Gratitude for a Near Miss With Burnout
In this article, Stephanie Sargent, our Chief Clinical and Quality Officer, offers a first-hand account of her time as an overworked nurse, suffering from the detrimental effects of burnout. Burnout can lead to feelings of lack of purpose, depression, anxiety, and emotional exhaustion. Read on to learn more about her journey through nursing, her battle and triumph of burnout, and the sense of gratitude she is left with.
The time period between my 2nd and 3rd year of nursing just about took me down. That year almost, almost broke me. I questioned my career choice and wondered if I had what it takes. There were days of complete physical exhaustion, emotional distress and spiritual depletion (“what’s the use?”).
Nonetheless (and perhaps because of my struggle), the nursing profession has been unquestionably life’s greatest gift and I am beyond thankful for that dark year of suffering.
Many other nurses also have their own stories. Sometimes it’s a single brush with burnout that presents and resolves quickly. Other times symptoms of burnout appear, linger for a while and then recede – only to return down the road. Though burnout is largely attributed to system-generated circumstances, sometimes situations in a person’s personal life (for example, a divorce) pile on and contribute to that person reaching their tipping point. In one of the worst cases, burnout is so all-consuming the individual simply cannot take it anymore and leaves the profession entirely – new graduate nurses are especially susceptible. This one breaks my heart.
Nurses typically chose the profession for its altruistic nature and their own desire to care for others. When the healthcare system rewards nurses for their virtuous career choice with crushing workplace stressors and little or no support, absenteeism, high turnover, poor clinical quality, low patient satisfaction and frequent medical errors should be no surprise.
I’d like to share my personal burnout story. As you read, I invite you to reflect on your own personal career challenges and experiences and how they’ve impacted you and molded who you are.
It was 1997 and I had 2 years of post-graduate nursing experience under my belt. I was eager to travel and had my eye on a highly desirable and competitive city. At the time, I couldn’t get a traveling nurse contract in that city, but my recruiter found a town about 1.5 hours away, promising a contract in the city would open for me soon.
I land in this 2-stoplight town at a 40-bed hospital. I was a med-surg nurse and my traveling partner (my best friend) was assigned to the ICU. The med-surg unit was a grand misnomer – it was a combination of step-down, telemetry, skilled nursing, ortho, neuro, GI, hospice – basically, everything.
Though I had my 2 years of nursing experience, in some ways I was in over my head. I was seeing and doing countless new things outside of my experience and this time, with no preceptor or mentor.
I worked the night shift (of course) and I had the happy privilege of waking surgeons in the middle of the night to report concerns, for example, their patient with the fresh colon resection is complaining of 10 of 10 abdominal pain and just passed 1000 cc of bright red blood. On top of extreme anxiety for my patients’ welfare (other than a full code, there is nothing more stressful for a nurse than a deteriorating patient) matters were made worse by irritation for me having called.
As the traveler, I usually got the worst assignments. The workload was heavy. The nurse-patient ratio was inappropriate and unsafe and there was rarely adequate PCT/CNA support. The patient acuity was high. The other nurses were also struggling so teamwork and cooperation were not abundant. They also perceived me as an outsider – as they typically do with travelers – so there was little emotional investment to develop a relationship. They knew I’d be gone in 3 months.
On shift, I looked like a soldier: I wore a fanny pack that had everything imaginable in it: tape, clamps, scissors, alcohol swabs, saline, syringes, ammonia inhalants, end caps, pin lights, you name it. I walked the halls with a headlamp so when I went into patients’ rooms, I wouldn’t disturb their sleep. And when I say “walked the halls” I really mean I ran – almost all night. Barely having time to eat, sit down or use the bathroom.
Every morning at end of the shift my feet, legs, and back ached. I’d get home, shower, and lay in bed staring at the ceiling and obsessing with things I may have missed or forgotten to do. I would just hope that I had not made an error. I dreaded waking and having to go back that evening.
I remember every night before going into work saying to myself, “please don’t hurt anyone tonight, please just don’t hurt anyone”. And as an outsider, I remember feeling fearful to raise concerns.
And unbeknownst to me, I did make a medical error that a nurse brought to my attention the day after it occurred. One that could have had a very bad outcome, but fortunately did not. I was so traumatized by that experience and I remember being fixated on the mistake, playing it over and over in my head, imagining what if the worst had happened. It took a long time to get over that and it was a horrific experience.
The surprising thing is that I had no insight into my own suffering. I was having all the classic symptoms:
- Feeling anxious, overwhelmed, emotionally depleted, physically overextended
- Powerless, ineffective, no sense of joy or achievement
…yet I thought this was just the cost of being a nurse. If I just kept soldiering on, it would get better.
When my contract finished, I did get that job in the city. I couldn’t get out of there fast enough – despite being offered a 50% pay increase to stay. No, thank you very much.
As I reflect on that experience, the only reasons I believe I survived that burnout experience were:
- I left the organization
- I had a strong, 24/7 support system who was also a nurse and my best friend. She understood my feelings and was a safe and sympathetic sounding board.
- When I landed in the city, I was placed on a unit with an incredibly cohesive, nurturing, and dedicated, and professional group of RNs. I was paired with a preceptor who taught me everything about OB (which I’d never done and knew nothing about), and I had an incredibly human / HUMANE nurse manager who brought joy back to nursing for me. I felt safe. Between the staff nurses and my manager, I had a strong, supportive work environment. This experience restored my love for the profession, and I stayed there for years.
My burnout experience did not end my career. I recovered and went on to have a wonderfully rewarding patient care career and it inspired me to ultimately end up here, telling you all my story and working to make a difference in healthcare.
I am so grateful for my entire nursing career, even the year that nearly crushed me. I came through that experience stronger, wiser and a better nurse and person. It gave me a deep understanding of the struggles nurses experience and informs my work today. I will continue to fight for nurses to improve the conditions that you work in and to make sure that your career choice is as rewarding for you as it was for me.
My deepest, heartfelt thanks and admiration go out to all nurses.