The Dread

It starts on a Sunday night. I get annoyed with my husband and I know that it is not his fault but I cannot help it. I hold on to small annoyances in my mind and go over and over them, working myself up into an unjustified anger. I am getting better at identifying when I get like this, that it is not real anger or frustration. I have not gotten to the point of being able to fix it yet however.

What is happening is anxiety about going to work the next day. I know that I will be stressed at work, that the environment will be uncomfortable and I have no way to fix it, so the anxiety builds.

My mind likes to fix things, it likes to plan and work things out but no matter how hard I try, I cannot come up with a plan for fixing my situation at work, other than leaving the job entirely. On some days, I can be positive and come up with ideas and strategies but when I have had some days off it is almost impossible to do that.

So I lie in bed, angry at something else because my mind cannot cope with applying those emotions to my job. After I realise what is going on I still have the anger I have worked up but it is now joined by the anxiety so my eyes are wide open and there is zero chance of sleep. I go over the things I might come up against at work, I stress that I will be tired because I cannot sleep and I get angry with myself for getting into this state.

The next morning I wake up tired and numb. The numbness is a new feeling for me. It is as though I do not have the energy for emotions. There is nothing except tiredness and a queasy feeling in my stomach. I have to go through the motions of getting ready – it is quite quick now as I no longer bother with makeup on most workdays and I have a quick shower otherwise I think too much in there.

As the time to get to work approaches the queasy feeling in my stomach becomes an actual nausea. I begin to feel light headed and my motivation to do anything is at rock bottom.

For a few months now, I have been back and forward to my GP trying to sort these symptoms out, it got to the point where I cannot even exercise because I have no energy and my energy levels drop so quickly it is dangerous. Only recently have I been able to connect the symptoms to my burnout (I will detail how I managed this in another post – but believe me it was not easy).  I have wasted so much time, energy and money thinking I was sick when really it was work all along.

I drag myself to work because I need to pay the mortgage and feed my family, I have no sick days left until August and I have minimal leave days. I spend the morning not wanting to see or talk to anybody on a good day, on a bad day I spend the morning trying not to cry. I am normally ok by the afternoon, I still enjoy nursing and seeing my patients and that perks me up a little. But it is repeat that night of the anger, anxiety and stress knowing I have a full week to contend with still.

I do not know how to fix it yet, I don’t know if I can. I am currently swinging between finding a new job on a bad day and remedying my situation here on a good day. Today is a bad day. Let the job search commence.

A Pat on the Back

One of the issues brought forward during my recent meeting with management was the lack of positive reinforcement we received from them. Our point was that we have had a tough time in the clinic over the last year and we have hardly had any “thank you”s or “well done”s. The difficulties we have had include;

  • Major renovations
  • Lack of permanent GPs
  • A few months of only a single GP who was unable to see anyone under 15
  • A new practice manager who was unqualified for the position
  • Cornerstone accreditation
  • Staff changes
  • Abusive, angry patients

So it has been a hard road and we have managed as well as we could have. There were times the clinic was hanging on by a thread but we made it through to the new building and permanent doctors.

What was missing during all of this time was some appreciation from our management. After a hard day, and believe me, some of those days I was ready to walk out and not come back, having your manager simply notice how hard you have been working and throwing a thank you your way would have been enough to get you through to the next day.

When we brought this up at the meeting we thought this would be one of the easier suggestions. How hard is it to say “well done” at the end of the day? Or to say “thank you” when you know there have been issues and everyone worked through them?

This turned out to be a sore point for the management and we ended up stuck on this point for the remainder of the meeting. Their understanding from us asking for some more recognition of our work was that we wanted to get a pat on the back every time we do something, and they will not do that.

I don’t blame them for not wanting to do that, undeserved praise given as a tick box exercise would not help anything. But that was not what we were asking for. We were asking for recognition of the times we go above and beyond, which we do often. I don’t think the management understood this. They simply kept reiterating that we should pat ourselves on the back and be happy with that, because no one does it for them.

I feel that any workplace would be improved if people give each other positive encouragement, be it from the higher-ups to front line staff or from the workers to the bosses, it will surely make the place a happier place. So why be resistant to doing this? Why make this your line in the sand? Why focus on this rather than the 16 other issues?

