Burnt Out

Trigger warning: Covid / Pandemic

I sit in the dark with my laptop, surrounded by the glow of lavender candles. My apartment is complete chaos. There are empty boxes piling up by the front door that need to be broken down and recycled, my table contains remnants of a lost chess match, and in my bedroom are small mountains of clothes camouflaging the carpeting — and here I sit, in the dark basking in candlelight because I’m too physically and emotionally exhausted to tackle the dysfunction surrounding me. 

If you work in healthcare, or more specifically are a bedside nurse, I am sure what I have described isn’t much different to the experiences and feelings you are going through right now. For those of you who are fortunate enough to have chosen a different path other than nursing, I fear I may not be able to describe to you the sensation of burnout — but I will try. 

When I was child, I never dreamed of being a nurse. I wanted to help animals and travel the World. I wanted to write novels and short stories and share them with anyone who would read them. As I got older, I became more interested in biology and science. By my senior year of high school, I didn't have a set direction or career option, I just knew I loved learning and I wanted to continue grasping knowledge anywhere I could.

When I applied to my undergraduate program, I applied undecided. I wanted to have a degree with a science focus, and at that time I grew interested in the idea of becoming a Physician’s Assistant. I had recently read a novel about a young woman who happened to be a Physician’s Assistant, and I resonated with her compassion for others, dedication for her work, and love of learning. I also liked the idea of being able to administer medical care without the demanding and tedious commitment that comes with becoming a doctor. During my undergraduate orientation process, I crossed paths with the Director of Health and Human Sciences. I expressed my ambitions and she advised I think about a career in nursing and pursue my masters to become a Nurse Practitioner. I honestly never thought of this as an option, I was immediately intrigued and investigated the field of nursing even further. Within my family and social circle, I never grew up knowing a lot of nurses. This was a field I was completely and utterly disconnected with, and it certainly showed when I embarked on my first semester. I would listen to other students describe their connections to the current profession: my dad worked night shift in the emergency department when I was growing up or my grandma is a retired nurse, she helped provide medical services during WWII and my mom and two older sisters are nurses, one just recently graduated and is taking her boards soon. Meanwhile, I was fascinated to learn that warm water is the best temperature for hand hygiene rather than scolding hot. From then on, I absorbed anything and everything that had to do with being a confident and capable nurse. I absolutely loved it.

I followed this path until I graduated, passed my boards, and became a licensed registered nurse. I didn’t hesitate in finding a job and accepted a position as a new graduate on a telemetry unit. I couldn’t get enough; three grueling fast paced high energy shifts a week—and I was still signing up for overtime. Vacation didn’t matter, and time off was just to prepare for my next shift.

Clock in. Patient assessments. Medication pass. Bathroom assistance. Admissions. Discharges. Charting. Clock out. Over and over and over again.

When the time came to advance my skillset, I found myself interviewing to work in the Intensive Care Unit. I was accepted for the position, and again found myself in awe. This was nothing I could have ever imagined. I thought my previous job was hard and tasking—I was entirely wrong; and utterly excited. I groomed myself to be the best critical care nurse I could possibly be. I soaked up knowledge from my peers and physicians. I found myself studying in my free time: specific interventions for laboratory values, evidence-based practice for early mobility, benefits of early extubation and prevention of ventilator associated pneumonia. You name it, I studied it.

I also developed into the nurse a patient and family really needed. For the patient that was dying, I was gentle and sweet. Calm and collected, reassuring. I supported them during this horrific time, as well as their families—because they were the ones getting left behind. I had to face tragic deaths but be the person a family could rely on while they navigated grief and loss. I quickly learned that not everyone can be saved, no matter how hard you study outside of work, there are things outside of our control. Modern medicine can be miraculous, but it still falls short.

I was a nurse dedicated to my field and more importantly—my patients. So, it was no surprise that when the coronavirus showed face in our city, I strapped up my boots and was ready to fight. Leaving was not an option and so just like the rest of my selfless colleagues, we sacrificed and dove right in. Our patient influx quickly became predictable. Covid positive, covid positive, covid positive …. Ventilated, ventilated, ventilated… I thought I knew what I signed up for, and I was entirely wrong.

