NHS after 30 years I feel I’m burning out

[ReformMyArse]

It’s been building for a while but I just feel so paralysed.
Ive had a few health scares (2 week waits etc, illnesses found but not cancer) which I’m sure haven’t helped. Also had a traumatic bereavement.
I find work so all consuming, am middle management and clinical, don’t feel as though I’m doing a good job at either.
I just took a holiday and only enjoyed the first two days, the remainder of the time had the back to work dread,
Sunday is so bad I often log in to clear the emails or so some clinical prep.
I feel so irritable, like one day I’m going to combust with rage.
I’ve started to let the mask slip and feel out of control. I say some outrageous things.
On the surface I am kind and caring but my empathy is at its limit. I don’t go the extra mile anymore.
At home I’ve become obsessive about cleanliness and order.
I can't bear the stress of socialising in my home, all that has stopped.
I’m grumpy with DH and DC.
Sometimes I throw up before work.
My sleep is dreadful on days I’m working, waking every hour, probably get 4 hours a night.

I’ve looked at what I find hard, the main things are:
Managing some difficult individuals under very poor and complicated HR policies.
The constant emails, passing responsibilities, mopping up the undone work of others. Some days it’s all consuming.
The hierarchy and those who just pass work down all day. Apparently their own boundaries are absolute but everyone else doesn’t have the same rights.
All the processes, many overlap, it’s all so bloody inefficient. No one will budge on this, apparently it’s fine to keep adding to them. For example, to book a treatment you need to do several lengthy steps when one would suffice.
The terrible IT system that cost a fortune but added so much work onto clinical staff.
Not having sufficient time to focus on clinical work. I feel I’m always making low level (so far) mistakes. Sometimes these haunt me.

I feel trapped as everyone who left has found the same problems elsewhere. I have a mortgage and am many years into the pension. Would appreciate guidance or hearing from those who experienced similar.

Oh poor you. At least you've recognised it. It does sound like you need to go and see your doctor in the first instance and get signed off until you get back on your feet - from what you say that could be a few months. Use the time to get some counselling (can you get that through your employer assistance programme) and talk to your doctor about trying antidepressants. When you do go back, talk to them about a phased return. Take care

Thanks for replying. I think what I’m struggling with is I take time off, come back and nothing has changed.
The scenarios as I see them are twofold: 1. I am never off sick, a resilient person, so people take it seriously and some changes happen. 2. Nothing changes and I one back to the same crap, which might be even harder to adapt to after time off. I’m also wary of being tarred with the ‘nervous breakdown’ brush.

Could you retire and return to a lower banding role? One without management responsibility?

Are you a band 7? That grade seem to be the most squeezed and dumped upon in the nhs and many feel the way you do and are looking for ways out!

Your health is really important. Go off sick and give your self time to recovery. You have many options here but at the moment you're so overwhelmed you can't see the wood for the trees. The worst that can happen is nothings changed when you return but you'll have been able to make decisions around what you will do in that situation.

It may be a return to a more clinically focused lower grade helps you maintain your job, your health and your family. But you'll only see the future a bit clearer when you step back from the cliff edge you're on at the moment.

I feel you OP. I've been in the NHS 16 years, and honestly, I've been looking for jobs in a supermarket! It's not worth the responsibility and extra training/stress required for the pay. Not for the length of service I've done and skills I have. I'm giving it a bit more time to change under a new government but in all honesty don't think I can do it much longer. Like you my health over the past couple of years has deteriorated, along with family life it's not worth the stress. Look after yourself and look at other options as I am. You don't have to jump at the chance. I know it's a taboo subject, but if you get, as I do, six months full pay on sick, take some time off, recuperate and think about your options. Your no better thought of for going to work, stressed with work and home life, or going off. In fact, in the past I've been criticised and nearly disciplined for going to work when a close family member was critically ill, for fear of repercussions and told in the future I was to call in sick and not bring my problems to work. You would be better to take the time to look after yourself

Explore other jobs outside the NHS either nursing on lower pay such in a hospice, care home or school. Or look to retrain playing to your people skills eg CAB advisor (there are paid roles), counsellor for Relate or become a trainer for corporates in self-care, emergency first aid, awareness of mental health etc. There are viable options.

I'd say throwing up before work is definitely not normal and a pretty clear sign that things are very much not ok. A breather might give you time to regroup and recharge, even if little changes in the time you are away.

