This is such a long post, I’m so sorry, but I really want to get this all down. Hopefully would help others in similar situation.
Literally days before the pandemic started I commenced a new role within the NHS, that I was to fulfil alongside my existing role. Not many nurses have taken on this role at our trust, to my knowledge I was only the second, with mostly consultant level doctors prior to this. So it was pretty unknown territory. But we were positive and optimistic and the plan was to have lots of support and training opportunities to help me grow into this position. I was nervous but excited, looked forward to the challenge. I loved the department I worked in, loved my work. I felt energised by problem solving, by achieving targets, by innovation. I was in really good place.
From the very beginning by necessity because of the pandemic I was thrown straight into a war zone. The outgoing person in the role was recruited into another role that took her away from the department, the service management teams were shuffled around, so we had new people trying to make sense of it all, some members of staff went in to shielding, At first I worked hard to learn what I needed to, but this was made difficult by not really knowing what it was that I needed to know, so the emphasis from the get go was upon responding to challenges as they arose, so the feeling that I was constantly fire fighting. Reactive rather than proactive. Communications from senior trust teams were chaotic, ever changing. No one really seem to know what was going on, we had to interpret the asks from senior teams in our own way, and hope for the best. Put one flame out and another flared up immediately. The support I needed wasn’t there. That’s not to be critical of those around me, they had their own challenges to face, and they simply didn’t have to resources to help and support me with mine. My line manager then left on secondment within weeks of pandemic starting and we had 3 temporary replacements, all in similar situations to myself- poorly supported, inexperienced and just fighting to stay afloat.We rarely saw them in person, and email was the main form of communication. We knew they were busy. There was a sense that we shouldn’t bother them, as they had major issues to deal with on a daily basis.
I knew I was stressed. I didn’t sleep, and if I did sleep the nights were filled with dreams and nightmares, and I’d wake feeling just as tired. People said I looked tired. I would ruminate over problems on a constant cycle, never seeming to resolve anything. I would worry about things that hadn’t happened, my mine always leaping to the worse case scenario. I second guessed every clinical decision I made, I was convinced I was going to inadvertently harm a patient. I was completely overwhelmed.
1 year into the role I fell at work and injured myself and needed surgery. I still have not fully recovered full function one year on and I am unlikely to. I am convinced that the lack of sleep and poor state of mind contributed to the accident. I was off work for 6 weeks and spent most of that time worrying about all that I would need to catch up on. I returned feeling worse, as I now had a life changing injury to also come to terms with. I was still in pain 6 months on.
I made the decision to resign from the additional role at the 18 month mark. This was after I had been shouted at by a colleague, for something I had no control over, and I felt that was the final straw. I cried at my desk for an hour, and was very late home as I didn’t want my husband and child to see me looking like that. I waited for the regret but fortunately it didn’t come. I expected to feel like I felt prepandemic pretty soon once my notice period was over, however that huge sense of relief I expected didn’t come. I still felt responsible, guilty and worried all the time. I worried about hypothetical situations, small things I never used to worry about at all.
My ‘usual’ role was more challenging as we had 2 of our team of 8 colleagues on maternity leave, and frequent covid related absences. Our line managers were largely absent. We were working every clinic session with an overwhelming workload coming through constantly and we started to fail our targets, despite working really hard. I felt the work we did no longer mattered, wasn’t valued by the trust as it wasn’t covid related. All they want from us were targets met, with no encouragement, support or recognition of the mammoth efforts we were taking. We had the constant threat of redeployment, and made to feel bullied and shamed into helping other areas. I helped in ICU on a number of occasions, and ended up mostly being a pair of hands, damp-dusting, cleaning and restocking. Meanwhile at my place of work we were failing, our work meaningless, and really, what was the point of it all? Everyone seemed unhappy, tired, irritable. I witnessed more anger in a few months than in my entire career. Sickness was high, and everything, literally everything, felt hopeless.
I began to feel physically more and more unwell. I was tired all the time. Evenings and weekends flew by with little productivity, and Monday always came back round too soon. I counted the days to my next days off or annual leave. I fantasised about having another accident so I wouldn’t have to work, hoping a lorry would smash into my car. I was detached from my family and friends outside of work. I developed increasingly worse joint pains, I would hobble around for the first hour in the mornings, I started to struggle to get up off my chair at work, typing hurt my hands and wrists. I felt irritable, angry, tearful most of the time, I had constant waves of nausea, jaw pain, tinnitus and blurred vision. I was absolutely beyond exhausted.
