Is this burnout or am I just not cut out for nursing?

[Fullforcegale]

I’ve been working as a nurse for 2.5 years and sometimes I feel like I hate it with a passion. I find the lack of control over my day depressing as I am constantly on edge anticipating the next admission or time consuming emergency. Many of the patients are perfectly pleasant but it only takes one very anxious/rude/demanding patient to upset my day. I hate how some senior staff and doctors speak to us. I detest being made to feel incompetent because I don’t know something minor or they are in a bad mood.

I work in haematology/oncology and the patients often die but I rarely feel anything. A death in my shift is an inconvenience because I will have to wash the body and transport it down to the morgue. I wish patient’s wouldn’t cry when I’m there because I have nothing to offer them.

I really don’t know if I’m completely unsuited to the job or whether I’m just burned out or depressed. For all the negatives, the majority of the team are great and we look after one another. I just can’t seem to shake this feeling that I am wasting my life here.

Sounds like you need a change.

Would you consider moving to community? You have abit more freedom. It's nice to get out and about in the car or on your feet seeing different people and places.

If not, you definitely need to change department! Or even consider if nursing is what you want to do all together.

As possible said, you may feel nothing for your patients or when a patient dies. However that neutral/nothing feeling may actually be doing a lot of damage to your patients and their relatives.

@Bezalelle I’m sorry about your loss with your father. Honestly, it’s very complicated and not a simple answer. I think it’s incorrect to just label it as ‘hatred’ as it’s much more multi layered than that. Certainly I personally never felt disgust. I’m also not defending it, saying it’s acceptable or right, just admitting I went thru a tough time and did have these feelings for a while. Burn out is a recognised mental health condition.

The best way I can perhaps describe it is a desensitisation. We are surrounded by death, negativity and some pretty awful situations. I honestly couldn’t tell you how many dying patients and their families I’ve cared for. Thousands. And I don’t think anybody who isn’t a doctor/nurse in the NHS can understand the sheer level of stress, bullying, and unacceptable attitudes that are prevalent throughout. I just felt resentful towards everyone as I had nothing left to give. I was empty, and had too much on my plate. So at the time, spending half an hour with a dead patients relatives, seemed pointless, when I already had too much work to do keeping other patients alive.

As I said, I know this is wrong, but I’m just being honest. It was a really dark time for me. Don’t get me wrong as well - I acted through it and was actually never rude or dismissive in real life, despite what I felt behind the mask.

I think you should move on to something else.
Your lack of compassion when mentioning those who have sadly died and calling it inconvenience sent a shiver down my spine.

Thank you so much for responding and sharing your own stories, it helps to see things from a different perspective.

To answer a few questions, I absolutely did not feel this way when I was training, but I also did not have the time pressures or responsibilities I have now. I am quite empathetic and I think that has made things worse because I feel guilty a lot. Supervision just doesn’t happen and even if it did I would be afraid to be so honest with a manager in real life, hence I am here. In my spare time I walk the dog, see my friends, paint and read. I have a good relationship with my other half but sometimes I find it hard to explain why I can’t be funny and engaging after a hard shift.

@jaffacake2 - I do think it is having an impact on my self worth, it’s interesting you say that. I feel terrible about myself. I have cared for thirteen people since Christmas who have died on my shift. I think this is abnormal even in nursing.

@hamstersarse - I doubt anyone at work knows how I feel. I have had compliments sent to management about my exemplary care of their dying relative. I’m not acting out how I feel, I’m struggling silently with it.

@Bezalelle - I do not feel disgust or hatred for deceased patients. I do however have a number of tasks that need to be done in a short period of time and when an additional task is thrown my way it can be overwhelming. Unlike when I worked in admin and that extra task was another letter to type up, I am caring for real people, live or deceased. I am here asking for help because I recognise that my feelings are problematic.

