Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

This Nurses Week: Ask your nurses if they are burned out

Emily Weston, FNP-C, RN
Conditions
May 9, 2017
Share
Tweet
Share

July 10 will mark my tenth year as a nurse. When I began, I was shy and naive. Now I am already an old nurse, surprised by nothing and filled with battle stories. I’ve spent the last seven years working in a medical ICU, and I’ve seen and done so much. I counseled a bewildered husband on withdrawing care on his cancer-stricken wife. I got in a fight with a hematologist who insisted we transfuse a man who kept going into pulmonary edema. I’m convinced my antagonism prevented an intubation. I’ve pushed morphine, and through tears, told a widow-to-be to hold her husband’s hand while he breathed his last. They were both 28.

A few years ago, probably to appease satisfaction scores, my hospital mandated a class in empathy training. We were instructed on how our own empathy fell short, on how we needed to learn to feel what the patient feels.

I can’t possibly feel what the patient feels. If I did, I’d be crippled with grief.

It hurts to be a nurse, especially in ICU or oncology. I remember a woman I cared for years ago who had a head and neck cancer. She was dying and before they withdrew the husband asked for a second opinion. After we took her off the ventilator,  I watched her sons, 6’5” men, weeping at her bedside. Her husband, a diminutive quiet guy, never shed a tear. When I was leaving later that night, I saw the husband standing in the hallway, hunched, expectant, holding a lunch pail, looking for all the world as if she was waiting for a third opinion. I went home, ate dinner and was watching something brainless when suddenly I began to cry. I kept seeing the husband in the hallway, so bereft he couldn’t yet process it. What happens to us, I thought, after we bag the body, clean the room and admit another patient? The wheels of the hospital move on.

Yet through all of these years, I’ve been stoic. I’ve understood that there is a time to live and a time to die, and I’ve considered it a privilege to provide a person with a good death. And there is a rush to saving a life, an edge to being to intimate with death and so far, I’ve been willing to give up neither of these things.

I may have come to the end of my capacity. A trifecta of patients pushed me to my limits one Sunday.  Number one was a boy with cancer. He was 26. Last year he was healthy and normal and when I met him his lungs were so bad that he had to be pharmaceutically paralyzed to allow the ventilator to do its work. On that Sunday, on my walk in, the hallway was filled with red-eyed nurses from the oncology floor who’d come down to check on him. The nurse that had taken care of him yesterday was crying in the breakroom and asking if she could have a different assignment. Lisa never cries, she runs marathons and shrugs things off. The patient’s father paced the hallways.

Patient number two was a middle-aged woman with a tumor on her carotid artery. She was demanding and cantankerous, and I liked her. She wanted everything done as fast as possible, but I could see through her tough demeanor. She was scared out of her mind. She and her family were given options. Hospice care or a procedure that would cause complications but buy her a few weeks. She chose no more interventions.

I went in to unhook the monitor and disconnect her IV. While I was touching her, she heaved herself upright. I held her while her severed carotid bled. She lost at least a liter of blood in my arms. This is the end I thought. I called for help, but there was nothing to do. I told her family to come in, even though it was horrifying. What if it was her last moment on earth and they were waiting outside the curtain? She stopped bleeding and didn’t die that day.

Patient three was a man in alcohol withdrawal with pneumonia. He ripped off his oxygen and screamed for air. He tried to jump out of bed on unsteady legs. He was verbally abusive and if we hadn’t pinned him down, would have been physically abusive. It isn’t unusual for nurses to deal with physically violent patients; our administration is very supportive to make sure we don’t get hurt.

However, this particular man got to me, with his unpredictable outbursts and I found myself wanting to hit him back. Together with the bloodbath in patient two’s room and the knowledge that patient one was dying, I was a frazzled mess. By the time I got home, I was worn out to the core.

My sister works on the oncology floor. She texted to ask me what was going on with the young boy. The whole floor is a wreck, she said.

When I went to bed that night, I couldn’t sleep. I was nauseated, shaking and crying. I kept thinking about all of the nurses on the oncology floor, trying to take care of other patients through their grief. I kept thinking about the blood spurting out of my patient’s mouth, the sure knowledge that nothing modern medicine had cooked up could save her life. I couldn’t face the thought of going back. I called in and spent the next day on the couch, letting my mind drift.

What about all the other nurses? What about the oncology nurses who couldn’t function? What about Lisa? There’s no acknowledgement that we suffer, that we witness tragedy. We are expected to keeping passing meds, charting and being helpful and positive when we interact with our patients. No taint of another patient’s suffering should mar our demeanor. We are not given a day off to recoup, or even an hour’s break with a cup of coffee. Instead, we are told to be empathetic. To commit to being more involved with our patients so that when they fill out their surveys, they remember the nurses as caring. We are given more charting, more alarms and more demands on our already tightly managed time.

ADVERTISEMENT

What is the end of all of this? Burnout. Our compassion tanks run dry. We either leave the profession, or we become lazy and embittered. This week, while we celebrate Nurses Week, my hospital is giving us badge holders and inviting us to walk the Monday Mile, thank a nurse. If you are in administration, ask yourself if your nurses are burned out. Ask yourself if you could witness death, day in and day out and stay sane. We need to change the expectation that being a part of agonizing loss is normal and give nurses space to grieve.

