Nursing burnout

[Battlecat98]

I was hoping somebody might be able to suggest some services or coping techniques. I am currently on my 3rd week of sickness due to burnout and anxiety attacks. I am a band 6 ward nurse. I have struggled to access any help at all.
I have finally got my first GP telephone appointment tomorrow having waited over 2 weeks. I am waiting on occupational health and am on a waiting list for counselling.

I have depression and anxiety normally, but well controlled with self care and medication but, this feels different. I can't sleep, I feel no emotion but, some days I cant settle and other days can't get motivated. My last few weeks at work were so awful the stress made me feel so unwell with palpitations/migraines and nausea. I can't go back into that, the expectation is so high. It's making me so ill.

I do need to work, and obviously have to return but, I just don't see how I can. My manager has just contacted me to ask about a shift change and I feel sick and couldn't eat my dinner. I am not even back at work.

Has anyone any experience of overcoming this situation. I don't drink alcohol, reduced my caffeine, try to get out of the house, I try to stay positive. The thought of returning to work makes me want to run away. I have been an NHS nurse for 17 years, I did love my job. I don't recognise myself anymore. It's like I am a different person.

I don't have any good advice. I burnt out of my job after 18 months but when I read about burnout the advice all said to leave the situation first and foremost then to work on recovering and rebuilding stress tolerance etc.

Is there another role within nursing that might make you feel better if you don't want a complete career change? Maybe practice nursing or community nursing/health visiting? Care home work? Or maybe bank work so you're in control of your hours?

Sounds like it’s time for a career change…

Hi, I just wanted to send you lots and lots of love, and let you know that you're not alone. I am also a frontline NHS worker and had to stop work this year due to a massive panic attack followed by a spell of anxiety and depression (which I'm still in the middle of). I've had other challenging life events this year but I think being in an incredibly stressful job with inadequate staffing/resources really pushed me over the edge. I'm nowhere near the person I used to be, and my job was such a huge part of my identity that it really feels like a double whammy of loss/failure. I had zero support from work. I have been able to access a course of free therapy via the Healthcare Workers Foundation and can highly recommend that to you too. I have a prescription for sertraline which I'm terrified to start. I don't really know where I'm going with this, except to say that you're not alone. I think in our heart of hearts, we all know that we're not to blame for feeling this way - the system has broken us, especially during the pandemic - and so many of us have left the frontline with feelings of guilt and sadness. Personally I want to return to my job but I also know it's really ruining me, physically and emotionally. I really hope you find a way through and I'm sending you big hugs.

Go and train to be an NHS podiatrist - your life will be 100 times better.
I left nursing after 20 years and a mental breakdown - now a podiatrist, it's very acute - no nail cutting, all wound care but I love it.
9-5 weekends off and progression up the bands much much faster.
I don't recognise myself.

I had to leave my nursing career due to a psychotic breakdown in 2012 and a diagnosis of Schizoaffective disorder.
I'm now a part time healthcare assistant on a surgical ward and while it can still be stressful I'm much happier.

Not saying for one minute you will end up like me!
But start looking now for a less stressful job that won't burn you out.
Sit down and make a list of what you want from a job and what you want to achieve in the future.
Remember you are totally replaceable in your job so your life & health are the most important thing.

Join a Union if you're not a member in case you need help too.
The RCN solicitor really helped me when I lost my PIN to get the NMC to let me go on grounds of poor health rather than being suspended (as I'd made no mistakes and done nothing wrong).
I've been told by the NMC that if my health improves I can do the Return to Nursing course but it's not improved and I have no wish to do this.

However in your case if you take care of your mental health and get a less stressful nursing related job you won't lose your PIN.

I recommend keeping in touch with your gp and staying signed off for as long as you feel like you do. Tell your gp exactly how you feel as there may be further help they can offer.
Do not try to go back to work too early before you recover properly as if you then go off sick again it would be counted against you as a separate episode on your Bradford Score.

Tell your manager please do not contact me about shifts as I'm signed off sick. They should not be doing so & you should inform occupational health & the union about their behaviour.

