What is "burnout" and how do you cope?

himilayaneyes · Dec 9, 2010

Unfortunately, this seems to be the reality of nursing. You're not alone in your sentiments. I've only been a nurse for about 2.5 years and already I'm tired of being on the floor. My answer is that I'm going back to school to be a nurse practitioner. I realize that being a floor nurse isn't something that I could do for the rest of my life. Perhaps you should consider something other than floor nursing (e.g, clinical educator, administration, nurse entrepreneur, nursing informatics, nurse practitioner, etc). There are many things you could do....home health is less stressful, reviews for insurance companies, or legal nurse consulting. Ask yourself what is it that you want to do for the rest of your life? Find your niche and keep your head held high. :heartbeat XOXO

rockabye · Dec 9, 2010

It sounds like you can either work with management and see if you can help them find solutions for better work environment and hope changes get made, or just search for greener pastures. Whiny CNAs, petty nurses, screaming patients, and unrealistic schedule may just be part of the job. My solution is I work in higher level neonatal ICU so I don't have or deal with CNAs. It is a large unit so I am unlikely to deal with the same petty nurses each shift. My patients still cry but some are intubated so I can't hear them LOL. Having a larger unit, we get to self-schedule and have more flexibility - although sometimes we have to switch a couple days and we still have weekend and holiday obligations. No place will be perfect, but if you can find a place with less cons then pros, I am sure you will feel better. I coped with burnout by loving the field of nursing I got into, working part-time with a consistent schedule, and moving to a hospital that fits my needs and where I feel like management actually listens to us. Good luck and I hope things get better for you!

MikeyT-c-IV · Dec 9, 2010

I suffer from burnout on a frequent basis. The odd thing is, I have a great job that is perfectly suited for me. I love it. My burnout is lived vicariously through my wife, who is also a nurse. And for my colleagues, I see extreme injustice.

I am 100% concerned with the way staffing is calculated. I have learned that the administrators and the number crunchers that run healthcare like a business firm are the folks who are the farthest away from the bedside and have no baseline to assess and 'calculate' what we do. Problem is, healthcare isn't about healthcare anymore.... it's simply another business that is interested in profit. Money. That's it. Our patients are individuals with individual needs, some more than others.

It's been allowed to happen. We are educated, professionally licensed individuals that go to work in a hospital. We get told to run from room to room, do our work with minimal help and risk our own license because we don't have the time to stop and use our God given asset.... our BRAINS. A lost resource in nursing because we are forced to occupy our time with putting out little fires and God forbid, the really big fires. Constantly.

I have only been a nurse for about 5 years, and the things I see sometimes makes me wonder if I should be there. I entered the field with intentions of caring for my patients, in a very serious, dedicated manner. And to provide them with their needs. That simply can't be done in todays hospital environment. I worked 3 different jobs at the same time, and each facility had the same practices: work their nurses to the bone. Absolutely ridiculous.

The only positive thing I have to say at this point, is how I cherish the moments when I have 15 or 20 extra minutes when I can sit in a patients room and just visit with them. We laugh, cry, or just have a good visit. It's called connecting with other human beings when they are most vulnerable. This isn't in the business model.

As for all that, I am back in school. One day I'll probably be fired for having the worst PMR and best staffing. I can't stand to see our patients neglected due to a broken system and poor staffing. Won't happen under my watch. And if it does...screw the system.

As for the CNA's...get used to it. For every 20 CNA's I know... 1 will be good. I don't know where they get their sense of superiority. If we were brick layers they would be the laborers, and be expected to work while we take our break. I honestly don't know why CNA's are allowed to behave as they do. I had a situation where I was the bad guy for writing up two CNA's I caught surfing the internet while the nurses were busting our butts. really? c'mon.

My advice, if you don't like healthcare and can't find a good fit. Run. Run fast. It's not going to get better.

skittlebear · Dec 9, 2010

This is going to be short and sweet but I believe this is a given in nursing. Stress, management, screaming patients, family members, etc. This can all get so old after a while. I am dealing with major burn-out and it has everything to do with my current employer. I'm switching jobs after 5yrs and I know and feel that, that will be my answer. At least, until I get exhausted there.

TheCommuter, BSN, RN · Dec 9, 2010

I'm coping by working PRN. This means that I can select the days that I want to work at a higher rate of pay than full time staff.

I'm also coping by working exclusively on night shift. There's too much craziness during daylight hours: doctors rounding and writing orders, rude families, demanding patients, and unsympathetic managers. I'm being pulled in too many directions during daytime hours. At least I am comforted by the fact that most families, doctors, and managers will be at home trying to catch up on their sleep while I'm at work!

beewink · Dec 9, 2010

I am 100% concerned with the way staffing is calculated. I have learned that the administrators and the number crunchers that run healthcare like a business firm are the folks who are the farthest away from the bedside and have no baseline to assess and 'calculate' what we do. Problem is, healthcare isn't about healthcare anymore.... it's simply another business that is interested in profit. Money. That's it. Our patients are individuals with individual needs, some more than others.
The only positive thing I have to say at this point, is how I cherish the moments when I have 15 or 20 extra minutes when I can sit in a patients room and just visit with them. We laugh, cry, or just have a good visit. It's called connecting with other human beings when they are most vulnerable. This isn't in the business model.

I really appreciate your whole post, but these 2 points are on the top of my burnout list. I think the hardest thing is convincing your loved ones of these realities. They simply don't believe it. I have had so many jobs since I've been a nurse that I have come to think of myself as irresponsible. (And I'm pretty sure my family does too). Lately, I've taken a really hard look at the realities of health care - and I've come to the conclusion that either 1)I'm just not cut out for it, or 2)things are really that bad, and getting worse everyday.

