Leaving the nursing profession is bittersweet. My heart left nursing a while ago when I came to the realization that nursing left me first. It never was a two-way relationship. The profession left me without acknowledgment of work-related stress, specifically post-traumatic stress (PTS).
First responders and emergency workers often hear the phrase, “It’s just part of the job.” So we all just deal with it — or not. I’ve heard this phrase countless times throughout my 17-year emergency career, and it’s a dangerous phrase. Not only does it reduce the stress we experience into ineffectual work, but it dehumanizes what we really do. Because of this phrase, I have witnessed the damaging effects of not helping nurses through their worst times because the expectation has been set that there’s no getting away from it; it just needs to be dealt with.
I broke down in tears when I described to my husband how it feels to leave something that’s been such a big part of my life and my identity for so long.
And yet, I feel so strongly that I need to. I want to. I don’t hate nursing. Actually, I love it. I’ll figure out what else I can do for the industry without being directly involved in the very things that drove me out. There’s work to be done.
Nursing gave me scheduling flexibility to accommodate raising kids, provided financially to help me get through single mother years, kept me afloat no matter what the economy was doing and gave me the opportunity to challenge my mind as far as I was willing to take it — not to mention timeless relationships, camaraderie built on shared experiences, insight to humanity at its best and worst, endless opportunities to practice new self-awareness and personal growth. Nursing did all that for me.
Also credited to nursing are chronic back pain, countless days of tears, wasted zombie days recovering from night shifts, PTS, numbed emotions, unhealthy coping mechanisms and a jaded attitude about health care that I’m working my way out of. And a tenacious desire to effectively help others with these same issues. There’s really no system, and it’s time to develop one.
Emergency nursing historically comes with a certain ego. Unfortunately, ego is a crutch to help us limp through some shifts. An ER nurse needs a thick skin, wit, intuition, strength, stamina, sharp discernment skills, nerves of steel, assertiveness, comfort with living in the gray, aptitude to predict the unpredictable, quick thinking, strong medical acumen, appetite for adrenaline rushes and resourcefulness to work through gripping realities of death. Beyond that, we withstand verbal and physical abuse. Every day. It’s just part of the job.
I eventually grew weary of wearing that ego mask simply for the sake up upholding some unspoken credo that ER nurses must be tough. I was tough for many years. Toughness manifested as strong, confident, fearless and, sadly, sometimes aggressive. Thirteen hours of this superpower, day in and day out, becomes exhausting. But it’s necessary to cope with the tragedy, pain, sorrow, and trauma — the effects of which seem to get ignored because it’s just part of the job. As time would tell, I became numb, even cold. These are common traits in ER nurses that go unacknowledged because they help nurses cope. Why would health care corporations want to put resources into helping nurses with these issues when being numb and cold is probably what helps them tolerate going back to work? Cogs in the machine.
I didn’t realize that PTS was even happening to me until it was too late. Excuses, pride, and ego got in my way. Even now, as I sit here recalling events over the years that continue to distress me so much, my keyboard feels the gravity of the tears that fall. At the time these events occurred, I had been conditioned to shake it off, make a joke, de-humanize myself by dehumanizing others. The mask looked like resilience.
How good is resilience anyway? There’s something much deeper that we’re ignoring — the fact that sometimes we become too resilient. We allow things (all things) to bounce off of us so easily so that we become impenetrable. Resilience, or bouncing back, if not done in a healthy way, has the potential to turn into disdain or, worse, apathy. At this point, what looks like resilience gains praise. Employees are coached to carry on with their strength and stamina. But it may actually be that we’re turning parts of our own humanity off in order to cope, fit the stigma, or to avoid penetrating our own feelings. Unfortunately, this modern-day stoicism can get mislabeled or misidentified as resilience and goes ignored because it looks like what employers want resilience to look like — sometimes to the point that we begin to neglect self-care, let alone meaningful care of others. Stoicism is not resilience. Is this what nursing is supposed to be?
Because I was so “resilient” for so long, I never recognized my PTS for the monster it is. If I hadn’t been so stoic, I would have been viewed as weak. I wouldn’t have been a good ER nurse. At least that’s what I thought.
I’m not alone. The result is the industry losing seasoned nurses that have a lot of knowledge and experience to contribute. New nurses are entering the profession and would benefit from veteran nurses. Instead, we are not only overlooked, but expected to return with altruistic hearts, resilience, and smiling faces — like good nurses.
What to do now? When I decompress from the accumulated stress and re-focus my energies, I want to re-enter as an educator or a leadership consultant who focuses on proactive, realistic mitigation of nursing stress, rather than the current reactive system that deals only with the systemic symptoms of burnout, turnover and nurses who permanently leave the profession. My eyes are wide open regarding the bureaucratic role in health care, governmental regulations, unbalanced priorities that do not focus on humanity, and misdirection in incentivizing health care workers. It’s time for nurses to take real action, not just be cogs in this dysfunctional system.
Sarah E. Jorgenson is a nurse.
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