I hate my job and I hate myself for hating it. I WANT to love nursing. I became a nurse for a reason. But I can no longer stand the idea of taking care of another person any more. I feel like a failure and a terrible person. Can I recover from this?
My story:
I am an RN in a MICU/CCU. I graduated from nursing school 6 years ago and immediately took a job in the ICU where I had done my senior practicum. I was one of few to be this lucky. The first year was hell (as it has proven to be for the nurses who have followed me), but I now recognize that this is typical as the learning curve is quite steep-- They do not teach you ICU skills in nursing school. Luckily, my unit has very strong team work, and my peers held me up until I could stand on my own two feet. After this I found my niche and became one of the leading nurses in the unit, training newbies, helping interview new-hires, obtaining my CCRN, and being chosen for advanced training opportunities. I loved the pace, the close relationship with the docs, the constant learning, and the autonomy. But for the last two years or so, I have been more and more miserable.
I don't think that burnout quite describes it. It is not just being overworked-- I really feel like medicine is a much darker world than I realized. It is not death that bothers me. In fact, I feel the most peace when I am caring for a hospice/ comfort care patient. The cases that weigh on me most are the ones involving families who cannot let their loved one go. Especially when those patients have an advanced directive stating that they wouldn't want these measures. I went into nursing to help people, but much of the time I feel like my hands are carrying out orders that are perpetuating someones pain. I think it became much worse after one patient in particular, but I will not tell that story here, because it is quite long. In essence, I just feel like I cannot make a difference. At first I felt irritated and overworked. I didn't look forward to work anymore. Then I started getting angry about little things that never bothered me. This got worse and worse. I would become so frustrated that I would have to leave the floor to cry-sometimes in the middle of rounds or report. I started becoming severely depressed, and I used all of my sick time. I was truly so mentally exhausted that I felt I could not function safely at work some days. I refused to be an unsafe nurse. I would get anxiety attacks the night before work. Many mornings I did not feel like I could even get out of bed, and I was often late to work. I work late charting almost every day. The harder I have tried to be on time the worse it has become. I started to become cynical-- not just about my job but about the world, mankind and life in general. But now something is happening that WORRIES me even more deeply. I am beginning to stop caring... about patients, about my performance, about my coworkers, about my social life. When I start to get frustrated, I just switch off. It affects every area of my life. I feel like there are no emotions left for anyone or anything else. I am in counseling, and he says to take better care of myself, but all I want to do is sleep. I don't want to talk to friends, I don't want to go out, I don't want to exercise or shower or even get a massage. I always said that if I ever stopped enjoying nursing, then I should get out immediately, and I always believed that a burned out nurse should choose another career or retire before the patients were affected, but here I am. I am that nurse. My husband got hit by a car, and is just recovering enough to get back into the work force so I am the sole income and I cannot just quit or take a leave of absence. I want to leave nursing or maybe I just want to leave civilization. I don't know what to do. I want my passion back.
I understand your stress. I, myself, struggles about the ethics of what I am doing. Like you, I think sometimes my hands are just being used as an instrument of harm. I see all these medications that is being passed which are a bit questionable, and sometimes I feel like doctors only care about sedating their patients.
It is such a shock as a new graduate, and I hope I find myself along the way. I don't want to end up soulless like other nurses who has been there for a very long time.
No one is soulless! You are judging the other nurses without really knowing them.
Specializes in Certified Med/Surg tele, and other stuff.
No one is soulless! You are judging the other nurses without really knowing them.
Going out on a limb here, but I think what the Illusionist sees as 'soulless' is simply a nurse protecting themselves emotionally by becoming detached from their patients. It may appear as soulless to others, but if nurses gave everything to their patients, there would be nothing left of the nurse.
The one thing I really felt from your post was your struggle with the ethics and morality behind the palliative care/ advanced directives of the terminally ill.. This destroyed me also. The patients wanted to die so much- not in a suicidal kind of way- but in a very painful, desperate, way where they feel ready for the next life but cannot go because they are still alive. I became extremely cynical, very deeply distressed- I'm not particularly religious but it made me question some very hard things like why are good people allowed to suffer in pain and we are actually keeping them in pain longer with our medications and machines that keep them alive when they're ready to go. It really warped my view of the world and I started seeing sadness and suffering everywhere. It felt like my heart couldn't cope with the sadness in the world.
i tried moving to areas of nursing where people weren't terminally ill- but the general sadness and stress of the ill and dying wore me down. I ended up severely depressed, post traumatic stress, anxious, couldn't eat properly or find any enjoyment in life- I never wanted tog et out of bed. Nothing could cheer me up because I knew that I'd have to go back into work the next day- the dread was making me sick. I kept going because I was in pretty desperate financial times- I couldn't afford to lose my job and I was so depressed and anxious I wasn't even in a fit state to think clearly and go job hunting! I did the same thing you did- showing up late, doing a terrible job, finding corners to cry in. I literally felt sick with unhappiness and stress. And then actual clinical depression set in- I wasn't just sad about work but about everything. I'd hide in a dark room unable to face the world. My relationship with my boyfriend started suffering, I avoided my friends, I stopped enjoying my hobbies and quit them. I literally felt like my energy and been sapped and all the energy I had left was focused on simply survival- getting through the day so I could make the money to pay the damn bills. I didn't know who I was anymore- what happened to the happy, life loving, carefree girl who thought life was amazing? Now it just felt like a hellhole.