I echo everyone else and think you need to try another ward environment to work out whether it is the job or you. I’m a paeds nurse and I can completely understand how the job can exhaust you, but I am really concerned by the lack of compassion with a dying patient and seeing them as an inconvenience. That’s not right. However much I might be having a bad day sometimes, it doesn’t mean that I don’t still give 100% to the kids and their families. They are potentially going through the worst time in their lives.
I think working in oncology all the time would get very depressing and perhaps you need a break from it. Do you get much clinical supervision or times to reflect on certain patients that you have lost? This can help. Try and think about why you came into nursing and what if anything has changed. Hang in there, but if it’s not right for you, it’s not fair on your patients or colleagues to stay in a job you hate x

What you describe is not uncommon. A lot of medical professionals react poorly to the death of a patient under their care. It’s quite understandable, your job is to keep them alive and if they die it can be a very unwelcome reminder of human fragility and fallibility and to feel you have failed, that if you’d been a better nurse you would have saved them. Even though rationally you know that’s not true, it’s easy to feel that way and to project those unwelcome feelings onto the deceased patient (who can’t be hurt by them). When you feel that way its understandable to prefer to focus on the patients you can still help.

You are obviously very effected by the death of your patients so you aren’t an unfeeling monster but you aren’t cut out for working in your current role. As other people have said another position might allow you to utilise your training to help others without constantly coming up against this situation.

There are so many different specialties in nursing, have you considered any of them ? It sounds like oncology isn’t for you. Don’t waste your training and experience just yet, explore other avenues. Don’t take any notice of negative remarks on here, I’ve been nursing for 30yrs , and I just work bank now, strictly for the money. I have no interest in it and wouldn’t do it if I didn’t have to, but, I can put on a good show to the patients. I do work in a field where every day is different, so that helps. Hospital nursing is slave labour and I couldn’t do it. Check out jobs in the community.

@IheartNiles - your description of nursing as one lacking in autonomy with a strong paternalistic hierarchy is spot on. I have never been afraid to speak to more senior staff for clarification or just to learn more before now. Maybe they’re just lacking emotional connection and I could become like that?

I would imagine the OP already works term time only. I have mentored many of them

@Inherdefence - I understand why you might think that but I have absolutely no problem with the concept of people dying. If a biological disease overwhelms a person’s body and ends their life I have not failed as a nurse.
I feel like I’m failing because I don’t feel much emotion towards death.

I would think about what appealed to you in nursing and why you aren't getting it.There is such a huge range and flexibility in nursing jobs so it doesn't have to be like the one you are in.

Are you just on the wrong ward or in the wrong speciality altogether?

13 people dying on an Oncology ward since Christmas is unfortunately normal - the inpatients will be very sick and near the ends of their lives.

However if you were doing elective Orthopaedics it would be entirely different. Or Women's Health. Or working in clinics. Or Theatres/Endoscopy. The list goes on and on.

Even if you did Chemo training, and the NHS is crying out for chemo trained nurses, the patients would be with you in the daytime, you would get to know them - a lot would be getting cured, it's an entirely different role.

Feeling the patients are actively hurting you is classic burnout - lots of us have been there. But it doesn't mean the end of nursing, just thinking that nursing has a huge amount to offer and you have done one job in it. There a thousands of other nursing jobs and one of those you will love.

You need to meet be to a different area.If will be good for you career wise and sanity wise.
I last the other way it takes one person/family where I know I made a difference every now and again to keep me going.
If you've been qualified 2.5 years you'll be revalidating soon.Use that to reflect on what is wrong and what you need to do about it.
Many hospitals allow staff to move to different area without reapplying,learning new skill in a different area may be all you need.

I understand why everyone is encouraging me to try a new area but I honestly feel so down about things that I couldn’t go to a job interview and be positive about my skills right now. The idea of starting at the bottom again is intimidating. I’m interested in trying emergency but there would be so much to learn and I don’t feel like I could cope with another year of feeling inadequate and googling in the bathroom because there’s no one helpful or pleasant to ask instead.

What makes you say that @Avelinebread? Sounds to me like op works in an inpatient ward.