Emily Weston is a nurse who blogs at Nursing: A Confession.

Image credit: Shutterstock.com

Prev

"Are you in ISIS?" my patient asked

May 9, 2017 Kevin 20
…
Next

Why physicians should not complain about school debt

May 9, 2017 Kevin 12
…

Tagged as: Nursing

Post navigation

< Previous Post
"Are you in ISIS?" my patient asked
Next Post >
Why physicians should not complain about school debt

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

More by Emily Weston, FNP-C, RN

  • I speak for the nurses

    Emily Weston, FNP-C, RN
  • Patients’ rights? What about the nurses’ rights?

    Emily Weston, FNP-C, RN

Related Posts

  • Nurses Week. Always and forever.

    Debbie Moore-Black, RN
  • Where is the nurses’ lounge?

    Trisha Swift, DNP, RN
  • Why nurses must help lead the NHS

    Dr. Ben Janaway
  • Nurses are in need of racial healing

    Janice Phillips, PhD, RN and Katie Boston-Leary, PhD, MBA, RN
  • I speak for the nurses

    Emily Weston, FNP-C, RN
  • Where are the nurses in the Transition COVID-19 Advisory Board?

    Yoo Jung Kim, MD

More in Conditions

  • Finding healing in narrative medicine: When words replace silence

    Michele Luckenbaugh
  • Why coaching is not a substitute for psychotherapy

    Maire Daugharty, MD
  • Why doctors stay silent about preventable harm

    Jenny Shields, PhD
  • Why gambling addiction is America’s next health crisis

    Safina Adatia, MD
  • How robotics are reshaping the future of vascular procedures

    David Fischel
  • How the shingles vaccine could help prevent dementia

    Marc Arginteanu, MD
  • Most Popular

  • Past Week

    • 2 hours to decide my future: How the SOAP residency match traps future doctors

      Nicolette V. S. Sewall, MD, MPH | Education
    • Why removing fluoride from water is a public health disaster

      Steven J. Katz, DDS | Conditions
    • When did we start treating our lives like trauma?

      Maureen Gibbons, MD | Physician
    • In a fractured world, Brian Wilson’s message still heals

      Arthur Lazarus, MD, MBA | Physician
    • When your dream job becomes a nightmare [PODCAST]

      The Podcast by KevinMD | Podcast
    • How doctors took back control from hospital executives

      Gene Uzawa Dorio, MD | Physician
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • Why shared decision-making in medicine often fails

      M. Bennet Broner, PhD | Conditions
    • My journey from misdiagnosis to living fully with APBD

      Jeff Cooper | Conditions
    • Why we fear being forgotten more than death itself

      Patrick Hudson, MD | Physician
  • Recent Posts

    • When your dream job becomes a nightmare [PODCAST]

      The Podcast by KevinMD | Podcast
    • Finding healing in narrative medicine: When words replace silence

      Michele Luckenbaugh | Conditions
    • Why coaching is not a substitute for psychotherapy

      Maire Daugharty, MD | Conditions
    • When the white coats become gatekeepers: How a quiet cartel strangles America’s health

      Anonymous | Physician
    • Why doctors stay silent about preventable harm

      Jenny Shields, PhD | Conditions
    • Why interoperability is key to achieving the quintuple aim in health care

      Steven Lane, MD | Tech

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 9 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • 2 hours to decide my future: How the SOAP residency match traps future doctors

      Nicolette V. S. Sewall, MD, MPH | Education
    • Why removing fluoride from water is a public health disaster

      Steven J. Katz, DDS | Conditions
    • When did we start treating our lives like trauma?

      Maureen Gibbons, MD | Physician
    • In a fractured world, Brian Wilson’s message still heals

      Arthur Lazarus, MD, MBA | Physician
    • When your dream job becomes a nightmare [PODCAST]

      The Podcast by KevinMD | Podcast
    • How doctors took back control from hospital executives

      Gene Uzawa Dorio, MD | Physician
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • Why shared decision-making in medicine often fails

      M. Bennet Broner, PhD | Conditions
    • My journey from misdiagnosis to living fully with APBD

      Jeff Cooper | Conditions
    • Why we fear being forgotten more than death itself

      Patrick Hudson, MD | Physician
  • Recent Posts

    • When your dream job becomes a nightmare [PODCAST]

      The Podcast by KevinMD | Podcast
    • Finding healing in narrative medicine: When words replace silence

      Michele Luckenbaugh | Conditions
    • Why coaching is not a substitute for psychotherapy

      Maire Daugharty, MD | Conditions
    • When the white coats become gatekeepers: How a quiet cartel strangles America’s health

      Anonymous | Physician
    • Why doctors stay silent about preventable harm

      Jenny Shields, PhD | Conditions
    • Why interoperability is key to achieving the quintuple aim in health care

      Steven Lane, MD | Tech

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

This Nurses Week: Ask your nurses if they are burned out
9 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...