I'm Burning Out (WARNING EXTREME)

[batgirl]

WARNING: This thread has what I guess would be some pretty hard to deal with content, maybe a bit extreme. Read at your own risk.

I'm sure everyone already knows my foray into Paramedic school and all the trials and tribulations that are contained therein, so I won't bore you all with what's already been said. However, I've been having some problems lately with...well me, and since writing about myself has helped in the past (especially here where you guys can lend a pair of eyes to my situations), I'm back to writing again.

Lately I've been feeling very burnt out. I knew when I started this adventure that it would be a very long and very difficult road. There's a ton of material to know, tons of skills to master and very little time to do it in. I've been fairly successful thus far, mostly due to my experience and my ability to use critical thinking to form appropriate diagnoses and treatments for my patients. I've also been told that my bedside manner and patient interaction is by far the best in the class. However, I live, breathe, sleep, eat and am completely enveloped in Emergency Medical Services. I work full time as an EMT, go to school and do rotations; essentially being involved in EMS 7 days a week, and it's getting to me. I took it in stride at first, fully immersing and involving myself, but now it's getting exhausting. I wake up at ungodly hours and get no sleep to go to rotations (in fact I'm typing this at work after a full 8 hour rotation. I will be awake until 7am when I can finally go to sleep).

I'm almost at the end of my program and it's just becoming more and more exhausting. I'm under pressure to complete a certain amount of clinical requirements, so there's pressure there. On top of that, I'm just getting more and more tired. I'm tired of class, tired of being in a cramped ambulance and very tired of being just tired.

I was working in the emergency room last week when it really became apparent. I was running around as usual doing a million things for the various nurses and doctors in the ER, helping out where I could. We had a bunch of pediatric patients that day, and I was trying to assist as best as I could even though I'm not cleared to actually do anything invasive on kids yet. Basically taking blood pressure, temperatures and just generally helping out. Two wonderful and adorable baby girls came in for fevers that were extremely high, both had seized multiple times. I was charged with holding the poor kids down for the IVs and helping with getting urine through a catheter. The kids wailed and cried, the parents wailed and cried and I got peed on. The whole ER was full of these kids screaming the whole day. I know that I personally did nothing to hurt them, but a part of me felt responsible. The pediatrician decided to do a spinal tap on one of the kids with the higher fever to rule out meningitis. I was invited into the trauma room to watch the procedure, not knowing I'd be roped into helping. This baby, all of 15 months, needed three of us to hold her still enough to get tapped. Here is this beautiful baby girl, naked on an unforgiving trauma table, being bent into a football shape so that the curvature of her spine was good enough to get a giant needle stuck into it. I was holding her head as she cried and cried, even with sedation. It killed me.

I held her down as delicately as I could, knowing I was still hurting her, as I needed to be hard enough to keep her from thrashing. She wailed and dropped giant tears on my arm as I held the oxygen mask near her face and tried to keep an eye on her heart rate while the doctor did the procedure. She missed twice but finally got it. I then had to carry the baby, now not so naked, but bandaged and bloody to her parents. I felt just horrible.

I know it was an important procedure, but the whole thing put me so ill at ease. Sick kids are not easy to deal with, and it's something I've not had to deal with much (thankfully). Since then, I've had multiple sick children, each hurting me a bit inside. Yes, I'm helping them, but they're kids, they shouldn't be this sick. I took a boy with a rare blood disorder to the ER the other day because he was literally vomiting up the blood he just got transfused. It ripped at my heart to see him like that. I was shaking by the end of the call. I'm confident in my skills, but damn, what the hell...It's getting to me now, and I don't want it to.

My question to you all is: How do you cope when things seem uncopable?

[TDK]

My advice would be to remember why you are doing what you are doing.

No one ever said it would be easy to make a difference. Just the opposite, in fact.

Not everyone is cut out for it, but everything I've read in all these threads you've made leads me to believe you are. You seem like a strong person.

In my experience, things like this usually go in phases. Either that is true and there will come a time when you stop being tired and overwhelmed, or there will not and you will have to either learn to cope or quit.

Maybe that doesn't help. :I

[Loyal]

My advice would be to remember why you are doing what you are doing.This, absolutely. I can only imagine, judging by the tone in your anecdotes, that you went into this to help people and make their lives better. Try to remember the people you've helped, in spite of the unpleasantness.

