You know the feeling. It’s your third shift in a row, it’s a particularly difficult patient or family, it’s a heartbreaking story, it’s an intense diagnosis, it’s short-staffed night on the unit. Nursing is profoundly tiring—physically, emotionally, and intellectually. Our shifts are long: Even on a normal day, by hour number 10 you may be feeling strained. You can pull from your reserves, but sometimes there isn’t anything left. You have compassion fatigue. You’re experiencing caregiver burnout.

These moments on the unit can be tough. You may feel yourself start to become anxious, or more stressed out that normal. An otherwise meaningless interaction with a doctor, colleague, or patient can leave you nearly in tears. What can you do to avoid burnout?

First of all, in the heat of the moment, take a second to breathe. Try to center yourself by inhaling through your nose and breathing out through your mouth for at least five breaths. This can help calm your body and mind, even when you don’t think it will work.

After your shift ends, it’s time to practice self-care. As nurses, it can be incredibly difficult for us to do this. But just like oxygen masks on an airplane, we all know deep down that it is difficult to care for others when we ourselves are in a fragile, fatigued place.

In theory, the easiest two things to control are our diet and sleep. In practice, we know this isn’t always the case. Aim for quality over quantity: If you can’t get enough sleep, try to make it the best sleep possible. Spend time enhancing your sleep environment with room-darkening shades, white noise machines, comfortable bedding, and a great mattress. Use the “do not disturb” feature on your cell phone. If you’re a night shifter, you could write a note on on your front door that anyone who rings a doorbell will be met with fire and fury.

For your belly, try to pack healthy, filling options for meals and snacks. Aim to always eat breakfast. Low blood sugar can easily translate into crankiness, so try to stay ahead of your curve by packing granola bars in your scrub pockets or bringing easy to eat meals for times when you can’t get a lunch break. (Which, let’s be honest, is every day.) 

Most importantly, assess yourself. We as nurses are in the business of assessing our patients, but we rarely turn that critical eye on ourselves. Try to really check in with your emotional reserves, and try to find healthy ways to process your stress. Make a care plan for yourself, and re-assess frequently. 

Laura Kinsella

Laura Kinsella, BSN, RN, CEN, is an emergency room nurse in Washington, DC.

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