Hopelessness & Joy: Breaking the Burnout Cycle (Feb 2024)
February is the month of love, passion and compassion
Do you feel these emotions for yourself as much as you do for others?
Or do you feel like you have nothing else to give? Towards others and yourself. People who go into healthcare tend to have some common characteristics; two of those being codependency and enabling behaviours. In unhealthy codependent relationships, the “giver” tends to be overly responsible, are self-critical and often perfectionistic; fixing or rescuing others makes them feel needed. They focus so much on pleasing others that they neglect their own wants and needs. Givers generally have low self-esteem, find it hard to set boundaries and be assertive, and struggle with asking for help when they need it. Enabling happens when you justify or support problematic behaviors in a loved one, coworker, provider or patient, under the guise that you’re helping them. These two characteristics lead to compassion fatigue, aka “burnout”.
Story time: I worked at Seattle Children’s Hospital in one of the clinics for 13 years. It was not until the last year of me working there that I realized how co-dependent and enabling I was towards the doctors I worked with in the clinic (and we all were/are). For most of the years I worked there, we worked in teams of one nurse supporting 1-2 MD’s and then a few ARNP’s/PA’s (except for the specialty within the specialty clinics-i.e Hepatology and Short Gut). When a family called into the clinic with question, concern etc, I would literally write the message to the doctor, point out in the phone note where in the clinic note the MD said this, now this other thing is happening and family needs next steps. There was so much work and re-work and handing them information on a silver platter so I could get back to the family. And at times, I would have to corner the MD in their office to get an answer. Instead of setting the expectation that the MD will check their messages (as a clinic, with the support of management), not at 4:59p and send all their replies. Or check their messages 1-2 times per week when they were supposed to be checking daily (this was the department head). I enabled this behaviour that the MD’s were to be handed any and all relevant information they needed to answer the families question/concern and then would chase them down in order to get my responses but then complain about this MD behaviour that I was in fact enabling.
How many times did I work thru my breaks? So many. Yes, there was always a shit-ton of work to be done. More than what can be done in an 8 hour shift. And in clinical work, it will always be waiting on your desk the next day. But when you are doing 9 hours of work in your “8 hour day”, I was telling the hospital that they don’t need to hire more staff. We take personal responsibility that the work will get done and feel horrible when we can’t get our work done. It’s not my fault. It’s not your fault. The system is set up to chew you up and spit you out (this is capitalism). What I found that needs to happen is things have to crash and burn, then the hospital will decide that things need to actually change. But if I’m continuing to fix or rescue the system I’m working in, it will not change. No matter how many times you put your true raw feelings on the annual workplace survey (that was the one true joy annually in my life) or if the MAGNET status becomes jeopardized due to the shit score the hospital receives, if the majority of employees base their identity and feelings on being the giver and supporting the problematic systems in healthcare, it will not change.
Imagine you are a cup; a limited cup (we are not endless beings).
But you work in healthcare. You already start with less in your cup than the average person because you went through nursing school. No one has time to fill their cup while going through nursing school and/or working at the same time. You are already less than half full. Then your first year as a novice, yes you don’t have to read endless text books and come up with nursing diagnosis you will never need again, but you are also having full responsibilities of someone’s life in your hands. More of the contents in your cup goes out, can’t fill it enough with the joy of not having to read text books. Then you are made charge nurse at 24-years-old managing other people’s interpersonal problems who are decades older than you are. Your cup is like a sieve. Suddenly you are 5-10 years into your career, maybe you’ve changed jobs and found a job that you like, maybe you are still only surviving each day in the toxic job. *note: I do realize nurses who have recently graduated have a high rate of burnout early due to the pandemic so you’re not making it 5-10 years into your career
But if you still have not found what will fill your cup and consistently do these things, your cup is chronically empty. There’s an echo of where your compassion used to be. Self care and finding daily joy is what fills your cup.
Your cup next to a campfire
Can you structure your life to include things you love and that bring you joy as your primary purpose instead of your secondary one? This year, set the intention of living life well-not in the few moments you have to yourself between responsibilities but by intentionally structuring your life to include the things you love and that brings you joy as your primary purpose instead of a secondary one that you may randomly make time for but usually don’t.
Here’s how to make it happen: draw a line down the middle of a sheet of paper. On the left side, write a list of all the things that bring you joy. On the right side, write the things that suck the joy out of you. Remember, the goal isn't to address these issues but to refocus your energy into the things that make your life worth living. Once you have your lists, review the joy list. Then on each day this month, write down the item you want to focus on that day and make time to incorporate it. If your item is "music", start your day playing music while you get ready for the day or play an instrument on your break. Do something because it makes you feel good, even if it might be a little silly. The more you allow yourself to live by joy, the more satisfying your quality of life will become. You don't need to spend money on an elaborate annual trip to escape your day-to-day life if you make your day-to-day life worth living. You will not remember all the time you spent scrolling but you will remember the book you read that made an impact in your life, the hobby you made time for that enriches your life and the community you make along the way.
Hopelessness happens when you have lost the feeling of joy. A few months after I had finally quit working as a nurse, and had been actively and intentionally working through my continued exhaustion and burnout, I started to get these spontaneous feelings of joy. I would just get happy for no reason. Previously, I had not had any time or space for many feelings because of being chronically overwhelmed and exhausted. I was just surviving every day. And would wake up more tired than when I went to sleep to do it all over again. I felt stuck in this never ending cycle that saw no end. That was hopelessness. I see it in the nurses I currently work with as clients. It does not have to be your story this year, you do have the power to create change in your life, to be intentional about showing up for yourself. That can be the hardest aspect of working out of burnout, showing up for yourself, putting yourself first.