SoundofMusic · Dec 9, 2010

After 3 years, this is why I left my unit -- then I tried another one, just to find out it was the same play, just different stage and players. I'm honestly too old now to just keep roaming around for a better job ...I know in my heart it's just not out there, so I give up.

I am in grad school to become a NP and working the bare minimum of hours as a nurse to keep current. I hope one day to be able to really sit, and think, and use my God given brain do something for someone that truly enables their life to improve. I already love, love, love, what I am learning in school.

And the thing about the CNA's really gets to me, too. Here I am a person who sweated it out through nursing school to get a BSN, to pass the NCLEX, (and sadly, many of them can't even QUALIFY to get into college) already have another bachelors as well -- yet I have to take crap off some kid who is about 10 times less educated than I am. I am in charge of this person, and responsible for every mistake they make, yet I have ZERO authority over them! Yet another scheme cooked up by HR managers and others who have no idea what goes on at the bedside. My dream would be to have techs have to report directly to nurses .. ..now wouldn't that change the game? Many of them all of a sudden, would have to show some respect and actually get some work done. I had to fill EVERY SINGLE water pitcher my last shift ... have to constantly fetch and lift and answer bells on my own. Where are the techs?? It's always my question .... if we made them accountable, perhaps some of them really could shine and work their way up and bring something to their profession ....but they don't.

NP duty ... no techs. No managers. No cranky family members ganging up . .. of course, there will be other responsibilties ...but for now, grad school has been the answer for me and the answer to keeping my sanity.

Vtachy1 · Dec 9, 2010

I'm reading an old book, its like 5 years old but out of date on a lot of things, anyway, they describe burnout as the lack of self care. (Something I have been through to a T!) It describes me exactly. Its saying when we don't take our scheduled breaks, when we don't eat, sleep etc. it contributes to burnout when we put everyone else's needs above our own. Been there done that! I can honestly say in the last 20 years of nursing, I can count on one hand the times I took a lunch break or bathroom break. and now I'm having to take physical therapy for a bladder disorder because it is not unusual for me to go 18 hours without urinating. Working 12 hours (which is really 14-15 hours), and if you have a precious family that needs your care, a house that needs your care, a husband that loves you through thick and thin, there's no time for us to care for ourselves.

I just always thought it was noble and good to put everyone's needs above our own. I am learning that I need to try to be a bit more shall we say, selfish. I need psychotherapy for this I think!! Its a learned behavior that I've practiced for years, many years. Nurses are attracted to nursing because we want to care for others, and caring TOOOOOO much for TOOOO long is what my nursing instructors always told us was burnout.

Self care is the antidote to burnout, it is regulating myself mentally, emotionally, physically, spiritually, interpersonally, using self awareness and self management. It is also conservation of energy to preserve myself.

Kris10k · Dec 9, 2010

It's really unfair for people to say CNA's are all lazy, disrespectful, etc. I am in nursing school and have been an aide for a few months and in my work place it is the exact opposite. Nurses will NOT help you when they know you are struggling, and often times I am the only aide on a shift. I really aspire to be a great nurse and I hope that someday when I have aides I will actually lend them a hand if they are in need--after all they are your patients. I feel that overall, the system is broken and I wish teamwork was more of a commonplace.

Vtachy1 · Dec 9, 2010

It's really unfair for people to say CNA's are all lazy, disrespectful, etc. I am in nursing school and have been an aide for a few months and in my work place it is the exact opposite. Nurses will NOT help you when they know you are struggling, and often times I am the only aide on a shift. I really aspire to be a great nurse and I hope that someday when I have aides I will actually lend them a hand if they are in need--after all they are your patients. I feel that overall, the system is broken and I wish teamwork was more of a commonplace.

I have heard this from a CNA the other day, and from others. Both RNs and CNAs need to realize what its like to be in the other's shoes. When I was an RN on med surg and even in ICU I worshipped the ground the charge nurse walked on when they allowed me to aid when we were short an aid. Because the legal responsibility of charting and calling all the disciplines to coordinate the patients care all that burden was lifted off my shoulders! Yay!!! I can do the physical stuff and work like a dog NO PROBLEM and be ever so helpful and respectful and realize that its my job to build up the nurses and help them. I was an aid for 4 years before I was an RN and I wish I could go back to the days of aiding. It was a mistake to get my BSN. I realize that now after 20 years LOL.

noahsmama · Dec 9, 2010

As for the CNA's...get used to it. For every 20 CNA's I know... 1 will be good. I don't know where they get their sense of superiority. If we were brick layers they would be the laborers, and be expected to work while we take our break. I honestly don't know why CNA's are allowed to behave as they do. I had a situation where I was the bad guy for writing up two CNA's I caught surfing the internet while the nurses were busting our butts. really? c'mon.

At the hospital where I used to work, the CNAs were AMAZING. They worked at least as hard as the nurses if not harder. Most were great about teamwork -- they would help me and I would help them. They really worked their butts off. I would have a 4 patient assignment, but they would have 12. They did all vitals, most patient hygiene, toileting, feeding. Don't know what I would have done without them.

However, at another hospital where I did my med/surg clinical rotation in nursing school, the CNAs were much as you've described. They would do vitals, but would pretty much disappear for the rest of the shift, and would look at you like you had two heads if you asked for help turning or bathing a patient. And I don't just mean me as a nursing student, they weren't around to help the nurses either.

I can only conclude that this situation existed at the second hospital because management tolerated it. At the hospital with the amazing CNAs, any CNA who slacked off all of the time would have been out of a job pretty darned quick.