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]

Originally Posted by batgirl

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.