[Aerozord]

I am a very empathetic person and seems you have simular issue. I learned to counter it with total apathy.

Harsh as it is, I simply put it out of my mind and accept what I cannot help. Breaking everything down into simple unchangeable facts. In your example of the baby, only think about what needs to be done. That you must hold something down, keep the mask on, monitor heartrate. Give no thought to how the patient feels, why you need to keep that mask on, or what will happen if something changes with heartrate.

I know its easier said then done, takes alot of mental training to pick and choose what you focus on to keep your mind from wandering, but you will see alot of suffering and death and if you give serious thought to whats going on around, well I know I'd never be able to handle it

[Seil]

:hug:

[Shyria Dracnoir]

Look at it this way; the world may be a terrible place when sweet, innocent kids get wheeled into the emergency room suffering from any manner of terrible disease or unfortunate disorder, almost always through no fault but that of random chance.

But it isn't so terrible when people like you and your coworkers are there to help them get better. Sure, the kids are probably too young to appreciate the huge fuckoff needle in their arm, but if that needle means the difference between the kid's parents planning a birthday party or a funeral, it means that you're making the world a better place, even if its just on a local scale.

My sister and I were once in a situation like the girls in your story; we ended up born almost two months before we were supposed to. We weren't going to survive without a lot of help. There's no doubt that we screamed, we cried, and made the doctors taking care of us wish they could do the same. But because of them, I'm able to sit here now and type this. Someday I hope those two girls will be able to do the same because of your work.

[Nique]

My question to you all is: How do you cope when things seem uncopable?

What you do and why you do it, simply put, impresses me. And it's not something I can even approach in terms of ability or experience. I feel weird trying to think of things to say to encourage you knowing full well I would've washed out long time ago if I were in your position. But when you asked this, I thought of this quote. It's only slightly more related becuase of your username:

"People are dying, Alfred. What would you have me do?"

"Endure, Master Wayne. Take it. They'll hate you for it, but that's the point of Batman, he can be the outcast. He can make the choice that no one else can make, the right choice."

You're going to be worked hard and unappreciated, but what you do is important to you and you clearly have the ability to do it. Things will eventually even out and you may even need to look for ways to make adjustments so that this works for you now. Make sure you're getting sleep! I've had a bad week myself recently, and getting solid rest has done wonders for my patience.

[batgirl]

I think my main issue is that for 7 years as an EMT, nothing has really phased me. I see people dying, people sick, people who should be dead etc and it doesn't bother me. Blood, guts, gore, piss, shit, vomit; it all means nothing to me. From the time I made that first intubation so many months ago and until now has been the first time I've been shaken up from all this.

[Shyria Dracnoir]

It's probably a combination of a lot of factors. You have the crunch of going into the endgame of your medical education piling on top of your existing stress and wearing you down. It might have also been the incident with the kids; nobody (or at least, a vast minority of people) likes to see kids in pain, and even if you've worked with cases like this before, taking it in combination with your existing stress could be a deal breaker.

[Nique]

If I had to guess, it's all the stuff you've had to deal with for years plus now it sounds like you're treating kids more often. I've heard battle-hardened firefighters say that they never get used to seeing kids hurt, or dead.

[Amake]

My advice is try to find a little break. Maybe a day or so. The vast majority of humans cannot work a job for more than 40 hours a week indefinetly before their body and mind begins to break down. I understand in the field of medicine you're held to a far higher standard, and at least going by what I've learned from watching Scrubs you need to be able to cope with extreme stress 24/7 to have a chance of getting to the top of the field, but I certainly hope that's not a requirement to stay in the game at all. You may* need to take a breath now and then, like any human being, but from where I'm standing you're still a pretty good EMT. I guess what I'm getting at is, what would happen if you took a sick day?

My personal method of coping is a lifestyle based almost entirely on avoiding stress, so I might not be in a position to advice you at all. But taking a pause to reflect and restore almost always helps, if you can.

*That's pure speculation on my part.

[Specterbane]

I'm not sure what I have to say will help a lot, but here goes. My best friend is getting to the end of his Med Schooling himself, and there are a few things we've talked about or that I've heard from him that I hope will help.

