From the Heart of a Nurse: A Tale of Caring, Burnout and the Path to Self-care

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By Chris Griffin, BSN, RN, CPN, guest contributor 

May 8, 2013 - I am a clinical coordinator at Children’s Hospital Colorado. I work on the Pulmonary Unit with the patients who have difficulty breathing on their own.  As a new graduate nurse, I connected to my very first primary patient in a meaningful way. I took care of her for over two years, until the day that she died in my arms in our PICU.

For the next year, I struggled to recover from that one moment. It wasn’t my fault, but I blamed myself. It was inevitable, but I thought it would never happen.

Chris Griffin, RN, tells her story of caring, nurse burnout and self-care.
Chris Griffin, BSN, RN, CPN, writes from her heart about what nurses see, experience and do for patients. Yet, she asks, "How can we care for another when we can’t see the importance of caring for ourselves?"

I thought about leaving nursing all together, until my passion was reignited by studying Jean Watson’s caring theory. I met Jean, and she taught me that you have to take care of yourself first before you can truly care for others. My journey to figure that out has led me to become a Caritas Coach (learning about Jean Watson’s theory in order to coach others in it), and then to become a HeartMath trainer (a program that teaches us how to manage stress in the moment to decrease the amount of stress we carry with us). I am now chair of Children’s Hospital Colorado Council for Caritas and the lead HeartMath trainer.

I have only been a nurse for 10 years, but in that time I think I have seen just about everything: 

- I have been there at the beginning of life and far too often at the end. 

- I have witnessed pain, both physically and mentally, and not been able to help. 

- I have seen true humanity in the nurses that choose every day to work in chaos, but stay caring.  

- I have had a mother literally hand me her daughter so I could hold her as she died--because she could not do it, and she did not want her to be alone. 

- I have cared for the worst diseases known to mankind, and learned from the kids that the disease is not what defines them.  

- I have seen humans at their worst, which demands that I be at my best. 

- I have connected so deeply with others that, at the exact same time, my soul aches and my heart is filled up. 

Something changes at your core when you are with another person at their weakest moments. Something alters in your consciousness when you are the last person another human feels before they die. 

Why nurses burn out 

Nurses become burned out because we are nurses. We choose to step into another person’s world and take care of them physically with our touch, emotionally by holding them up when they can’t hold themselves up, and mentally by helping them feel safe when their worlds are in chaos. By the way, this is usually with complete strangers.  We step into the most stressful moments in our patients’ lives, and do this time after time, because we want to make a difference. 

What happens when we can’t make the difference that we want to make? What happens when we can’t let go of the weight of one patient so that we can walk into another patient’s room, and then another’s? What happens when we can’t find the hope our patients so desperately need? 

Our shoulders can only bear so much before we feel the effects of compassion fatigue. Our hearts get heavier and heavier. We begin to see the world from a different lens. Everything changes, but we continue to work and continue to care for others, putting our own needs at the bottom of our priority list. Slowly, our hearts begin to shut down and our minds protect us by putting up barriers so we can pretend we don’t care, and that suffering is just part of the job and we signed up to deal with it. 

Balancing passion, compassion and self-care 

There are so many aspects about being a nurse that helps me hold onto my passion for nursing. The most important is that when you truly choose to care for another who is sick, you can transcend all misconceptions and stereotypes and meet another person on a basic human level. To understand that everything that has happened to them and everything that has happened to you prepares you for how you will interact with each other. You can connect with them in a way that will change you both forever. 

We have this incredible ability to choose to put someone else’s needs above our own, and in that moment we are doing what all humans are meant to do. We are meant to take care of each other.  Understanding that, at its basic level, is the most important thing I do as a nurse. It is what brings me to work each shift and what grounds me during my most stressful moments. 

The only way I know to help nurses with compassion fatigue and burnout is to help nurses see their own self-worth. Understanding we have to practice self-care in each moment first, before we reach out to help another. Not just at the end of the week, but moment by moment. 

Before we enter the room, before we take the vitals, we must take our own vitals and provide ourselves with the same compassion and love we give our patients. 

How do we do that? First we must pause. We must breathe and understand what we are experiencing. Is it fear? Is it doubt? Is it anger? Whatever it is, it is okay in that moment. If we let go of what we think we are supposed to be and just feel our own truth, then we can face anything. We will walk into each interaction knowing we are as close to our true self as possible in that second. When you are closer to your true self, then you are going to be all that anyone needs. You are going to be resilient and able to provide amazing empathy and compassion without being completely drained yourself. 

How we can help each other be better nurses 

As a profession, we need to inspire each other not only to hold onto our passion for being a caring nurse with our patients and families, but to realize the importance of showing the same care for ourselves. 

We need to build into our framework a place for nurses to focus on self-care. That the concept of taking care of yourself, so that you can then take better care of others,  is not just a nice idea. There is an important ideal and even an ethic to be found in the importance of handling your own stress and meeting your own needs before you attempt to care for another. 

How can we care for another when we can’t see the importance of caring for ourselves? It is counter-intuitive to offer someone aspirin for a headache and scream at them while they take it. Isn’t that what a nurse does if she enters into a room, filled with stress and anxiety? 

What we bring with us to the bedside matters. Our patients know what we are feeling on the inside even if we try to hide it on the outside. The nurse who is stressed and uncared for cannot help but bring all of that with her into the patient’s bedside.  

I have been told countless times that we need to be trained in assessing, critical thinking skills, use of technology and that self-care and managing stress is just a side priority. I am a huge proponent for being clinically trained and safe at the bedside, and agree that the use of technology can advance our ability to improve health. I also argue, of equal importance, to understand the nurse and the environment she creates with her presence is a big part of the healing that happens with our patients.  

You can give a nurse all the tools she needs to work in a hospital, but if you are not teaching her to take care of herself or manage her own stress, everyone suffers.  

Self-care lets nurses be more available to their patients. Self-care reduces the amount of stress that both the nurse and patient experience. Self-care creates a more healing environment so the patient feels more cared for.  Self-care makes us better nurses--better, less-burned-out nurses! 

About the author: 

Chris Griffin, BSN, RN, CPN, is clinical coordinator, Caritas coach and HeartMath trainer at Children’s Hospital Colorado, where she has worked for 10 years.  Chris has a bachelor’s degree in kinesiotherapy from California State University Long Beach and a bachelor’s of science degree in nursing from Regis University in Denver, Colo. She is a certified pediatric nurse and is a master candidate in the nursing program at Regis University.


Related links:
Children’s Hospital Colorado
Caritas Coach Education Program (CCEP) - Watson Caring Science Institute