This went on for weeks before something just snapped. I had a nervous breakdown at work- I burst into tears I front of several staff and patients (talk about embarrassing!) and could not stop crying for hours. Thank god my manager understood depression and refused to leave my side until I made an appointment with my GP- she even sent me home from work early tog et to the GP. I sat in her office holding a pile of tissues unable to even speak properly because I was crying so hard- for literally hours!! She threatened to call an ambulance if I didn't go to a GP right away- I was in that extreme distress.
i never went back to work there. I was on sick leave for two weeks and then quit altogether, going onto unemployment/ sickness benefits.
I also removed my registration so I couldn't work as a nurse anymore- I'm not registered. My doctor put me on short term sickness benefits while I see counselling and therapy- it's not much money but it'll keep food on the table. But even that act has completely changed my focus on life- I'm actually happy, cheerful, energetic, I get out of bed feeling happy with my day, everyone now comments on how damn happy I am! My family and my partner are over the moon- my partner was so worried about how sick I was becoming,and overnight I've become the old me again- happy and healthy.
I'm currently getting therapy and am on an antidepressant (because I have underlying depression) because obviously I need to work through these issues- and I need to get well so I can get back into a new job. Now I want to become a children's teacher- I have enrolled in a course! In the meantime I'll find something to pay the bills- even just stacking shelves at a supermarket, I don't care. Just no more sick, dying people.
you need to find a way out- talk to a therapist about how you are feeling. It's helped me immensely to talk to someone who understands and can provide insight and ideas into my suffering, and best of all- teach me coping mechanisms to heal and recover.
Find a way to make money in the meantime- even try agency nursing- it's annoying and unpredictable, but also it's lots of variety, lots of different things, you won't be anywhere long enough to become attached to anyone therefore causing you distress. Get counselling. Once your husband is back on his feet you will be able to figure out a long term plan- a different area of nursing perhaps or a new career entirely.
no paycheck is worth the mental suffering, there are other jobs, even if it is agency!
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
I understand your stress. I, myself, struggles about the ethics of what I am doing. Like you, I think sometimes my hands are just being used as an instrument of harm. I see all these medications that is being passed which are a bit questionable, and sometimes I feel like doctors only care about sedating their patients.
It is such a shock as a new graduate, and I hope I find myself along the way. I don't want to end up soulless like other nurses who has been there for a very long time.
Wow...soulless. That is using strong words.
I don't think seasoned nurses are soulless...I think we had been able to find that balance of remaining aloof but caring. You have to find that place to put things away...let them go...in order to survive the daily grind.
I am confused by
medications that is being passed which are a bit questionable
my hands are just being used as an instrument of harm.
struggles about the ethics of what I am doing.
Struggle with the ethics...I don't struggle with the ethics. I don't try to make people believe what I believe. I don't try to make people conform to what I believe is right. Each person has to make their own decision of what they feel is appropriate for their family. It is not my judgement to make.
Maybe it is helpful that I come from a time that we didn't have "DNR status...that the MD was free to tell the family "there is noting more we can do" and it was left at that...fait accompli. We would go into the patients room and "slow code them" we allowed dignity. However that time also came with...once on a vent you stayed on a vent until you died or were weaned..period.
I remember a physician I worked with who called it "expensive care" instead of intensive care. We would shove a tube in every orifice that man has and then make a few ourselves. People would third space and ooze fluid....it was difficult to see....but it was what we did. You had to find that place to leave the baggage to survive. Soulless? NO...we have souls and we grieve. We just know how and where to place that grief so we can go back another day.
I had no grand illusions of great things when I graduated nursing school. I had no illusions of making great contributions to mankind. I just wanted to comfort the sick and if they are dying...comfort the family. A soft touch. A kind word. A moment to say I'm sorry or are you Okay? I told a story about the simple things...Why I love being a nurse….take a moment and read it...it is all about the little things.
Our job is not to perform miracles. Our job is to make the most of bad situations. We have ALL had that patient that we carry in our hearts that really bothered us for some reason...but you still need to find that place to put it away. To cope. Read this....All the Things We Carry you are not alone.
OP...I think you have too much in your plate. I think you need to see your PCP and follow your therapists suggestions. I think you are depressed and need to work through some things, including that patient that changed things for you...talk it out. You sound like an excellent nurse....((HUGS)) we are here for you.
You sound absolutely devastated, and I agree with all of the comments previous to mine. It hurts one's heart when the passion disappears, and it is a struggle to continue to do the day to day survival routine. I also say, get a different counselor, the one you have doesn't seem to "get it", It is hard for others to understand (not in the nursing life) what we actually go through day to day, week in and week out. There are new programs in assisting nurse's to get their "passion" back. It is called the Integrative nurses and there is a certification that goes along with that title. Sometimes, just opening another window can get the adrenaline pumping. Best of luck to you, Keep fighting for your passion.