I think you are doing all the correct self help things but ultimately a change of job is the only way to feel better.
But first you will need to get through the interview stage so if your anxiety and depression are really a problem you may need to speak to your gp about anti anxiety medication and anti depressants.

Good luck

Thanks to everyone for their kind replies. Sadly, I think I do need to look for a different job which is upsetting, because, like another on this thread it is a massive part of my identity, I do not recognise myself.

I have started on Mirtazapine so am at least now sleeping and the relentless conversation in my head has stopped.

I just didn't see how unwell it was making me. I tried to put boundaries in place but they didn't last. I was, always in early and out late to stay on top of the work. The final straw, was when my DH picked me up from work and I was unable to even speak to him I felt so unwell.

Nursing is what I have always done and all I thought I would do. It's very depressing.

How about community nursing ?
not necessarily district nursing, but something like diabetes, or continence, or macmillan nursing.

it’s tough in hospital these days, thank you for what you have done so far

It’s no better. Those jobs all come with huge caseloads, are often solitary and boundaries are even harder as there is no one to hand over work to. Plus you have constant targets and reports to write.

op, I hear you. I feel similar, 30 years slog and I’m feeling done. It’s so relentless, responsibility enormous and it’s unappreciated work. I’ve been throwing up a lot, gnawing cramps. Went away on a break for a few days on a couple of occasions and it completely stopped. So it must be anxiety triggering IBS. I start to feel dread about Monday’s on a Saturday night now.

it’s really hard to just leave when it’s been your identity for so long, or have the courage to make a change when you feel low in mood and confidence.

Could you step back to a band five? I did 9 months as a band 6 and found it very stressful. I'm much happier as a band 5.

Or reduce your hours and do agency.

The RCN might offer you some help. They were very good to me when I went on longterm sick. Would you consider stepping down and looking for a support worker job. The pay can be better than rmn and you dont have the responsibility of a rmn. The guardian have jobs on a Wednesday. Take as much time off as you need. You will be on full pay.

What helps is the usual stuff,
exercise every day, find something you like . Yoga and Pilates both really help to get back into you own body
mindfulness-try Heaspace app.
eat proper meals with good nourishing food
laugh with friends and family
get outside every day
sleep well
vitamin D
and enough time. You many need another month or even two more off before even thinking about going back

I really feel for you, OP. Other replies here are well meaning but I don’t think they fully address the distress and grief that come with leaving behind such a big part of yourself. The NHS is so tough at the moment - our boundaries will continue to be trampled on to meet the needs of the service so we have to exercise self-preservation, however painful that may be. I wish you all the very best xx

@Hopeful51 believe me I grieved having to leave my career as a Staff Nurse, took me years to get over it and I'm afraid I sometimes see student nurses now and think what makes him / her any better than me?? Then the meds kick in again and make everything feel ok.

So glad the meds have helped you! I’m building up the courage to dive into some sertraline…

Have you thought of trying a job in a Hospice? I work in a hospice (non clinical role, so not completely up on the nursing role) and lots of our nurses are older, approaching retirement and looking for a slower pace. It's obviously challenging emotionally at times, but the overwhelming atmosphere is of fun and making people as comfortable as possible. The hospice sector is really struggling for qualified and experienced nurses and whilst we don't follow the NHS bands, we do roughly track NHS pay levels. Everyday is different, we've even had penguins and reindeer in to play with this year!

EAP is a service line for nhs staff, can arrange counselling.
0800 028 0199 ran 24 hours a day. Via health assured (think there's an app as well)

Missed if you have done a self referral to Occy Health yet.

Good luck

I burned out 5 yrs ago after 35 yrs, it was impossible to do the job properly, trying to do more with less resources every day. My friends who stayed on say it’s got worse since, now it’s close to collapse only surviving on the good will of staff.

@Hopeful51 do try the Sertraline- a friend takes 100mg and it really helps her depression. I found it didn't work for me as I needed an SNRI so I'm on Venlafaxine.
Also I take an anti psychotic. Also promethazine prn at work if I get stressy.