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Tuesday, December 19, 2006

Nurse's Story: Sharon - Witness a Case of Burnout - Saying No is Hard to Do

Sharon -







From first grade I knew I wanted to be a nurse, so imagine the toll it took on me to find myself burned out after 20 years from trying to cover the staff shortages by working 10 days in a row, sometimes 16 hours at a time or trying to herd 80 patients through exams a day. And to top it all off, when I couldn’t the impossible, I got replaced by someone younger they thought was faster!

My burnout came about because in every job I had, they worked me until I dropped. If I could work ten hours, they wanted me to work 12.“Nursing is a calling, if you don't answer it keeps calling.” If 12 works, then why not 16? If I could work five days, then they wanted me to work ten days in a row, and then when my skills weren’t as acute as they had been when I was working fewer hours, they replaced me with somebody younger and faster. I was working as hard as I could, yet I was a failure in their eyes.

I repeatedly said I needed more help and I was overwhelmed, but no relief came. I needed to work, so I moved to another hospital but the conditions were the same. They would tell me the budget was limited, yet they kept building new wings and getting new equipment. Nurse staffing was not a priority. So after enduring those circumstances as long as I could, I changed jobs and worked for a private practice and money wasn’t an issue to them. But one doctor I worked for wanted to see 80 patients a day. We had an MA, an LPN and I was the only RN, and he was angry because we couldn’t get that many patients in and out of his office in one day. He called me to task and asked, “Is there any way we can see more patients?” I said, “Only if they get naked in the waiting room.” He was furious with me. Shortly thereafter, he decided he could find somebody else, and that was fine with me.

I worked for awhile in a feminist clinic where even the doctors were women. During that time I felt I had power and people respected me for me and what I could do. I was empowered to say, “You know, I think this recovery room would work better if we did this,” and five women would say, “That’s a pretty good idea. Let’s try that.” If I had said that at the hospital, a doctor would have said, “We’ve always done it this way and that’s how we will continue to do it.” The feminist clinic had a teamwork atmosphere, without the competition that I found in the hospital. We all respected one another. We nurtured each other. We would go to lunch together every Saturday and share things about our lives.

My last nursing job was at a long-term care facility. I liked working with the seniors because they appreciate the tiniest things I would do for them. But after working there for a short time, I started getting calls at 3 a.m. “The day shift nurse can’t come in. Can you do her shift as well as your 3-11 shift tomorrow?” I would explain to them that I wouldn’t have time to sleep, but then they would ask if I could work an extra half shift. They would ask over and over again and I was not good at saying no. I felt if I didn’t work when they asked me to, there would be repercussions. If I didn’t play along, I wouldn’t get pay raises or promotions. I soon realized that even though I did what they asked, I still didn’t get the pay raises or promotions. I felt unappreciated. That’s when I left nursing to open the bed and breakfast.

Running a bed and breakfast is very much like nursing. My husband would tell people, “Sharon gets to give lots of TLC, nourish people’s bodies, and change beds, the only thing she doesn’t have to do is bathe them.” I say nursing is a calling, if you don't answer it keeps calling, so I found this way to heal. To me the bed and breakfast is as spiritual as nursing. I believe everybody who stayed came to bring me a gift or to receive a gift. People told me incredible stories from their hearts and souls. I felt I made a difference just by listening. I even nurtured my housekeepers. I listened to their problems and helped them in any way I could. I encouraged them to move on to better jobs, because I saw more potential in them than they could see in themselves. I helped them build confidence. I think nursing gave me the gift to help people feel good. The empathy I developed throughout my nursing career has made me a better host, mother and friend.

I always felt there was a spiritual aspect to nursing. My job was to make patients comfortable and help them heal. Sometimes I knew I said the right thing at the right moment, and that would fulfill me. I remember a non-English speaking patient I cared for. I didn’t speak Spanish, but in the back of a nurse book I had was a list of a few Spanish phrases, so I grabbed the book and made an attempt to communicate with him. I had enough information to ask him if he was in pain, where the pain was, and if I could give him something to ease the pain. He had been laying there suffering for quite awhile, and the nurses hadn’t picked up on his discomfort – or they were too busy to care. I know I made a difference for him that day.

I loved nursing when I was able to really care for the patients, but most of the time competing and conflicting pressures got in the way. I believe that cost me on a spiritual level. I’m sure it attributed to my burnout. I try to keep my sense of humor, and posted a quote from Dear Abbey to keep myself laughing:

We the Willing
Led by the Unknowing
Are doing the Impossible
For the Ungrateful.

We have done So Much
With So Little
For So Long
We are now Qualified
To do Anything
With Nothing.

Anonymous

I can’t find the cutting I had posted so I googled it for my story. Most likely, Abby printed a nurse altered version. I would think most nurses would be adverse to using the ungrateful line, for fear others might interpret it as referring to the patients instead of management. I don't believe any of my patients were ever ungrateful. I was willing to tolerate the conditions in order to have the opportunity to give them the best care I could, the care they deserved. Many times I went to work exhausted fearful if I didn't go to work that day, that my replacement wouldn't be as caring or tender with them as I would.

I was a hospital patient recently and found it interesting how nursing has changed in the 10 years since I left the profession. I saw a difference between the young nurses and the older nurses. The young nurses are technologically-oriented. They came in, looked at the computer, read all the dials, made their notes on the computer and then left. I felt like I was a piece of equipment when they were in the room. The real nurses, who tended to be older, came in, asked me how I was doing, and then looked at the machines and entered data.

I had one really bad night when I was in a lot of pain. The next day I was supposed to have a chest x-ray. The charge nurse called x-ray and asked them to bring up the portable x-ray machine, but they refused and said I had to go to x-ray. I explained to her that I didn’t want to go to the x-ray department, because they kept me there forever and I have to have the oxygen on underneath the mask. The mask gets hot and after awhile, I can’t breathe. She decided to take me to x-ray herself. It took a long time and she could see that I was having a hard time. She reached over and held me and comforted me. That made a big difference for me. I was so happy to have a real nurse caring for me.

I no longer have the bed and breakfast, and my recent hospital experience inspired me to return to nursing. I may return in an educational capacity. I know I’ll be able to find a niche somewhere, and I’m motivated and excited to care for people again.

Power Strategies: Dedication, Loyalty, Service
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