Mysteriousdarkness, your post brought me to tears. I feel like this and that if I don't get out of nursing soon I will end up in the hospital or worse. I feel like no one understands how this profession can affect some people. I have never been so depressed in my life until I came a nurse, I have often wished I would get into a car accident so I could miss work!!!!!! Then I feel bad for not liking it especially when I see all these happy, peppy nurses. Your post does gives me hope that I can get my old self back one day. I will certainly jump for joy when I get a job where I don't have to sign my name with RN after it.
It sounds like you have done amazingly well with your career and you are to be congratulated for this!! This is coming from someone who also started out as a new grad in ICU and had to go to stepdown because I just could not do it at that time. But I know what you are talking about, the families who don't want to let the patient go.
I now mostly work with those chronic, severely disabled children whose brains are mostly gone but their bodies are young so they just hold and hold on. It's depressing and the patients have a horrible life. Eventually these patients do die. It just takes longer for the families to say goodbye but one way or another they eventually have to.
KEEP READING . . my post gets more positive, I promise.
One thing I just keep telling myself it it's out of my hands. I am not the one who has to make those awful decisions. It's not my job to make those decisions. I try to avoid owning any part of the patient's past or future, and just deal with where they are right now, and what I am tasked with doing. My job is to provide the maximum amount of comfort to the patient and assist the family in grieving. I keep the patient medicated, positioned, and clean.
I need to tell you a story, too. I have had two families that held on and held on. The patients became more stable but the brains were pretty much gone. They became chronic patients on my unit. I wondered why in the world we kept them alive, their lives were terrible, their families were totally tied down to the care of these patients and it was a huge burden. But I kept saying it was out of my hands. Both patients eventually got so sick that they ended up in ICU. Both families finally realized, after caring for the shells of the people these children once were, that it was time to let go. Both families decided to donate the organs of their children. Because of their prolonged goodbyes, the families finally found peace, and lives were saved through the organ donations.
My own father coded many times and his wife, also an RN, kept insisting on trying to save him long after I knew he was gone. I wished she had told them to stop and not have my dad continue to be put through more codes and then be "stabilized" on the drips and vent and all that. After a few days on all the ICU support, after the brain tests were done multiple times, she accepted the facts and donated his organs. I am in contact with one of the organ recipients and feel so glad that we were able to help him. There was a whole list of other anonymous people he helped or saved the lives of. If his wife had not insisted on the repeated resuscitations those people may not be alive today.
Know that you are helping as much as you can help in the role that you play. And let go of owning the problem any further than that.
I say this as someone who is also struggling right now and getting counseling to deal with the stress of the ICU and the grieving and tragic things that happen there. It's enough to give anyone PTSD. I shared my feelings with a veteran nurse and she told me that we can't prevent these things from happening. It's part of life. But we can be honored with being there to help in any way we are allowed to help.
Be strong and know you are not alone with your feelings.
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Mysteriousdarkness, your post brought me to tears. I feel like this and that if I don't get out of nursing soon I will end up in the hospital or worse. I feel like no one understands how this profession can affect some people. I have never been so depressed in my life until I came a nurse, I have often wished I would get into a car accident so I could miss work!!!!!! Then I feel bad for not liking it especially when I see all these happy, peppy nurses. Your post does gives me hope that I can get my old self back one day. I will certainly jump for joy when I get a job where I don't have to sign my name with RN after it.
It is OK to not be in love with nursing. It is not for everyone! ((HUGS))
That's what made me realise I had to quit or it would kill me. Someone actually asked me- a dear friend- she said: how would you feel if you could quit tomorrow and never have to go back into nursing again?
i burst into tears- the dream of it sounded amazing- It sounded like winning the lottery or finding out some amazing news- what if I could quit!!! It was like "wow. Quit? I can quit!! I'd be so happy!,, oh my god, to never have to go back into any area of nursing again- wow!,,"
it's not perfect yet- I've only recently just quit in the last few weeks (after getting so ill that I was unable to work or cope). Not having to go back.... That's the best thing that's ever happened to me.
i still have underlying depression I need to cope with, and my therapist says that I'm a sympathetic person who has been traumatised by the sad and horrifying things that I've seen- she says the only reason I'm so affected is because I cared sooooo much- my compassion and caring was so great that I couldn't maintain it and literally burnt out. We're working on me coming to terms with some of the particularly more haunting memories- the patients that really haunt me, and also generally healing from the trauma.
she says the best thing is that I can learn to turn that compassion and caring towards myself- to forgive myself for not being able to be a nurse, to care for myself the way I would care for a depressed patient in a hospital ward- we can use that compassion to heal myself!! And then I can heal and recover and go into a future where I find a job that makes me happy rather then tears me down.
brandy1017, ASN, RN
2,910 Posts
No one is soulless! You are judging the other nurses without really knowing them.