I separated myself from my middle-aged parents, worried that I would bring home the devastating virus that was selfishly taking away the lives of numerous patients. I didn’t want to put my parents at risk of not only contracting the disease, but worse, having to die alone in a hospital. I couldn’t fathom having to watch over a zoom call as my mother’s heart would steadily decline, fighting to do what it could to stay alive, knowing ultimately it wasn’t enough. Me on the other end of a screen. I would want to be the one holding her hand, not the nurse covered head to toe in protective wear. I would want to be there with her, for her. But I wouldn’t be able to, and for that reason I put more physical space between myself and my family at a time in my life when I needed them the most.

He was young, he had a family to take care of. He struggled to breath as I held his hand. The worried look in his eyes and I confidently reassured him everything was going to be okay, knowing whole heartedly I was lying. I stayed with him there you go, take slow deep breaths. Okay good, see your oxygen level is coming up. I helped him turn over slowly to lie on his stomach, an attempt to better oxygenate his lungs. No, I won’t leave yet, not until you’re feeling better. I sat next to his bed until he fell asleep. I left his room only to go next door and do the whole routine over again, with another patient.

Over time, my hands became so dry from constant hand washing, the skin was basically deteriorating. I developed sores on the bridge of my nose and marks on the side of my face from wearing restricting respirator masks. I showered obsessively in the locker-room before heading home, and then again when I got home. I was gaining weight, even though I didn't have much of an appetite to eat. I limited hydrating during shifts so I would spend less time in the bathroom and more time with my patients. But whatever I was going through—I knew my patients and their families were far worse off. I counted my blessings, and I kept going.

Isolated in my own way, social media was no longer a respite. Family members, old acquaintances, and longtime friends posting their personal opinions on the virus and pandemic: only 1% die! … this is just the flu … I can’t breathe wearing a mask… I slowly pulled away from friends, because our group chats voiced resentment of not being able to go to bars, get their hair trimmed, or travel. I felt disconnected to them, as my fears and frustrations grew into something more than they would ever understand. To them, they were invincible, for me—no one was.

I held onto the days when I loved being a nurse, when I was excited to begin my journey into this field, to help and care for people. I held onto the spirit that thrived inside of me to go above and beyond for my patients, that spirit was still embedded in me, but it was starting to writher. Nursing had become engrained into me; it became everything I was and everything I am. I couldn’t detach, I couldn’t turn away. It was a calling, a destiny. And now more than ever the World needed nurses. I was there and I was ready, and although it wasn’t killing me the way this virus was doing to my patients—I was slowly declining.

We made it to what we thought was the end, only to face spikes months later. Again, we were there. The World slowly started opening again, and I had to learn to readapt. To be okay with visiting others and being in groups. I had to relearn that we would be safe, or at least safer than before. I hugged my mother for the first time, after an entire year without her physical contact. The worst was over, and it was time to begin again. Only new struggles were only on the horizon.

I continued with my nursing career, but it was different than before. I would still see the faces of those that we lost to Covid, I would still grieve for them and their families. Many of our nurses left and we lost support. With our patient acuity increasing so were our responsibilities. For the first time in my career, I felt tired and exhausted. I struggled with the idea of leaving too, turning, and leaving this all behind. The physical wear on my own body was beginning to show. Stress and adrenaline that was constantly pushed down during the height of the pandemic was making its way through me now. I wanted to run from it all, find sanctuary outside of patient care. Never having to see a patient struggle ever again. I wanted an easier path, one that was not so physically and emotionally demanding. A career where I wouldn’t have to tell a patient that we were doing everything for them, knowing they needed more than what modern medicine could provide.

This career was everything I had ever wanted. Early on, I thrived and accomplished. I cared for people and saved lives. I made the ill become healthy. I made those feeling depressed laugh. I cared for people as if they too, were my own family members. I felt their pain, I felt their fears and I felt their joy when they were improving. I celebrated their holidays and prayed with them no matter their religion. I tried my hardest to make their hospital stay feel like home. I learned their family members and would great them as old friends when they came to visit. I loved this job. I loved being a nurse. Although it feels like the easier choice to turn and leave this all behind, every atom in my being would be drawing me back.

She cries because she had an accident in her bed, it’s the first time. She’s sorrier for me having to help clean her up, but what she doesn’t know is this is routine. I reassure her and make her laugh a little bit. Trying to make her feel less embarrassed. Her body is fighting, and healing. She doesn’t need the added stress of worrying about me and my feelings. When we’re finished, she takes my hand, she thanks me and says I don’t know how you do this job. But I do, I do it for her and all the others who are struggling to get back to their lives and to their families. I do it because I care about them, so in the meantime I will continue to care for them.