this place has control of my life.

With so many different opportunities in nursing maybe a change of specialty is needed,or just a new place.

Take up kickboxing,become a volunteer dog walker at a shelter,do something for yourself...if you are not whole as a person then how can you be a good nurse to your patients? I let it all go,nursing was my absolute life,and 6 years later I was doing enough demerol to knock out a linebacker ! I had lost myself,I pray that doesn't happen to you,because you seem like someone very special.!!!

Sorry for the rambling,:yawn:

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Specializes in Long Term Care, Pediatrics.

:hug: Have you ever considered teaching? You sound like someone who should be teaching. When I was in nursing school, the teachers I loved the best were the ones who had a story to tell to make a difficult concept make sense; it sounds like you have alot of stories to tell.

You sound like the kind of nurse I would like to work with and learn from. You're my hero. This is my 2 cents, I think you should teach. Hugs to my hero.

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Snoopy29, You have taken all of the thoughts of my mind and put them here in your post!

I experienced my first burnout after 5 years of nursing,yet worked through the burnout. I still feel compassion for my patients yet I am really cringing at what I have seen over the years and I am losing the love I once had for nursing. I now have been a nurse for almost 10 years and am at a burnout point again. I am considering leaving nursing, yet I am exploring my options outside of bedside nursing.

The patients that I see come into the hospital are different than what I saw years ago. Where I work I see so many people come into the hospital expecting a magic cure with a magic wand, non-compliant with MD orders and care, manipulative, and I could go on and on yet I am sure you get my point. I too see that there are people out there who really need the medical care nurses provide and are appreciative, compliant, and want help to get better. There is ying and yang in nursing and I am trying to focus on the positive, yet when my health and family become affected by it all I have to re-evaluate my priorities. Taking care of my self comes first and no matter how much I love my career, I will give it all up if it means I am healthy, sane, and can provide for myself and family. Be encouraged and do what is best for you because at the end of the day you don't want to end up being the "patient". Our employers will replace us with another person once we move on. Make nursing what you want it to be, I am trying to do that too. Be the best you can be.

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Hey, Snoopy. I hear ya. All dedicated nurses have experienced something of what you describe. Here's the thing. You can keep doing what you're doing, or you can take your own advice. It's ok to put down this particular job. You can take what you have elsewhere and continue to get job satisfaction. You made several comments about the nurse you don't want to be, but your "self-talk" is that kind of nurse. I can tell that's not really you. You can take a break and do a different kind of nursing for awhile. you can always go back too. In my experience, nurses who ignore their body get sick or injured. I know a lot of nurses with fibromyalgia. You are the only one who can live your life, and right now you are miserable and suffering. If you were your patient, you'd have all kinds of advice...will you take it for yourself? There was a book a long time ago called "When taking care of you is killing me". I'd really recommend doing some reading on codependence, which is the human condition. We're not taught to set appropriate boundaries and in fact to ignore our internal boundaries when they say "enough!" The system is insensitive and as long as we will do it, they are happy to ask, until we are run into the ground. Then they will replace you with 2 more. I know you love your co-workers, and you can keep them as friends and have tea with them from time to time. As they say, "last one out turn off the lights." Look for options. Wherever you go, your nursing will go with you. I hope you will give yourself time to regenerate when you're off duty. Best of luck.

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Specializes in PACU, OR.

You're definitely burned out. Before making any decisions that you may later regret, take a holiday and get away for a while! If you have a few quid salted away, invest it relaxing in Greece (a la Shirley Valentine?) or any nice place that offers you a good exchange rate! You will come back refreshed and better able to take an objective view of where you are and where you would like to be.

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Specializes in Cardiac.

Do you work on the same unit as me? You described my unit exactly and after 1 YEAR, I am burnt out too! Don't know where to turn as well. I know where I would like to go, but the chance of that happening is about impossible! Today I actually considered quitting despite being the provider for my family, I don't know how much more I can take.

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I think it's clear that you need to move on, but as the others have said, not from nursing as a profession, but maybe from bedside nursing. Thank you from the bottom of my heart for coming to work, day in and day out for the last (insert number of years here). But, I think you would be doing yourself a huge dis-service if you didn't explore other options now, it sounds to me like you are one of us that truly does LOVE your job, and if you don't get away now, you will become someone that no longer does. Perhaps teaching is an avenue to explore, or even management. You say that you have trained many of your own direct supervisors, and despite all of your anguish toward your current situation you still seem to have a very clear head about all of this--something that many managers lack. If you still demand the clinical side of things, I strongly encourage you to consider a career in home health. I NEVER ever thought that I would consider home care in a million years, but I too was on the verge of losing my mind after 5 years of bedside nursing, it had affected my home life, family life, and was starting to affect my performance at work--I no longer had the compassion and drive that I once did. So, I tried homecare, and I LOVE it, it gives you the time and attention that you really strive for at the bedside, and you have the opportunity to develop relationships with some of your patients.

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Specializes in Oncology.

That sounds like a very difficult crowd to deal with patient wise. Perhaps you're not burnt out on nursing, but just your particular unit (sounds like A&E?). Maybe you're ready for a change to a different area? I find oncology to be very rewarding. You don't get not-ill patients. You don't get too much attention seeking (they all get enough attention). You do get trying patients, but it's much easier to deal with as you know they're actually quite ill. You deal with a lot more "real" medical issues. And the patient population, on a whole, is the most grateful population you'll find.

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