@Fullforcegale your feelings aren’t unusual, despite what some are saying on here. I’ve been a nurse for nearly 30 years and I’ve seen this frequently. Nurses and doctors are often ashamed of these feelings, and so they just don’t get talked about. Very difficult to do so too in a culture of short staffing, doing more for less, expectations from both staff and patients to be an ‘Angel’, shutting up and putting up with shit management and support.

Compassion fatigue is a type of post traumatic stress disorder. It’s almost always experienced by the most empathetic of people rather than those who are ‘cold hearted’. It’s very common in areas such as cancer nursing, where we witness and counsel people in the worst kinds of physical and emotional pain and fear. It’s highly stressful and as you are experiencing, relentless. Coupled with this we are occupied with a million and one often menial tasks and expected to backfill lots of other staffs jobs in order to ‘prove our worth’ at one end or ‘not be seen to be too up ourselves to answer a phone or take notes somewhere or clean a room’ at the other. There is no time set aside in the paid day to think or process. Nurses are particularly vulnerable as they cant escape patients, being at the bedside or end of the phone. Patients are also (sometimes brutally) honest with nurses about their thoughts and feelings and at the end of that honesty can lack the polite inhibition they maintain with other HCP. It’s really stressful and you’re not prepared for it at all during training or afterwards.

At the moment you are outwardly coping and are able to “act” normally with patients. This is only sustainable for so long. Eventually people go off sick or act rudely to patients/colleagues. Try and talk to your line manager and also ask for a referral to staff services, who will be able to help you process these feelings and navigate your way to improving your situation. It might mean learning tools to help you cope, or may lead to changing the area you work in. In the early years of nursing it’s good to rotate around areas to find out what suits you and you also work out which hospitals and departments are well managed and better places to work. Everyone is desperate to recruit nurses so don’t just put up with an unsupportive environment.

@AnnaMagnani - I am chemo trained and day oncology might be a better fit but I’m afraid to make any moves right now as I mentioned above.
I was referring to thirteen deaths I have personally dealt with during my shift, not across the whole ward. There’s always an increase in deaths after Christmas and new year because this is when a lot of people chose to stop treatment/the end goal

I just wanted to add my voice of support. I am a GP and did many years of hospital work before this (including two years of oncology). I think what you are describing isn't particularly unusual unfortunately. From what you have said I am sure that the level of care you are actually giving patients is satisfactory. I know from personal experience that it is possible to behave as a caring and decent health care professional whilst feeling dead inside. I also have experienced the feeling of being annoyed/frustrated/useless when asked yet another simple task and not feeling that I had anything else to give. Many of the posters here understandably have no idea of what it is like to work in an overworked, under resourced modern day NHS.

I know it is difficult when you are feeling like this but unless you make some changes this is only going to get worse. You need to look after yourself and put your needs first. I don't know whether this is taking some time out, changing jobs/fields etc.

Please remember not to blame yourself. It is the system/modern day NHS which is at fault rather than you. But please do something to change this situation.

Reading that you have dealt with 13 deaths since Christmas, I am sorry for my previous comment. Although I have been an ITU nurse and worked in lots of different specialities I have never dealt with so many deaths in such a short period. You must be completely desensitized and I can understand why you are feeling like this. Please think about going into another area of nursing to give yourself some mental space to process what has been a traumatic time.

Call occupational health and get some counciling.You need to talk about how you feel as at the moment you are overwhelmed by it all.
See your gp too.
Starting again in a new area may not be as difficult as you think and you will never know everything.If you are interested in emergency care go for it although it is another high stress environment.
You say that the team you work with is supportive,is there really no one you could talk to there,?
On the first ward I worked on we had 12 deaths over 2 weeks and it was emotionally draining.We had meetings to talk about it ,the students on the ward especially needed it but we all benefited.
For now you need to take care of your mental health then work out what you want to do but unless you find the courage to ask for help on your ward you need to change.
I have been nursing for 40 years and still ask questions if there's something I don't know or have forgotten,not worrying about asking even the daftest question comes with experience and at your stage in your career shows and interest in learning and is better than googling.

