A wise woman recently shared this quote with me, "cognition needs limitations and emotion needs freedom." Over the last few months my profession has shown me multiple traumatic events, I have been a PICU nurse for about 8 years now which I have witness a lot of trauma and heart wrenching things. It was brought to my attention that these traumatic things are similar to a battle field, the blood, the vomit, dirt and glass matted in a patient's hair, or even brain matter oozing from a bullet hole or incision, and the smell that goes with it.
For years I have been able to be a robot when trauma patients come rolling through the PICU doors, and do what I need to do for my patient, I see them in pieces not whole. Then there is a short moment when you stop doing things and look at the patient and realize it's a baby or toddler or teenager, they are human. I remember when I first realized this is what I would do, there was a baby who was in a fatal car accident several years ago. I was a robot when this patient first came into PICU, getting things done that needed to be done; assessing the patient, assisting physicians with lines, and so on. The neurosurgeon needed to place a bolt (measures intracranial pressure), they do this with a drill (sounds grotesque I know). As the neurosurgeon was drilling into this baby's skull, I lost my breath and started looking at her as a baby. After that moment I hear my name being called several times and I shake it off and carry on. There are times after a tough shift I get into my car and cry, sometimes bawl to the point where it's difficult to catch my breath, and other times it would hit me days later.
I have heard it is around seven or eight years when ICU/ER nurses experience burnout, and I have certainly witnessed it. The unique thing about PICU is we see it all, we are not just cardiac or trauma, we are cardiac, trauma, respiratory, surgical, and attempted suicides or patients that have suicidal ideation. I would have to say traumas are the hardest for me and have been through out my whole career, and I believe the reason they are hard is because one minute the child is healthy and in a moment they are not.
Burnout is a real thing and recently I identified it and currently working through it. When I have witnessed it I didn't think it would happen to me. I'm very fortunate to have the support from my unit and especially my boss. I come from the era of nursing when senior nurses ate their young, it was a sink or swim culture. The culture has changed, it takes a village not only to care for patients but also to care for each other; nurses, physicians, techs, dietitians, pharmacists, house keeping, respiratory therapist, pastoral care, occupational, physical and speech therapist, and child life. This is our PICU village, and the village merges with other villages in the hospital.
I want this message to get out there so others know they are not alone, again burnout is real. In the beginning of my PICU career I was able to shake it off. After repeated exposure it starts to build, layer after layer until it gets too heavy. It can be scary until you identify it, I was feeling irritated and forgetful, not like myself. I am also very fortunate to have a good therapist that will help me through this. I love PICU and I have many more years to give. I want to be a nurse leader that will advocate for my fellow nurses and other health care professionals.
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