We need more nurses that care.
The problem is that nursing is a very hard profession. We care, we want to care, we want the best for our patients.
What I’ve seen happen with nurses is 1 of 3 outcomes.
- Compassion Fatigue
We want you to reach gratitude in your career and avoid burnout or compassion fatigue as a nurse.
In this episode I offer one, very simple, strategy to help you find gratitude and joy in your career as a nurse.
NRSNG Podcast episode number 221. What’s up, guys? Today we are talking about burnout, compassion fatigue and gratitude. At the end of this podcast I’m going to give you a tip, it’s a massively simple tip that you can start doing today to prevent burnout and compassion fatigue, and to fill your life, especially your life as a nurse, with gratitude. Hang on for that, it’s a simple tip, you won’t believe how easy it is but I really, I plead with you one more before we get rolling, to please do this. Before we get started, I want to remind you guys to head over to NRSNG.com/academy, that’s NRSNG.com/academy where you can get started for just $1 in our massive nursing education website.
We have over 500 modules, we have tons of tools, flash cards, apps, cheat sheets, 4000 NCLEX questions, tons of courses on EKG cardiac lab values, nursing [forum 00:00:53], OB, peds, mental health. There’s just so much there. Head over to NRSNG.com/academy. It’s just $1 for a three day trial and I promise you you’re going to be satisfied with this, okay? With that said, let’s roll into our show about compassion fatigue, burnout, and gratitude. If I were forced to define nursing in one word, okay, to define the profession of being a nurse into just one single word, to be honest that word would be “hard.”
Being a nurse is difficult. It doesn’t get easier necessarily after school. It just becomes a new kind of hard. You’re still required to learn mountains of information, how to communicate with doctors, what medicines are common on your floor, how to care for different kinds of patients, how to really deal with that interaction between patient and nurse and physician, and how to really coordinate all that care. The learning still continues, and then added on top of that, as a nurse, we’re confronted with the most difficult situations in life. Okay, there’s very few professions where you’re actually confronted with life and death decisions.
The accountant makes a mistake and someone loses money. The baseball player makes a mistake and they lose the game, but as a nurse, if you make a mistake, it could be someone’s life on the line. Not making the right decision at the right time can lead to life or death consequences. We’re confronted with that, with that stress of trying to always be doing the right thing for our patients at any given time, and that adds an enormous amount of stress to our job, and then we add on top of that the sickness of patients, their stress with being sick, and how much their emotions play into that and how hard it can be to really take part in that as a nurse, to take part in these very difficult and complex situations, but at the same time we’re also confronted with the best in life.
As nurses, as nursing students, you get to see new life. I remember the very first time I actually saw a live birth. It was incredible, and I was one of the very first people to touch this brand new baby and it was just an incredible experience. You get to see patients heal from very complex disorders. You’ll see a patient come in with a stroke, not be able to move one side of their body, not be able to speak, they go in, they have a procedure, they come back and they’re moving and they’re speaking and the family’s so overjoyed, so you really have those experiences. Then, on any given shift, you might have a patient who is contemplating “pulling the plug” or terminating life support, and then in the next room you have a patient who is recovering, as we just talked about.
You have to balance your emotions going between these two rooms, going between the family and the patient who’s incredibly elated that they’re going to now have more life. Then, at the same time, you have to balance dealing with the family and the patient who is contemplating terminating life. That can be an incredibly intense amount of emotional stress, physical stress. The idea of working, people call nursing a 12 hour shift. It really turns out to be more like a 14-15 hour shift. When I worked 7 p.m. to 7 a.m. I would leave to go to work at 5 p.m. because it took about an hour to drive downtown, sometimes an hour and a half, so I’d always leave about 5-5:15, so I’d leave at 5, get my report right before 7, start my shift, shift would end technically at 7 p.m. I would do all my charting, finish things like that, report, be out the door by about 7:30, take me an hour to get home.
It really turns out to be … Then, you’re working overnight. You’re leaving your family at night, you’re trying to stay awake, you’re dealing with all this stress. Now, because of how difficult this profession is, and none of us can really … Even if you have a mom who’s a nurse, even if you’ve worked as a PCT or CNA, it’s really hard to comprehend truly how difficult nursing can be. I’ve seen people who have worked as CNAs for years and years and years go to nursing school, become a nurse, and then realize that it’s not what they thought it was. Then, you see patients or people who come in, have never had any experience with healthcare or nursing, they come in and thrive and vice versa. It’s hard to really know exactly how you’ll react when you’re confronted with the career of being a nurse.