I have no answer, I am still confused as to why we can’t all be more supportive.

But you know what? It doesn’t matter. I don’t need permission to be kind, or to tell others they are doing a good job. I don’t need management to approve me congratulating them on getting through a hard day. So I will just do it. And maybe, just maybe, it will rub off on others, slowly making its way up to the management. And then work will be a happier place to be.

The Beginning

I began my nursing career in primary health. Since my first semester in nursing school that was the only type of nursing I wanted to do. The idea of preventing diseases for occurring and battling health inequalities in the very communities they exist in was of great interest to me. I had always thought nurses work in hospitals, so that was what I wanted to do. But discovering this wonderful world of prevention was fascinating.

I had been told by various nurses throughout my degree that I would not be able to start in primary care, that I would have to work in the hospital for a few years before I would be experienced enough for primary health care. I didn’t agree however and pushed myself to be involved in everything primary health related I could find. I joined clubs, I led inter-professional groups and buttered up the primary care lecturer to be my reference for a new graduate job.

It all paid off when I secured a job at an NGO as a practice nurse at their GP clinic. I have never been so relieved and excited in all my life. I had done no practice nursing during my training which made me quite nervous but my position included an extensive new graduate program so I could get the relevant further qualifications to work as a practice nurse. This extra level of preparation was beyond what my fellow graduates had to do at their hospital jobs. It made for a very busy first year of nursing when combined with the post graduate paper I had to complete.

As beneficial as I found this extra training I think it ultimately led to the burn out I have now. I began my nursing journey pushing myself and having no free time on my days off. That became my normal. My work/life balance was skewed from the start. It is only now that I am at crisis point that I am figuring it out.

It is surprisingly hard to relax. Don’t let anyone make you feel lacking because you don’t know how to relax. It is a skill that they don’t teach you at nursing school and it can be hard to work out. I have found that I won’t relax if I sit at home watching tv, my mind will still be working overtime about work things. I relax by doing. Painting, writing, sewing, anything really. Now that I know how I relax I just have to work on not feeling guilty when I do.

 

Meeting with Management

I feel numb right now. I should be angry, I can feel the embers of what would have been smoldering rage at this injustice only a few weeks ago. Now I’m just tired. I’m tired of trying to make things better. I’m tired of having to justify my opinions and I am tired of being ground down by my job.

Today I, with other members of my team, presented 17 reasons why we are unhappy at work to our management. These 17 reasons were carefully thought about. Our process involved each individual writing down their issues and then a comparison was done between these lists. We only took further those which we all had in common. We found examples for each to prove that they are real. We reviewed them to make sure they didn’t come across as catty or whiny. We wanted to appear professional and we wanted to be taken seriously.

 

That didn’t happen.

 

I don’t know what I expected really. I knew there would be issues that the management wouldn’t take so well, but I expected at the very least to have gotten some acknowledgement of the situation we are in. Three of their staff members were crying through an impassioned speech and their response was to ask us if we had thought about the way we do things and to see if we might role model what we want to see. No questions about why we were so emotional over it, no expressions of concern about our mental health. When your nurses are breaking down in front of you I would have thought a human response would be to express some concern.

I feel so tired from it all I’m numb. I don’t have the energy to do any more to make this work. I had to claw my way through burnout to put this presentation together and now I feel like I have just made more problems and made work an even worse place to be.

For anyone out there who is having issues with their workplace I implore you, please find the courage to have these brave conversations while you still have the energy. If you are worried you are getting burnt out you need to say something before you hit the bottom. Because down here in burnout lane your reserves are so low that getting through basic daily tasks is an achievement. Trying to create a culture change in an organisation that has long term issues, without the support of validation of your superiors, is like scaling Everest in heals. In theory not impossible, but it might as well be.

 

Introduction

Nursing it right.

 

Nursing – Both in the sense of nursing as a profession and the act of assisting in healing.

It – Patients. Diseases. Problems. Struggles. Life.

Right – The correct way of doing it. Or. Putting something back to the way it should be.

 

So that is the scope of the things here. Its a pretty large scope, I’ll admit. I’ve given myself a lot of wriggle room in terms of content.

 

Here’s hoping its good.