Day 2/36

Today was an emotionally draining day. I think the proper definition would be something like “compassion fatigue.” I’ve heard my share of lectures that talk about “burn outs” and how nurses need to “detach themselves” from their patients. What I struggle with is, how can nurses care for their patients when they remove themselves?  Nursing isn’t a glamourous job, trust me! Just the other day, a nurse on my unit had her scrubs soiled from one of the kids. Aside from the initial laughing, our jobs aren’t always fun and enjoyable. But.... no matter what, I believe compassion is an important part of nursing. 

[What is better?] Having a nurse cuddle a child who is crying and fussing, or a nurse who closes the door to drown out the noise - so she can have some peace and quiet? I believe that there is an important balance when it comes to caring for our patients, because we are all susceptible to experiencing a burn out in our careers at one point or another.  

Burn outs can be due to many reasons. It occurs when someone endures major/continual stress (emotional or physical) and has difficulty coping. This could be seen from:

• providing care around the clock 
• patients becoming vulnerable and too needy
• health care constantly changing
• development of new technologies
• constant noise & business
• critical ill patients
• crisis of patients and family’s
• work environment - work overload (limited time, resources, staff)
• demographics - young age, early in career, high level of education
• personality - low self esteem, need for approval, perfectionism, impatience 

Whatever the reason may be, it’s important to be aware of these and know our limits. If burn outs aren’t treated, one can become ill, exhausted, have a mental break down, go through extreme depersonalization and have an extinction of passion. YIKES! I tell you, I’ve worked with many burnt out nurses; they are miserable, cranky people. During this 12 hr shift, I had many opportunities to think about burnouts, and how they could affect me - or how I might be heading down that path.  

Working with children is rewarding. They are full of life; their smiles warm your heart. BUT..... on the flip side, working with children can be extremely challenging; especially sick children. For those who read my previous post, I had the chance to work with the 2.5 month old baby; aka... my little Prince Charming. When I first came onto the ward, I went into his dark room to check up on him. As I approached his crib, I peeked through the individual bars that surrounded his tiny body. I noticed immediately that his NG (nasogastric tube) had come out of his nose. Ever since he was admitted to the unit, he was put on a continuous feed (the tube goes into his stomach - making feeds much easier on him). So because of his tube being pulled out, his bed and clothes were wet from the formula. 

After morning report, I hustled back to his room where I scooped him up into my arms and headed down the hall into the bathing room. I filled up his baby bath and got everything ready. He loved his bath, which made it easier for me. After his bath, I got some new clothes for him and rocked him back to sleep. After his little cat nap, E (my RN) and I re-inserted his NG tube. That was one of the hardest things to do. His fought with every muscle - squirming and arching his back, how he usually does when he’s upset. I hated the fact I made him cry, it broke my heart. To make a long story short, the shift was a great learning experience. The majority of my day was spent in his room, cuddling him with every opportunity that I could. Because of the neurological damage, I was scared to leave him when he got upset/started to fuss. He’d arch his back so much that he’d burry his face into the blankets we have in his crib to keep him from rolling over.  I was worried for his safety, so of course, I’d come to his rescue and pick him up - cuddle him and put him back into his crib. 

There were times during the day where I was late - getting to my break because I wanted to calm him down before I would leave his room. It wasn’t until later on in my day that I realized how exhausted I was. As I was rocking my little man, I could feel my eyes growing heavy, wanting to close. I felt spent. It is evident how exhausting nursing can be. For example, a clock fell down in the hall way and made a loud crash! All the rooms that were close by heard this. Of course, the children/babies were scared. It was like an orchestra of screaming and crying that echoed the hallways. The majority of the nurses would try and calm/sooth these children down -lemme tell you...it’s hard work! 

The biggest thing that I learned from today was as much as you want to take care of all these little kiddies, you got to take care of yourself. In doing so, we can prevent ourselves from becoming physically and emotionally exhausted. In order to avoid burnouts, we must set boundaries, keep balance in our lives, be involved in friendships (which are giving and taking of equal amounts), get a significant amount of sleep, participate in self-renewal activities, be more organized, and seek love and support from others. 

Overall, the day was great! This is definitely something that will be on my mind for quiet sometime. I may choose to not “disconnect” myself from my patients, but I do need to look after myself as well! Once again, I need to trust God, know that He'll fill my "compassion tank" when it's running low. I believe He put me in this place - to be a nurse- for these specific reasons. I will continue to love on my patients and be a shining light for them! 


"I can do all things through him who strengthens me." Philippians 4:13