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  • "I know this is burnout. I didn’t want it to be. But it is."

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    Summary

    I have been honest in my blogs during the pandemic. I have been apprehensive, scared and, at times, excited to work in the pandemic. So why do I feel so low at this moment? I am experiencing feelings that I have not had before. I have thoughts of leaving nursing. Surely, I can’t be the only one?

    Why now? Why am I feeling like this? This blog is to explore why this might be.

    Content

    It has now been over 70 days since lockdown. Yes, the restrictions are easing – and this is great news for people who have been isolated for so long, it is great for the economy – but we are waiting for the second wave.

    My last blog spoke about how we are going to get back to ‘normal work’ and my anxieties about how we were going to do this. Slowly, we have been trying to get back to some kind of normal, but it feels confusing, slow and uncertain. None of us can see the ‘end’. None of us knows what the ‘end’ will look like, when it will happen or will even know when it happens.  

    Remembering the early days of lockdown, the streets were empty, the roads were quiet, there were huge queues for food, and everyone seemed scared. It was a little like the post-apocalyptic film '28 Days Later'. We have all had our highs and lows: the NHS clap every Thursday, rainbows in windows, connecting with family, being furloughed, has meant some people have enjoyed lockdown. The flip side is that for some it has been a living nightmare: money worries, domestic violence, child abuse, operations cancelled and bereavements.

    Unlike the film that lasts 113 minutes, has a set plot that it follows and ends up with them being rescued, we are still stuck 70 days plus in and there seems no hope of a rescue. Real life does not offer us closure, does not always have a happy ending and, unlike dramas on the BBC, life is not always fair.

    I’m not even sure we are in the middle, which makes me feel even more helpless.

    I have been nursing for over 20 years. I have loved working with patients; I have even loved working in the institution that is the NHS. The politics, the hierarchy, the culture, yes, it's difficult work trying to negotiate around obstacles and blockers, but we do it and, weirdly enough, enjoy it. But this pandemic is different. In all honesty, I can’t do this anymore. Work was hard enough, but now it’s even harder. Knowing how to care for patients safely in the right area, wearing PPE all day, not being able to communicate properly through the masks, and having procedure and policy changing weekly, sometimes daily, is wearing.

    I feel like a new starter every day, especially after days off. I’m tired of it and can’t see an end. Due to this lack of enthusiasm, I feel I am failing at giving the care I want to, failing to give patients the care they deserve. This feeling is horrible. What kind of a nurse are you if you have ‘run out of care’?

    I know this is burnout. I didn’t want it to be. But it is.

    In January, I didn’t feel like this. This burnout has been because of the pandemic. I am interested to find out why now? I can’t be burnt out from a few months of difficult working conditions, can I?

    While looking into this and trying to make sense of my feeling, I came across Kanter’s Law. Rosabeth Kanter is a Harvard Business School Professor and according to her in the middle, everything looks like a failure". Everyone feels motivated by the beginnings and obviously we love happy endings, but it is in the middle where the hard work happens.

    She states that in the middle, we all have doubts. This feeling is principally produced because important changes are not developed the way we would like it to, lineal and smooth. The changes that remain usually involve two steps forward and one step back. This is evident when we are trying to get back to ‘business as usual’ but new cases of the virus are detected and we can’t proceed as we thought.

    In addition, it’s easy to feel that when we are in the middle we are very far away from the expectations we had made. Unexpected events take place as well as deviations. What it had been estimated in regard to the need of resources appear to not be enough. It is then when despondency appears.

    We can’t plan, we can’t mitigate risks effectively, which often leads us into failure. This is why it’s important to fully understand that failure is a necessary part of change, because there will be periods of confusion in which the temptation to abandon will be great. 

    I’m at the abandon bit! This work is difficult. I am not in the position where I can make big changes in my Trust. I must trust that others are making good decisions and they will support us if things don’t go as expected.

    Call to action

    I can’t be the only person feeling this now. What are Trusts doing to guide staff through uncertainty, prevent burnout and inform staff of plans for the future?

    About the Author

    Claire is an experienced nurse of over 20 years. She has worked in numerous specialities in the NHS and in different places around the world, from being a repatriation nurse to volunteering in refugee camps and striking up collaborations with nurses in the USA. Since 2011, Claire has worked as a Critical Care Outreach Sister where her desire for patient safety was ignited.

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    I couldn’t agree with this article more.

    ive burnt out so much it’s light a fire for me to leave nursing! I look above at the leaders , most have never worked on the shop floor, but they have a masters. So that makes them clinically sound.

    everyone I speak to feels broke and done.

    its very sad to hear such a dynamic nurse say this. But I feel exactly the same! Who do you discuss this with? Where do you go from here?

    difficult time. Needed to be said though. 

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    Claire, I am so sorry you feel like this. As I reflect on your words and feelings it makes me think of the three psychological phases of crisis: 1) Emergency where we have shared goals and a sense of urgency which make us feel energised, focused and even productive, which then moves to 2) Regression, where we realise the future is uncertain and lose the sense of purpose, feel tired, irritable, withdrawn and less productive (which is where so many of us seem to be right now) and then to 3) Recovery, where we begin to reorient, revise our goals, roles and expectations, and focus in moving beyond rather than in getting by. My question is how do we work to take the positive from all that has happened so we have ‘post traumatic growth’ rather than distress. Leaders have a choice to support their teams and to codesign  a future that works and is stronger. I hope they use their choices wisely.

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    Thanks Eve,  looks like I am in your stage 2 category.  All the positives to look at are great, but what I dont want is praise or grand gestures from our leadership team  What I would like is to feel valued.  

    I hear that some Trusts are taking away the wellbeing hubs, the free tea and coffee and free parking.  That to me suggests that they only valued us when they needed all hands on deck.....now not so much.  

    Simple steps to value our wellbeing is a start.

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    Thank you so much for wanting to do the very best for patients.  I can't begin to imagine how exhausting it must be to nurse under pandemic conditions when the rules keep changing.  Please don't feel bad about taking some time away to recharge your batteries.  Your health matters above everything.  I do hope that your hospital's management understands that if they want to retain their staff they must support them in every way they can.  You are humans not machines.  Please - what can we patients do to help? 

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    I echo Katherine's comments. Do take time to recharge. I worked for the NHS for 34 years and had "mental health" days off for myself and suggested them to my team. You do have the capacity to recover!  And the system has a responsibility to support you in doing so. 

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