Thanks. I’d look to a lower band once retired and returned but I think if I took one now I’d have even less control over my working days. Unfortunately, lots of alternatives don’t pay enough. I’m also in the critical years before claiming the pension so am loathe to sabotage it. Appreciate though that ultimately leaving will be the right thing to do.

See your gp and get signed off. You do sound on the edge of a breakdown. Honestly, even if you were to keel over and die, the nhs would not care. They would just get someone else to run into the ground.
Use the time off to explore other jobs and when you feel better and get back to work, start applying. If you are a nurse there are loads of opportunities out there and you have plenty of transferrable skills.

Same here. I can only cope because I have 4 years to retirement. I had to go on antidepressants due to the stress and I've had 6 months off because my back went and my legs didn't work for 8 weeks. I'm dreading going back. I dont know how I'll cope physically but I too have a mortgage which is paid off in 4 years.
The antidepressants have helped a lot. Might be worth a try. I'm on escitalopram.

I meant loads of opportunities in the nhs. It is easy to transfer your pension.

The NHS is gruelling at the moment. I've done 45 years. I agree with previous poster. Get signed off at take at least 3 months off if not more. I get 6 months off with full pay.

I left a very stressful job in hospital in my 50s and moved into general practice. It was a revelation. Still challenging but no nursing hierarchy to deal with.

Poor you, I totally empathise, dh is NHS and three years away from retire and return when he will go part time. He is basically dragging himself to work every day. It's no life.
In your situation I would definitely recommend a few months off sick followed by a phased return. And ask GP about counselling and maybe anti depressants - I wish I could get dh to agree to those!

Sorry to hear so many others are affected. But not surprised.
i don’t want an antidepressant, I feel like my brain is having a normal reaction to an intolerable situation.

It is horrifying that people need to take medication to be able to cope with their job. Shocking. It doesn't need to be like this and the faster we move to a European health care system the better.

I'm sorry to hear this OP- I am also NHS and I am frankly amazed that you have got through 30 years.

I agree with other posters about taking time off- my concern here is that you've mentioned 'low level' clinical mistakes- you need to step back in case you harm a patient. You might also risk your registration if you carry on like this. You are absolutely in burnout.

As well as speaking to the GP, I'd also look at some counselling- you can access this through work, or your professional union if a member. My work offer psychology sessions for leaders, if your trust offer this that might be a good place to start.

I think stepping back and giving your brain time to rest will allow you to take the break that you badly need and let you consider what the best option for you going forward might be. As already mentioned, there are lots of roles within the NHS and you don't have to stay in this job.

You mention concerns around your pension (which are perfectly understandable)- have you got a copy of your most recent forecast? Then you can work out/get some advice to check your position and see what might be feasible.

Please do listen to the advice here and take some time out- after many years of trying to help others, now is the time to help yourself.

I don’t think it’s specific to the NHS, I think there is too much bureaucracy everywhere and so many people have too little control over their jobs. I feel I do very little of the actual work I trained for. I spend my whole day firefighting, correcting mistakes, dealing with problematic individuals, reading endless emails, despairing about mandatory training.

Low level mistakes are more omissions really. Due to a lack of thinking time and constant interruptions. Sometimes I think would I have made that decision with hindsight.

This was me 11 months ago.

You need to pause, take a breather, look after your health, and work out what to do.

First things first. Go the GP and get signed off sick. Possibly for a good few weeks maybe even months. Your body is crisis managing right now, hence the anxiety, sickness, doom and gloom, sweats and racing heart.

Get some talking therapy, it really helps.

Be honest with your employer about the impact stress is having on you.

Think long and hard if you can physically return to work there or if you need to move depts or trusts, take less responsibility or give up NHS altogether.

This does get better. Believe me. The first step is the hardest.

Thank you. What did you end up doing?

I work in the nhs and a colleague has taken partial retirement which means dropping a day and starting to take some pension and she is better off. Could this be an option.

Went back to work, had a very reduced workload for a while, back to full speed now but I'm looking for work elsewhere.

In a few years. I could do it now but the reductions would be too severe.

was hoping Labour might reverse all the downgrades to our pensions but that is probably too much to hope for.

Could you keep your job and reduce your hours? It would mean your pension doesn’t build so fast but would still be awarded at your current grade?
Managing staff with lack of support is tough - is there another job at your grade where staffing would be less of a problem?
If I was you I’d go off sick now and consider your options fully.