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Recognizing and Treating Nurse Burnout

Nurses - Let's get honest here. Really honest.

Have you been burning the candle at both ends - or so brightly at one end - that you dread leaving your apartment/house/condo?

Do you have to give yourself a pep talk about how you're going to tackle Monday morning? Or, Tuesday afternoon? Or Wednesday evening? Or the holiday weekend?

Have you ever felt, or do you currently feel, burnt out?

If you feel this way, have ever felt this way or know someone who has felt this way, this blog is for you.

If you've never felt this way examine what are you currently doing to prevent this from happening to you.

If you read my last post you know that I never want to retire!

But, it wasn't always that way.

Like the droves of nurses that have left nursing to pursue careers in real estate - I used to day dream about leaving nursing altogether too.

Becoming a Nurse Practitioner taught me about the importance of a topic that is seldom discussed amongst nursing colleagues between giving meds and performing compressions - emotional burn out.

As a nurse I have said Yes - a lot.

Extra shift? Yes.

Unit council? Yes.

Special project? Yes.

Speaking opportunity? Yes.

Teaching opportunity? Yes.

Put in the IV line on the hard patient on another unit? Yes.

Skip my break to help a colleague? Yes.

Hold my bladder to get a glass of water for a patient? Yes.

Empty the garbage bin after the code blue? Yes.

Trail blaze ? Yes.

Give up my social life? Yes.

Forgo quality time with loved ones? Yes.

Go in early and stay late unpaid? Yes.

Give up my mental health for the mental health of others? Yes.

Yes - is the default response for many nurses (and women) in many situations.

Nurses are an oppressed group in both class and sex.

So, it is no wonder that in 2016 when male dominant professions of first responders including police, fire, and paramedics fought for recognition of Post-Traumatic Stress Disorder (PSTD) as a work-related injury under the Workers Compensation Act were successful while Nursing was left out.

PTSD is is a mental health condition that's triggered by a terrifying event — either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event

In nursing we are directly involved in the spectrum of health and wellbeing to illness to chronic disease to end-of-life events for individuals and families.

Nursing, as a female dominant profession, indoctrinates Nurses in a philosophy that puts others ahead of themselves. So much so, that their work is taken for granted.

Mental health - and pay rates - are both at a disadvantage compared to male dominated professions.

Most accept this as the norm, but divorce, addiction, anxiety, depression and suicide may be a consequence of unattended mental health needs of Nurses.

I am no stranger to burnout.

In my first year as a Nurse I didn't take any vacation as each new career opportunity was met with a pre-programmed "Yes".

Towards the end of my Intensive Care Unit hospital nursing career before taking time off to pursue a Master's degree, I felt compelled daily to consider calling in sick to avoid facing another day filled with uncertainty and anxiety for the lives of my patients.

Recurring thoughts included:

How much more suffering would I have to witness?

How many more unnatural and painful deaths would I see?

How many more families would I reassure?

How long until I will enjoy my life again?

No one had taught me in my undergraduate education about how empathy can lead to emotional burnout.

None of my nursing colleagues ever overtly discussed their mental health.

But - looking back - there were plenty of signs I wasn't the only one experiencing cognitive dissonance (aka mental stress) about my shift work.

Drinks at 8am after night shift anyone?

In fact, I didn't learn about mental health in any detail until I took my Nurse Practitioner certification.

As a Nurse Practitioner student I studied depression and anxiety in detail and learned the evidence based practices that could lift someone from such a state.

As a Nurse Practitioner the most common concerns of my patients stem from mood disorders including depression and anxiety.

I am a big believer that mental health care is under recognized, under treated, and under supported.

Further, I believe ongoing mental health care and counselling should be fully funded under provincial health programs with a greater number of psychologists, psychotherapist and social workers employed in primary health care teams.

As Nurses we spend so much time caring for others that we are the last to be cared for.

If you relate to this post, spend a moment to reflect on whether you are approaching or have developed any mental health issues related to your work as a Nurse.

If you are experiencing work related emotional burnout here are 3 recommendations for you:

1. Seek Professional Help

If you think you might have anxiety, depression or PTSD seek professional help. Psychotherapy including Cognitive Behavioural Therapy (CBT) and Eye movement desensitization and reprocessing (EMDR) are evidence based therapies for PTSD. Find your local mental health specialist through your local hospital, workplace employee wellness plan, the Canadian Mental Health Association or through a company like Greenspace.

2. Medications

Medications can help therapy be more effective.

Several medications are approved for the treatment of anxiety, depression and PTSD. These may include SSRIs, SNRIs, MAOIs, Antipsychotics, Beta-blockers and Benzodiazipines. The right medication should be determined between you and medical professional.

Medical Cannabis may also be an option. As with all medication, approval is on a case by case basis by a medical professional.

Do not attempt to self-treat with medications originally prescribed for someone else or for another purpose. Do not attempt to self-treat with alcohol or recreational drugs. If you are doing either of these, discuss what you are currently using with a medical professional.

3. Support Groups

You are not alone. It may be difficult for friends and family to be able to relate to your Nursing stories. The good news is there are support groups of Nurses with like experiences. Learning from others who have gone through similar experiences and emerged on the up side can be empowering.

If you need immediate help contact your local crisis-line.

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