1) From one of this teaching Docs. "You don't fuck around with Meningitis." My understanding is that if it's bacterial it can kill you in a day, going from "feelin' fine" to coffin measuring that quick takes drastic measures. Dealing with the stress and pain of seeing that in a child who can't understand all that is something I can't imagine going though, but as hard as it was you did the right thing when other's could have made excuses. THAT is a rare quality and one you should be proud of, even with as hard as it is.

2) My friend's Dad told him a story a while back as he was going into Med school, don't know how true it is but it seems like he learned from it.
So there are these three ER Docs on call in a night shift at a hospital in the middle of the city. They've been dealing with patience all day and are exhausted and terribly hungry, so they get together and order a pizza. Pizza place says it'll get there in 30 minuets to and an hour; so they wait, continue their rounds, watch the clock a few times and the hour goes by. Continuing to wait they check on patience, do some busy work that doctors do, and rest for a bit being hungry and tiered, it's not been a few hours. Suddenly and emergency is brought in, gunshot victim bleeding badly for an unknown amount of time. The Docs rush to help and work for what seems like hours trying to stop the bleeding, get the bullet and treat the victim. The kid dies, even with the Doc's best effort. Exhausted, they sit down and have some pizza that finally got there, resting and taking in what just happened silently. But when had the pizza gotten there? Who'd paid for it? They realize the kid they'd done their best to save was the delivery guy. Finally one of the Docs says "So what do we tip him?" The other Docs look at him, laugh a bit, and get back to work.

Helping people is grueling work, and it doesn't always pay off. The hard truth is sometimes you just need to make a joke to get by. But someone's got to do it, and like you said you're doing great. I don't know if it'll help, but find something to laugh at; doesn't have to be related to what's stressing you, but take a moment to laugh and see if that helps out.

Finally, to end this wall of text, 3) Worst case, carry around some lolly-pops when you work with kids. When you can give them one for being so brave at going through those hard procedures. And be happy that they can have that little bit of hard sugar syrup.

That's everything I can think of. I hope it helps, and I'll be praying for you for what it's worth Batgirl. Good luck, you make us all proud of you that you're on these forums and that we get to read the stories of your bravery.

[Terex4]

I think my main issue is that for 7 years as an EMT, nothing has really phased me. I see people dying, people sick, people who should be dead etc and it doesn't bother me. Blood, guts, gore, piss, shit, vomit; it all means nothing to me. From the time I made that first intubation so many months ago and until now has been the first time I've been shaken up from all this.
You're human. Of course 7 years in and you're just now experiencing this for the first time, I'd dare say superhuman.

We all have our moments, and, truth be told, you're one of the strongest people I've ever known. I'm with IQ on this one though, how much would it hurt to take a sick day? It sounds like some R&R is what you really need.

[CelesJessa]

I think my main issue is that for 7 years as an EMT, nothing has really phased me. I see people dying, people sick, people who should be dead etc and it doesn't bother me. Blood, guts, gore, piss, shit, vomit; it all means nothing to me. From the time I made that first intubation so many months ago and until now has been the first time I've been shaken up from all this.

My dad is a nurse in the ER and he was one for quite awhile before I was born (I think he was an EMT for awhile too), but shortly after I was born, he had to treat an infant girl who was about the same age as me. Even after so many years and everything he's seen, it still shook him up, and he's probably one of the strongest people I know. But still, 24 years later, he's still doing it.

It's okay- normal, even, to feel bad. Just remember that you're doing the right thing, helping people, even when it's hard to do so. Those girls would be a lot worse off if they didn't have someone like you helping them.

It makes me think of when my brother had cancer. Sometimes I would go with him to get his chemotherapy, and because of his age, he went to the pediatric oncology ward, which meant lots of little kids with cancer. It was really damn hard seeing little kids getting the same treatment, and I can't imagine what it's like being the nurses and doctors there, having to give chemotherapy to the kids, but the important thing is that they are getting the treatment they need so that they can grow up happy and healthy, even if the treatment is terrible. Those doctors and nurses are heroes, and so are you Batgirl

[Bard The 5th LW]

Just remember that these kids would very likely be worse off if it weren't for you and others. Its not your fault they are in bad condition.

