Friday, October 07, 2005

Burning Down the House

What did YOU accomplish this morning? I managed a cup of coffee, my email and some blog reading, as a matter of fact! I don't even read newspapers anymore. I sit with my cup of coffee, curled up on the couch with 2-3 cats and my laptop. When you write your blog, remember that someone may be reading it with their mouth full and don't write anything that makes them spray it all over the monitor! Nothing like a "spit-take" to start your day....

I was thrilled to find a copy of this ad. If I could, I'd get a paper copy and have it matted and framed. I first saw it while suffering from an overpowering case of burnout many years ago. It helped me refocus on why I was a nurse; it gave me a sense that what I did with my life was important.

I knew I had crossed the line into severe, pathological burnout when I was standing at my kitchen sink and heard an ambulance in the distance. I put down the dish towel, turned around with my hands on my hips, surveyed my house and thought, " where am I going to put them?" It sounds comical to me now, but at the time it was the final straw in a deep downslide into the world of the burnt-out nurse.......

The term "burnout" gets tossed around very lightly but it can be a serious, depressive state. Your soul is a black hole. You have absolutely nothing left to give anyone, you're hollow. It takes every ounce of your strength to move your 5000 pound arms. You're an emotional zombie giving an eight-hour "performance" five times a week during which you smile and "act" like a nurse. When the curtain comes down you leave the stage of your unit, numb. You're on the verge of tears, but they never come. Your chest is heavy and breathing almost too much trouble. There is no enjoyment of time off because you dread the next shift - even if it is two days away. You feel trapped, without options. The world is siphoning off your will to function. I hated nursing.

That was me in 1987. I had it bad.

Here are a few suggestions based on my experience.

  • Don't overwork.
    • Double shifts, double backs, extra shifts and long stretches will take a cumulative toll on your body and your psyche. It's one thing to help out occasionally but there are hospitals out there that will want you every single day for one hole in the schedule or another.
    • Learn to say no. Practice it. It's hard to say no to "The Call" when you have nothing planned but relaxation for the day, but you can't be all things to all people all the time. The sooner you realize that the better.
      • Mark yourself as "unavailable" or "N/A" on the schedule to decrease the chance you will get a call.
      • If you can't say no, get a message machine and screen your calls. If you are not available, don't answer it.
    • The extra pay is nice, but it isn't worth your mental health. And you know what? After awhile it's the law of "diminishing returns" - meaning that most of that pay goes to taxes anyway!
    • If you do work extra or do a double shift, try to negotiate comp time, i.e. another day off if you pick up the extra.
  • Take advantage of flexible schedules and creative uses of holidays and paid-time-off to give yourself "mini-vacations" on a regular basis, short stretches of time off that you can look forward to.
  • Realize that you have options.
    • The flexibility of nursing is its best asset. Take advantage of it. Feeling restless, bored, empty, depressed?
    • Change your hours, your shift. Look at what other facilities are offering. Better hours? Better pay? Weekends only? No weekends? Less commute? More challenge? Less stress?
    • Realize that one position may not fit your needs, or your lifestyle for your entire career. Don't be afraid to explore, to step out and try new areas/specialties.
      • We are being actively recruited. New graduates are being accepted into specialty preceptorships and experienced nurses are highly sought after.
      • A wide variety of experiences makes you even more desirable to nursing employers.
  • Take care of yourself. It's not a cliche. If you are sleep deprived and eating poorly your ability to cope with the stress of nursing will be greatly diminished. If you aren't physically healthy your mental health will suffer.
Burnt? I was crispy fried, folks.

Without making it too simplistic, I was able to work my way out of the pit of my burnout-that-lead-to-depression by following the points above, working with a counselor and in my case, using a brief period on antidepressants. It worked. I regained my passion for nursing and more importantly I was able to feel compassion for my patients. I could care again.

My advice? If you start to feel the twinges of burnout, take steps to stop it STAT.

It is much easier to avoid burnout than it is to cure it.


At 10/08/2005 12:41:00 AM, Blogger Julie said...

Thanks for that extremely moving post Kim, you obviously had a really close call there and the advice you give is excellent. It is a testament to you that you have managed to once again be the kind of nurse you want to be.

Reading your post helped me see how very close I came, and also how I need to take care of myself all the more.

Thanks Kim, great post.

At 10/08/2005 03:09:00 PM, Blogger I am a Milliner's Dream, a woman of many "hats"... said...

Thanks; good to read before I am through school...and exactly what our instructors told us all this week! *Have you ever thought of teaching?*


At 10/09/2005 12:01:00 AM, Blogger Gypsybobocowgirl said...

Very good advice. I see nurses working themselves to death, and they aren't theraputic with the patients or anyone else.

I did the overwork thing straight out of school, until one night when I called in "I don't think I can be nice to the patient's or anyone else tonight." They let me off, and I learned not to work too much.

At 10/09/2005 09:22:00 AM, Blogger kenju said...

So many people get on the path to burnout and they don't see it coming until it is too late. Good for you for working to overcome that pit of depression and for sharing the steps that helped.

At 10/10/2005 02:27:00 PM, Blogger Judy said...

My burnout cure is a weekend alternative. I have 5 days in a row off every single week. They're pretty full, but not at the hospital.

I knew I had the burnout thing licked the day the scheduler called to ask me to pick up. When I said "No" she asked, "Why not?"

"Because it's my day off" I replied.

At 10/10/2005 06:55:00 PM, Blogger Dr. Deborah Serani said...

I think that nurses put in such long hours...I am amazed at how you all do it. Burnout seems like a logical progression when you are a healer.

Your advice is so good. When you feel the slightest edges of burnout, address it!



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