The Sacrifice of Nursing – The Things They Never Teach You in Nursing School.

No one wakes up one day and says to herself,

I feel like working 12 hour shifts. 12 hour shifts where I can neither have my own time to eat, pee, and where my coworkers take out their own version of ‘hangry’ and burned out on me.

No. We wake up one day and say,

I see you there. I see that you’re hurting and I see that this is hard and I want to find a way to make it better for you.

We enter the field with hopes and dreams. We can save the world and our intentions are well meant and sound. They even come with some perks; decent pay, 3 day a week work schedule and sometimes even schedule flexibility.

When you start into this field, you hear the quiet whispering — the hints, warnings, from other nurses. Be careful, they’ll say, they eat their young here. If you thought nursing school was hard, you’ll re-learn everything in your first year out of school. School was merely scratching the surface. There are so many things, though, that they fail to teach you in nursing school.

When you’re in school, you don’t hear about the bullying (eating their young) that is so common. One study reported that in the United States (US), up to 70% of those impacted leave their job, 33% of these victims leave for health reasons and 37% because of manipulated performance appraisals (Rocker, 2008). They don’t tell you that this behavior is a learned behavior in the nursing work environment (Lewis, 2006) and that you will waste your time wondering why some people are so cruel.

You don’t hear about how there is no unique nursing job — the trends are the same even when the work changes. There is always that one person — the one that will make the job hard to come in for and will manipulate the situation for no obvious reason other than you are standing there.

They never mention that you might have to hold your urine for 12 hours because something might happen — the moment you walk away, it always does. Someone or something is always more critical.

Or how your 12 hour shift is never really 12 hours long. By the time you catch up on all the charting, give report and then address the criticisms of the oncoming nurse about how you failed to change the sheets correctly in room 234 again… you’ll be there 13.5 hours and you’ll have to be back again in 11.

They don’t tell you, really, that you will see people die. You will see their loved ones cry. You’ll see them near death, in heart breaking pain, and you will find yourself crying with complete strangers and make bonds with people in a way that you never knew possible. You will leave so emotionally spent some days that you can barely muster the strength to speak to your loved ones when you get home. Sometimes, you give so much that you can find little left for yourself.

There’s no class on how nursing changes your whole life — you’ll become so used to giving that you may even pick partners that take, take, take, and you cannot find it in yourself to give up on him. You are so sure you can help him be better and fix everything.

There was no warning that you’ll lose all tolerance for emotional stress at home and that you might snap at them because there’s nothing left in you to say the right things.

We spend hours, days, shifts, weeks, and years of our lives educating and encouraging our patients to take care of themselves. We teach them to advocate but we also advocate for them; protecting them from themselves and from the system. We stand for them when they cannot stand.

But when do we stand for ourselves… ?

Do we stand up for ourselves after a nurse has verbally abused us? Do we stand after getting a urinary tract infection because it’s hospital policy that we can’t have drinks at our nursing station? Do we stand up after we get nauseated and light headed after we last ate something of substance over 10 hours ago?

Do we stand after someone makes a life-threatening mistake — because we’ve been working for weeks, months, years, short staffed? Or when management says our safety costs too much?

When do we change our culture? Our learned behaviors?
When do we choose ourselves?

After 10 years of healthcare, I have had to make the hard decision to choose me and I am choosing to step back from nursing to pursue my value again; to relearn what it is to give and take and not simply give. I am choosing to sacrifice for me.

Nursing is not like anything else — it is a magical field unto itself and it is a gift in so many ways. The learning, growth, and change you get from the field is invaluable and the experiences are not ones that I would ever give away. I became stronger through nursing and I respect all the wonderful and amazing nurses that I have learned so much from over the years. Yet as I ready myself to care for this little human that is coming into my life, I have come to realize that I will need more of me to give to him or her.

This may be one of the hardest changes I will ever make; it is difficult to realize that you are separating yourself from what you have known for the last 10 years. Tapering yourself from giving, nursing, is such a strange concept. It is hard to know what comes next; what comes after. Is there an after? At some point, you realize that you have become nursing — it is the way you think, the way you view the world, the way you care for others… and even when you stop nursing, you can never lose it.

This will not be everyone’s solution but I can only hope that as we all learn to choose something — and in doing so, choosing ourselves. To decide that we are going to change our culture, to stand against the angst and stress, to band together and care together… to stand for nursing. We deserve to care for ourselves.


Post-update / Edit:  I want to caveat something on this post.  This is not my every shift.  My current nursing job is pretty decent, actually, and I take “working” lunches maybe once a week.  When I worked emergency room, my life was more like that.  My first few years were pretty difficult and I’m just burned out now.  I’m ready for a change, a break, a separation or a backing up on nursing to focus on me a little.  The post is stronger than intended but it was written out of emotion — written in the burnout. I know it’s time for me to take a break and so I’m doing so.  No one else is required to deal with it the same way.


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