The post atleast seems like your approaching the end of your classes as well. This may very well not be the best of advice, but maybe you just gotta make it over the hump as for as that goes? It gets more and more difficult, but if you can endure then the stress from that particular thing can be done with.

[The Murderer]

I can't really say much that other people haven't already said and i haven't been on these forums long, so i don't really know much about you but you shouldn't feel bad or guilty for any of this. Your the one trying to help them and if you didn't the result would be much worse. Of course to fell bad for this is just to be human

Your clearly stressed out and you really should be taking a break. Lord knows i couldn't stay up and work as much as you do. I would have to take a break sooner or later.

[synkr0nized]

I have issues with focus and coping with stress, but like I can't in good conscience claim working on software and meeting paper deadlines is on the same level as dealing with emergency procedures and human lives.

So my advice to drink and play video games is likely off-target (besides, I'm still not done, so clearly it's worked out well for me).

I think it's worth noting that you start out talking about being burned out and then give multiple examples of events that have hit you that all involved children. I am assuming, as EMT work goes where the calls are coming from, you can't just try not to deal with children, but it does sound like you might be served by time off, if you can get it, and/or not having to deal with those kinds of procedures. I don't know how you'd be able to manage that, as I have no knowledge of the inner workings of your workplace.

Can you cut back on what you are doing? Most folks I know that are still in some kind of education AND pulling jobs aren't also adding a second job on top of that, and they already have full plates. I don't presume to know how stressful it is to not only still be in classes in a med program but also working two jobs; I am fortunate enough to get funding from my lab as I work on my dissertation (at least for now...).

[Bells]

Think of a Firefighter... Military personnel, Cops, Submarine rescue Divers...

These people go through thousands of hours of training and testing and challenges to obtain 2 skills:

1- Be able to negate your natural instincts
2- Remember complex procedures under pressure and do them.

You are one of these people. Firefighters run right into the fire because there is one more person in there, even when the fire cannot be stopped. Cops rush in into the unknown, sometimes outnumbered, sometimes out-gunned because they feel they have too.

You start to hear what people like the marines or the navy seals have to do for their training and you start to "get it" that you, yourself also falls into that category, because you know that what you're doing is better than what these people will have to go through if you don't do it. You ARE helping, you know it. It's not even a gut feeling... it's in the books you read, it's in the talks you have with more experience people... it's tried and true, proven fact that your actions save lives.

The one thing that some have and some loose is that you give a damn, that sometimes will be a barrier that can cost you seconds or precision to do a high risk maneuver... but it's because of stuff like that, that you never really work alone! Because there is someone else there with you that can take over.

On the other hand, sometimes this will be your best asset. That will be the thing that pushes you to check things twice, comfort people at their best and their worst and will also be what makes you feel that special feeling i know you do when things go 100% well.

Which also means that in YOUR job, when someone that does the same as you do, cracks and fails, you are the exact type of people they need around to get back up...

You said it yourself, it's the final stretch of this phase right? Breath in, buckle up and get moving... you've done this before, you can do it again.

And for god'sake woman, when you wake up on your day off please give yourself a nice present will ya? Something shiny and pretty, i'm pretty sure you earn it. Also purple, make it purple.

[Overcast]

I can't say anything nobody else has said before. Hang in there. You are still human so find something to blow this steam out on, we can help with that I'm sure because we are all terrible. You will be great, because you already are.

[shiney]

Maybe you should speak with a mentor type person or someone you work with regularly that you trust and respect and who has been doing medical work, emergency or no, for a long time. They may have insights you could use to help yourself through this time.

[Osterbaum]

I think you need a break.

[Overcast]

Sometimes we aren't allowed a break if we are attempting to complete an assignment. This is a school, a program in order to become an EMT, this isn't just the job it is qualification. You can't just ask them to put the program on hiatus just for you, and I'm sure she won't want to start over.

I don't think a break is possible until it is over. Though I will admit this is just an assumption.

[akaSM]

Hey Batgirl, I'm not sure if you can take a break as in take a week off but, maybe your colleagues can help you offload some work, if you ask them to.

Also, you've been in this for 7 years, right? I'm sure you've been doing a great job for those 7 years and that you'll be able to finish your schooling. Seeing kids in bad situations can be heart wrenching but remember, you're there to help them.