I think the idea of some counselling is a good one as I don't think you can see the skills you have.

Yes, if you start in a new area, you are starting a new job. But you also aren't starting from the beginning - you have all your experience and traning coming with you, it's not like the first day you stepped on the wards.

I stayed in a job I hated for far far too long. I did one bad job after I left and now am in an amazing one. Every day, it's a mystery to me, why I stayed so long and why the people in those jobs made out I was the problem when in my new job, it's clear that I am not!

But when you are ground down, it is very hard to have any confidence in yourself and see the skills you do have rather than all the bad things.

I would also suggest you seek counselling before you do anything else. You need to try and unpick these feelings and I don't think now is the time to ignore them and change jobs, now is the time to confront them head on and find out what's going on for you. It sounds to me like you are having warning signs and I don't think ignoring them is the way forward.

I worked on an acute respiratory ward for 6 months & saw many deaths of people I'd got to know, we had no support, my response was that I became very sad & depressed & went off sick.
I realised that Medicine wasn't for me.

I currently work on an elective Surgical ward & yes we do still get medical & terminally ill outliers but it's so few deaths most people recover or go on elsewhere. I feel a sense of achievement generally on this ward. If a patient does die then all the staff are supported.

I think you need to stop now & go to OH & take time out before you have a breakdown.
It's a cliche but taking good care of yourself enables you to take good care of your patients.
Also see your gp as you sound depressed.
Not caring about things can be a symptom.
Then when you feel up to it ask OH & HR to support you to be redeployed elsewhere.

I think it’s sad that you feel like this after only 2.5 years and demonstrates that you are in the wrong job now.

I think some counselling would be helpful, and then maybe look at applying for jobs in another area. I’ve been qualified for 25 years and in primary care for 20, and wouldn’t go near a hospital again for all the tea in China.

I think we all have frustrations and get burnt out to some degree. I love my job and most of the patients I see are great but I’ve noticed a definite shift over the years - a huge increase in the level of arrogance, entitlement, lack of common sense and demands on our service. We live in an instant consumer culture and everyone wants everything, for free, and they want it now. It’s hard to reconcile what we can do with what demands are upon us.

Don’t jack in nursing completely, not yet. Maybe try getting mentally stronger then see what else is out there.

I've been a registered nurse for 10 years. It can be such a tough job, mentally, physically and emotionally. Your lack of empathy sounds like you may well be burnt out or having a mini nurse melt down. It's your body and minds way of dealing with such sadness to enable you to get through the day.

I've had a big breakdown about 4 years ago and had to see a psychiatrist and take anti depressants. It took me till last year and 3 job changes to find my feet again. I would book a gp appointment to discuss. I found a serious lack of support from peers and management when it came to emotional support. I was in some scary and really sad situations and my line manager told us to get on with it.

Dont beat yourself up, be kind to yourself. Its definitely time to act on how you are feeling now.

I have worked for the NHS for 20 years and I think you need to find another role in a different sector or leave , because you are definitely in the wrong job with that attitude.

Your post is so so sad. You are not lacking in empathy, you are not a bad person. You are totally burnt out. As much as it's difficult to hear for patients, NHS doctors and nurses are on a knife's edge in terms of what they are expected to do without being expected to feel and care too. It's a horrible, broken system.
I coped by diversifying my role. I'm a GP 2 days a week (and totally drained/knackered /end of tether at the end) but I also do non clinical roles which is stressful in a different way but doesn't expect so much of your personal capacity. Compassion fatigue is very real. I have seen so many terminally ill people, depressed people, distressed people that it doesn't have the same impact on me it once did.
You are struggling. Well done for acknowledging that things could be different. Take some time, find a mentor and slowly build your CV and look at other roles. Nursing is an amazing career but it takes everything from you.