I looked through the trust internet for resources, but all I could find were well being rooms, courses to build resilience… both required time to take advantage of. I also felt angry that the implication was that I felt the way I did because I ‘wasn’t resilient’ in other words, it was all my fault. I was weak. My failure to cope. Instead of dealing with the ‘too much’ of everything (paperwork, targets, red tapes, rules, mandatory training, etc etc) the trusts approach is to pile on more work, and more responsibility, believing that they are in fact empowering people to self treat mental health issues, but really they are adding to the problem. Victim blaming in effect.
The day I went off sick I simply ground to a halt. Like a car run out of petrol. And similar to that analogy, when the engine dies everything goes very quiet, I too was silent as I realised I couldn’t go on anymore. I had nothing left. My physical and mental exhaustion were so extreme I could hardly raise my arms. I hurt all over. I couldn’t even cry.
I got up and went home. The first thing I did was contact my line manager and tell him I needed some time away. He was very supportive of this, and immediately seemed to understand the situation. I made an appointment with my GP. I was convinced at this stage that I had a physical problem, something autoimmune. I sat and researched for hours. I insisted on trying HRT (I’m 47, almost certainly peri menopause, despite none of the usual symptoms) and my GP referred me to rheumatology, although the wait times were months.
At first, I slept, a lot. I’d need frequent naps through the day, the pain and fatigue was overwhelming. I often had thoughts that I’d be better off not being here. My family would be much better off, they didn’t need me. The insurance would pay off the mortgage. Now, to be clear, I didn’t want to kill myself, I wasn’t suicidal, I just wanted to go to sleep and not wake up. Just be gone and to not have to feel this way anymore. These thoughts were very distressing to me. I love my husband and daughter more than anything. The guilt was huge. The burden I was putting on my family and my work colleagues made me feel wretched.
But over a few weeks, little by little, I was able to go for short walks. The fresh air and gentle exercise seemed to help. My sleep improved. I remember waking one morning realising I’d slept a solid 9 hours, and I felt refreshed- first time in well over 2 years. My diet has never been terrible, but I made improvements there too, less processed, more whole grains etc. I soon found energy for creativeness, doing crochet, drawing, painting.
As the fog started to lift I began to wonder if I had a mental illness such as depression or anxiety. Or if I had a neurological disorder such as Chronic fatigue syndrome or MS. But none of those conditions really seemed to fit. Although I had felt hopeless and tearful, I didn’t feel I was depressed. I had interest in my family and hobbies. I was motivated but lacked energy. It was only when a colleague said that I was likely burned out that I began to research that, and I came across a website that could have literally been written me. I ticked every single box. I finally knew what wrong with me. But more importantly, I finally knew there was a way out of this, that I could feel better again.
My knee jerk reaction to this has been to suggest we sell our house, reduce the mortgage to a point where I could work less or get a lower paid role. This is a financially sound option, but it’s occurred to me that making such a huge change that impacted on my family so much was probably one I shouldn’t do whilst feeling the way I do. I’m currently feeling that getting out of health care altogether is the direction I want to go, but I also know that not so long ago, I loved my job. Can I get back to that?
I’m at a point where I have been off for 8 weeks and need to plan my return to work. I set a date for tomorrow to start a phased return, but the closer the time came, the more I started to feel physically achy again, my sleep restless, and an innocent text from a work colleague set me off circular worrying again. I struggle to make decisions still, I ended up with 3 bags of oven chips as I couldn’t decide which to buy. I’m getting better, but I’m not ready yet. I am very fearful about ever feeling the way I did on ‘burn out day’ again. I am managing to control my worry day to day, but it’s an effort, it takes concentration, and I’m concerned if I relax for a minute and take my eye off the spinning plate on a stick it’ll all just crash again. I’m worried about being worried.
I met with my line manager and had a long chat- he was incredibly supportive and made some good suggestions regarding a return to work. He didn’t pressurise but encourage some small steps, such as brief visits to the unit. After the meeting though I felt very very drained and tired. I think although physically
What I can’t understand is why me? Why have I ended up this and not the medical director, the senior directorate leadership team, the surgeons, the people with far more stress than I have. People without family support, financial worries, illness, bereavement. Why only me? And why, in spite of doing all the right things, is it taking so long to go away?
If you’ve read this far- thank you! I’m sorry it’s such a long post 