There'll be situations were you won't be able to save or cure a patient but remember, a doctor's job isn't only about curing people or saving lives. Doctors are there to help the patient feel better, you might not be able to save every single patient but, from what you told us, you're great at making the patients feel better.

Keep up the good work and, don't forget we're here to help you.

[batgirl]

Thanks everyone, I appreciate the words of encouragement and kindness. Unfortunately I can't take a break right now, as I have:

a- A program to finish
b- My life prescheduled through August
c- Bills and rent

So I will do my best to try and relax when I can a bit more, and I'll just soldier on as I always do.

Thanks everyone!

[BitVyper]

You might want to investigate simple breathing excersizes. I've always found it effective for just forcing my mind and body to calm down. Even just like, practicing abdominal breathing. I also tend to do a lot of little things to keep my mind from spazzing out and going all over the place. Counting little actions like footsteps, breaths, or even heartbeats has always been helpful for me.

Calm music and mantras I find can help too. You sorta gotta make them work though - you know, actually make yourself believe in it.

[rpgdemon]

This may or may not help, but keep in mind: No matter what you're facing, if you weren't there, it would all be that much worse. You're helping these situations.

[synkr0nized]

Thanks everyone, I appreciate the words of encouragement and kindness. Unfortunately I can't take a break right now, as I have:

a- A program to finish
b- My life prescheduled through August
c- Bills and rent

So I will do my best to try and relax when I can a bit more, and I'll just soldier on as I always do.

Thanks everyone!

Again, as just some poster on a forum I know I'm significantly removed from your situation and ultimately not able to offer much help, but I feel like I should point out that this post reads a little like, "OK, thanks, going to ignore the issue now and keep at it." I hope you don't burn out! <random rooting for you>

[Overcast]

We are cheerleaders synk. At least when we aren't terrible dicks.

[synkr0nized]

At least when we aren't terrible dicks.

I like how folks here like to post things like this like at least once a week. It's kind of cute that you think NPF is at all that bad.

[Overcast]

See just like that, terrible terrible dicks.

[shiney]

Look at synk trying to keep us from our dreams of being the worst place on the internet. :/

The same synk who routinely links pictures that would make a baby-eating rapist arsassin* blush.

The same synk who got us in legal trouble no fewer than fourteen times last year and reaped our single highest count of C&D orders received in a month.

The same synk who really sucks and is mean. :<

* Arsonist & assassin!

[akaSM]

Yeah, seriously, what kind of people are we if some of us gather most weekends to get a chance to:


Puke at others
Spit green corrosive goo at others
Hump your friends' heads
Headshot people (Shyria! :argh:)
Throw pee darts at others
Throw pee jars at others


Among other insanities.

[rpgdemon]

I like how folks here like to post things like this like at least once a week. It's kind of cute that you think NPF is at all that bad.

Well, to be fair, if the biggest argument was about gender stuff, it might mean that we are literally -terrible- dicks.

[The Murderer]

A forum full of people with a dream to turn there virtual home into the worst place on the internet by giving headshots to people and puking on each other? yesssssss

[POS Industries]

A forum full of people with a dream to turn there virtual home into the worst place on the internet by giving headshots to people and puking on each other? yesssssss
This is the empire of shit men like me have spent their whole lives working to build.

You know, for the benefit of future generations.

[The Murderer]

And you have indeed made a great one.

[synkr0nized]

Look at synk trying to keep us from our dreams of being the worst place on the internet. :/

The same synk who routinely links pictures that would make a baby-eating rapist arsassin* blush.

The same synk who got us in legal trouble no fewer than fourteen times last year and reaped our single highest count of C&D orders received in a month.

The same synk who really sucks and is mean. :<

* Arsonist & assassin!


I thought I told you to keep quiet about all that. You know what this means now.

[shiney]

Did you seriously just quote Spelling the Vacuum? You're awesome.

[Ecks]

I just left a thread about killing people related to political nonsense and mumbo jumbo to this thread about a poor overworked batgirl FULL OF ADVICE AND HELP. I could feel the love man. Then you terrible dicks had to end the moment, and we're back to being less of an asshole than some other places on the internet. Thanks guys, I was going TO SHOWER THE BOARD WITH PRAISES!

Dicks.