The battle against burnout

My work keeps me humble, but it can also distort my sense of reality, make me think that normal existence consists in large part of suffering and death. If I lived in a war zone, that reality would be true. But I only live in a war zone at work, and the kids are a lovely and constant reminder of the normalcy of my non-work life. Hearing that homework is a drag and learning about friends’ foibles are the irritations of everyday life, and a needed antidote to the grim realities of cancer. Other oncology nurses with school-age kids chauffeur them to cheerleading practice, art classes and track meets, enjoying a similar sense of gratitude for the responsibilities of ordinary life.

Some nurses use exercise to keep the hard emotions at work separate from the rest of their lives. One of our nurses, Shannon, recently ran the Chicago marathon to raise money for The Leukemia & Lymphoma Society. Another, Ketah, is practicing yoga. Mary J. has gotten into biking so that she can do “Tour de Cure” and raise money for diabetics like her husband. I ride my bike to work as often as I can. It’s only two miles, but on the days I ride, work is much easier to put behind me.

One thing all nurses do, without realizing its capacity to comfort, is talk about the hard times amongst ourselves. Nursing can be lonely work because outside friends don’t always want to hear about the burdens nurses bear, so we unload on each other. One day a new nurse had a patient who had just gotten very bad news. The nurse couldn’t stop crying. Through her tears she asked me, “Is this normal?” “Yes!” I said emphatically. We talk about death, and we worry together about burning out. We make sick jokes, grieve as a group for patients we’ve known well and lend an emotional hand when another nurse needs it.

Sadly, a coping strategy for some nurses is simply to work less. Elaine has been an RN on my floor for eight years. Early on she realized she could not do this job full-time—it was too emotionally demanding—so first she became part-time, and now she’s casual. Other veteran nurses have joined the official weekend staff. It means they have to work every weekend, but they make a full-time salary for working just two 12-hour shifts a week, and they are guaranteed five days off.

I have also chosen this strategy, although by accident. In September 2008, a piece I wrote for The New York Times landed me a book contract to write about my first year as a nurse. The contract came with a large enough monetary advance that I could afford to work less, and I went part-time so I’d have time to write. The dirty little secret of my switch from full-time was that it made the emotional burdens of the job much easier to bear simply because I encountered them less. The book, Critical Care: A New Nurse Faces Death, Life, and Everything in Between, is now done and awaiting publication in June of this year.

Once I finished the book, I could have returned to full-time nursing work, but chose not to. I told myself it was better for the kids because I would be home more. Also, I now write regularly for the New York Times blog “Well” and I needed time for that. But the truth is, returning to such a constant dose of sadness would have made it harder for me to find the joy in my everyday life.

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