Now, there’s usually about three paths that people take when they’re confronted with the difficulty of nursing, with how hard it really is and dealing with that. The three paths are usually burnout, compassion fatigue, or gratitude. We’re going to talk in this episode about how you can get to gratitude as a nurse, right? Because we need more nurses, we need dedicated, focused, intent, hardworking, compassionate nurses. We need that in the field, but given how difficult and how hard it is, a lot of nurses end up going the burnout route or the compassion fatigue route, and we really don’t want that. Let’s define these three terms really quickly. Let’s talk about what is burnout.
What burnout really is is burnout is where it gets hard and it continues to be hard and it’s hard for all of us. It’s almost like running. I always told my wife before we got married that running never really gets easier. The interesting thing about being a runner is that running a mile when you’re out of shape and when you haven’t been practicing is hard, but running 50 miles at a faster pace when you are in shape is just as hard, so it never really gets easier necessarily. You just keep on going. That’s kind of how it is with nursing. The problem is it doesn’t really get easier, it continues to be difficult, and as you have more experience in nursing, it can be more difficult because you’ll have new roles, new responsibilities.
What can happen with that is people reach the stage of burnout where they’re like, “You know what? This is not what I wanted, this is not what I expected,” and they quit. One of the people that I precepted as a preceptor in the ICU was actually a good friend of mine and he came no and we precepted and it was a very, very difficult floor. It was massively understaffed, it was night shift, it was a downtown Trauma 1 ICU, so it was very difficult floor, and what he realized soon after finishing is, “You know what? This is not what I wanted, this is not what I expected,” so he hit burnout very quick. Other people will hit burnout much farther down the road and quit at that point.
Okay, so that’s burnout. It’s when we realize, “Oh, my gosh, this is terrible. This is not what I wanted,” and we stop, we stop wanting to be a nurse. The other, and I would say probably unfortunately probably a worse alternative is something called “compassion fatigue.” Compassion fatigue is really what it sounds like. As nurses, we generally are people who have a bit more compassion. We have empathy, we want people to be better. We want the world to be a better place. It’s not like we’re Pollyanna with rose colored glasses or anything like that, but we want the world to be a good place. We want patients to feel better, we want people to know that we care about them, and we want that caring that we provide to equal something. We want people to get better, people to see we care, and that’s just who we are as nurses, right? We’re compassionate people.
The problem with nursing is as you see so much bad and so much difficulty, and so much struggle, and so much strife and death and so many just rough things, we stop having that compassion. We get so tired of caring, and that’s a real thing. We have a couple of posts already on the blog at NRSNG.com about compassion fatigue and I would really recommend going back and listening to some of those episodes in the podcast. It was one of the first episodes we did about compassion fatigue and it’s sad and I remember the first time I started feeling compassion fatigue. It wasn’t that long into my career, maybe about a year, and I was driving home from work and I was just like, “Oh, my gosh. I’m so tired.”
With compassion fatigue versus burnout is we keep on going to work and we hit this roadblock of compassion fatigue where we just don’t feel like we can care anymore. It’s like we’ve cared too much almost and we’ve exhausted our level of how much we can care. That’s really what compassion fatigue is and it’s a common phenomena with people like nurses, physicians, people who are in these positions of taking care of others. Social workers experience it a lot, psychologists, therapists, things like that where you’re caring about other humans is you can reach this level of compassion fatigue.
The third outcome is gratitude, all right? Now, I believe that you can work through these even as a sequence. You might hit some burnout and you’re going to say, “Before you quit,” you’re going to keep pushing through and then you might hit compassion fatigue and be like, “I can’t care anymore.” Then, you can get to this level of gratitude, but what we’re going to try to do here, guys, if you’re feeling burnout, if you’re feeling compassion fatigue, or if you haven’t even started yet, we’re going to try to get you to gratitude, okay? That’s going to be our goal. This isn’t a sermon, this isn’t me being preachy, this is sharing with you the experiences that I’ve had as a nurse, and some things that I’ve done and I’ve researched and I’ve found that have helped me be able to get to that position of gratitude as a nurse.
In order to stay working as a nurse, in order to keep pushing through these difficulties, I think you need to get to this position of gratitude and let’s talk about how you can do that. First of all, I want to tell you four short experiences that I had and have had as a nurse both before becoming a nurse and as a nurse, that have helped me reach this position of gratitude. Some of these at the time created some of this compassion fatigue and led to compassion fatigue, but looking back and reflecting on these experiences have filled me with an enormous amount of gratitude and so I want to share these experiences and then I want to also share with you a few ways that you can begin to find more gratitude as a nurse and in your career so that you can achieve that and versus going to compassion fatigue or burnout, you can achieve gratitude.
First experience I remember was before finishing college the first time, I got a job as a patient transporter for a radiology department. This was in a big hospital here in Dallas and my job was basically when someone had a procedure, I would go upstairs to the hospital, bring them back to the radiology department, they would have their procedure, and then take them back. I had a lot of opportunity to meet a lot of patients, talk to a lot of patients and just really learn how to speak with patients and things. I remember one patient specifically that I had. He was a patient who was suffering from end-stage pancreatic cancer. As a patient transporter, you can imagine I would go up to the room, these people didn’t know me, I wasn’t a licensed healthcare provider by any means, I was a transporter.
I would get them into a wheelchair, get them in a bed, bring them to their procedure and then bring them back, but I had a lot of opportunity to talk to people, and this one patient in particular, as he was suffering from pancreatic cancer, he was a younger guy in his 30s or 40s and I noticed on his nightstand in the hospital he had a couple of pictures of his children. Remember this was end-stage pancreatic cancer and so he knew that death was imminent and that death was coming and that it was going to happen sooner than later, and we began to talk. We began to engage and the stories that he told me about his children and his daughters that really impacted me massively. Now we’re looking 10 years later and I still remember this patient as he knows that he’s going to die, what he wanted to talk about was his children.
That really was difficult for me to understand, it was difficult for me to understand why. He was going through this suffering, and everything and that experience lasted with me. It’s lasted with me about a decade and it’s really helped me reflect on the challenges that our patients go through. At the time, I didn’t think a ton of it. I remember it impacted me and it stuck with me but I don’t remember everything about them. I remember talking with him and I remember his fear of death and that he wanted to speak of his kids. A couple of other experiences I want to tell you guys are there was an experience one time when I was working as a nurse in the ICU.
We got called to the emergency room for a patient who had just arrived and this patient had arrived DOA which means Dead On Arrival, and what had happened is this was the day before Thanksgiving. This was Wednesday, the day before Thanksgiving, the night before Thanksgiving, it was one or two in the morning, and this truck driver was driving his load day before Thanksgiving, making a last run, and his semi plowed into an overpass column. Semi plowed into an overpass column, exploded, diesel fumes everywhere, fire department arrived, patient was essentially dead, brought them to the hospital and he was Dead On Arrival, and we brought him to the morgue.
As I was sitting there with that patient I’m thinking, “Okay, this is the day before Thanksgiving, all families are gathering, families are thinking about their loved ones,” and this patient had been delivering this load right before Thanksgiving. Maybe possibly taking a load and then coming home so he could have Thanksgiving with his family, with his friends, but what happened was that he got in a truck accident, passed away, he was a John Doe, we didn’t know who he was, didn’t have family to contact, and so imagine this family’s now getting this phone call about their loved one who had passed away right on Thanksgiving.
That was a really difficult experience for me to handle at that time, too, as I’m thinking about my family and everything. Another experience I had was another young gentleman. As I’m working in the neuro ICU, we saw a lot of neuro trauma. This patient was in his late 30s, early 40s, had a couple of daughters as well and he was in the home working outside. Had a ladder up, just working, I think it was around holiday times again, maybe putting up Christmas lights, cleaning out the gutters, something like that. So, he’s up on a ladder, maybe 10 feet whatever, loses his footing, falls, hits the concrete, suffers massive head trauma, experiences a traumatic brain injury, is unable to speak, is unable to communicate, and this was just going about his normal daily living.
As I began to experience these types of stories and there’s many, many, many more that I’ve shared before but as I began to experience these stories, I started to get to this point of compassion fatigue, like I wanted to care about these patients so much and it became so hard. This compassion fatigue really started to wear on me. To counteract that, I realized I had to find out how to work passed that compassion fatigue and to start experiencing gratitude. I want to give you a couple of things that can help you with this and I want you to do this. I know I offer a lot of tips and suggestions but this is one that I really want you to do and this is more meta than a practical suggestion to deal with nursing. This is going to help you deal with the emotional side of nursing which we don’t talk about a lot. Not a lot of people talk about that.
We talk about how difficult it is, we talk about how hard it is, the schedule, the staffing, all that stuff, but this is going to help you deal with that emotional side of nursing and help you get beyond burnout and compassion fatigue and experience gratitude. It’s a very simple suggestion, okay? I want you to start a gratitude journal. All right. What is a gratitude journal? Basically, if you go to Walmart or to Target, wherever, and just get a journal, like a composite diary. You know those $1 little books that you use for chemistry class or whatever? Just get one of those, $1, little book or even just a loose leaf thing.
Anything just really cheap, something with paper, right? What I want you to do is I want you to daily, every single day you open it up, first thing in the morning, this is when I would really suggest it, first thing in the morning, you open it up and you write one, two, three, 10, however many are on your mind, things that you’re grateful for. You’re not writing pros, you’re not writing paragraphs, you’re not writing sentences. All you’re doing is writing one word, two words about what you’re thankful for. I began to do this and what I realized is it started to get really hard by like day two or three to not just continue to repeat the same things.
I would repeat “Thankful for family, thankful for our home, grateful for home,” all these types of things. Those are the easy things, but what I found is I had to start to get very detailed about what I’m really thankful for. One day I wrote, “Thankful for the crisp air that I get to walk in.” Thankful for all these different little teeny, tiny things and you’re not writing anything long. You’re just writing one word, two word. Not even grateful, you just write the date, so today’s December 14th, so I’d put “12/14, cool weather. Fog outside. Music.” Those are the things that I’m thankful for today. I’m grateful for the school that my kid gets to go to.
You begin to just write these very, very simple things, maybe completely outside of nursing, things that you’re truly grateful for and as you start to get to these things that you really don’t have control over like the weather or like the clothes that you have or the friend that you have or the trees changing colors. I’m looking outside my window right now and in Texas we have a really late fall, but the trees are just turning red and yellows outside. I’m grateful for that, like that’s beautiful to me. You begin to write these very, very simple, these very meta things that start to help you really hone in on the things that you’re grateful for.
You guys, I get it. I know this sounds massively oversimplified but I’m hoping that one or two of you will start to do this, and if you do start to do this and it starts to help you, give it a week. Let me know, reach out to us on social media or on email and let us know if this is helping because I promise you it will. If you do it first thing in the morning, it starts your day. Rather than first thing in the morning checking Facebook or checking Instagram or checking your email or the news, do this the first thing. Wake up, and I would just keep it in my closet, my little journal. I keep my journal with my pen right in my closet with a glass of water, or a bottle of water. Drink some water and write a couple of things I’m grateful for.
If you do that everyday, I promise you as simple as it sounds, it’s going to help you get beyond those feelings of fatigue and burnout. Now, I want to give you a couple of other things that you can do. A lot of research and money and effort and picketing and boycotting and all these things have gone on around nursing, talking about how we have to improve nursing conditions and patient conditions to make nursing a better profession and I am 100% onboard with all of those things. What I do want to offer, though, is a warning that if you begin to focus on those things so much, it can start to create some of this anger and everything within the profession.
What I want you to do is I want you to think about those things that you can control first of all, and will getting involved help? What things can you control? First of all, you can control your attitude, your outlook, and that’s how the gratitude journal helps. With patient staffing, what can you control with that? Okay, well you still need to go to work and what can you control with that and will getting involved help with that? Are there boards that you can get on at your hospital? Is there someone you can talk to? Is there an interview you can do? Is there people you can get involved with to help improve that? Which will then hopefully help with your burnout and your fatigue.
Are there things that you can personally do and will doing those things help? The reason I want to caution you on that is what we can sometimes do is we see all these bad things around us, we hate the patient staffing, we hate our manager and we just complain. Doing that complaining is absolutely going to lead to burnout. Rather than doing that, how can you get involved and will getting involved help? If there’s nothing you can do to get involved and getting involved won’t help, stop worrying about it and move on, and deal with it, or find a way to change the situation. If you can get involved and getting involved is going to help, do that and stop complaining.
The complaining is not going to help. It’s just simply going to lead to burnout. Then, we need to really get to this position of gratitude as a nurse, and the one simple tiny, tiny suggestion that I’m going to leave you with, and I’m going to plead with you to do, I’m truly going to plead with you to do this, is get a $1 journal, even if you don’t have that, just put a piece of paper in your closet tonight and a pen. When you wake up in the morning, walk in there, write the date and write two things that you’re grateful for. Don’t write a sentence, don’t write a ton, don’t write a paragraph, don’t write why you’re grateful for it, just simply write those couple things.
Do this throughout the Christmas break, do this throughout the holiday season and it’ll be a good time to really reflect on those things, and then as the new semester starts, as the new job starts, as the New Year starts, continue to do this. I promise you it’s going to help give you a sense of deeper gratitude and a sense that you can continue on. Nursing is hard, there are ways to deal with it, and obviously you guys, at NRSNG we are here to help you. Our entire goal is to give you the tools and the confidence that you need to succeed. This podcast is intended to give you confidence, it’s also intended to give you one tool, the gratitude journal that I want you to start, to help you continue on, to help you achieve your goals in nursing and we want to be there with you, all right?
With that said, guys, know that we love you. We’re so grateful for you being a part of this community. Throughout the year of 2016, our website’s been read about three and a half million times, the podcast has been downloaded two and a half million times and … Excuse me. We love each of you, we’re so grateful for you. If you ever need anything, please reach out to us and share us with your friends, okay? We want to keep this family growing and we really appreciate you. All right, with that said, happy nursing.
Date Published - Dec 19, 2016
Date Modified - Dec 21, 2016