A Nurse’s Journey With Mental Health

Helping is a beautiful thing, but when it becomes a person’s identity, it can bring with it a lot of pain as well. I always wanted to help others. After years as a paramedic with the ambulance service, I decided to explore what I then considered a more sustainable career path and went to university to become a registered nurse. It seemed a great option; I could gain knowledge, help more, earn a more livable wage, and be safer while doing it.

A nursing instructor and mentor once told me that nursing school was a double-edged sword. It teaches students how to do the absolute best job for patients, and then graduates them into a healthcare system where they will never be able to practice like that. This contrast between the growing body of education and knowledge, and the reality with which nurses work in creates immense pressure and stress. This is often called moral distress.

That beautiful desire to help others, which is a strong value, can leave us in the water outside the Titanic, thrashing to get as many of the people around us into the lifeboats while we slowly freeze in the cold water. In time, we all know where that leads, but we keep going because we believe in the sacrifices and in the duty we’ve taken on.

A Changing Profession

I grew up in BC in the 1990s. My mother worked in hospitals as a unit clerk, and many of her friends were nurses. Because of this, I spent a lot of time during my childhood and adolescence visiting and spending time at the nursing station. This undoubtedly coloured my experience of what I thought it was like to be a nurse. The next time in my life I spent a lot of time around nurses was as a paramedic, bringing patients to the hospital or transporting them between hospitals, with nurses riding in the ambulance with me.

Things had changed significantly by the time I was a paramedic in the mid 00s, and they have changed even more drastically since then, particularly since COVID. In the early 90s, the average nursing shift in BC lasted 8 hours. Now, the minimum is 12, and the average is often 14 or longer. In the 90s, the average nurse could generally expect to stay in the profession for 30 years, or until retirement age. Now, we are bleeding nurses faster than we can train them, with as many as 40% leaving the profession in as little as 2-5 years.

The nursing world I entered in 2015 was already overworked, understaffed, and working with a significant risk of personal injury. In a world where workplace injuries are decreasing across the board, nursing remains one of the top careers in terms of worker injury. On top of that, nursing wages have not kept pace, while the education required to become an RN has dramatically increased in most places.

The Rise of Nursing Burnout

All of these things contribute to the overall well-being and mental health of nurses. Burnout among nurses has reached an absolute crisis. National data reveal that the majority of Canadian nurses experience symptoms of burnout and a startling number meet criteria for intense, clinical burnout. We can engage on the numbers in a much larger discussion than I can write about in a blog post, but I don’t see much point to it. I know it’s bad, and the chances are that if you’re reading this, you know it’s bad too. 

Nursing has a somewhat unique situation. I’ve seen in myself and my colleagues that most of the people who enter the profession are doing so from a true desire, a calling, to help decrease suffering in others. Because of the desire to be a helper, it can be difficult to talk about the negative emotions and pain that can come with the job. When we can’t talk about something, we tend to internalize it.

Helpers often struggle with balance. I know I certainly do. Left unexplored, it can be like continuing to place bricks into our backpack, and eventually we get bowed over from the crushing weight of everything that we’re carrying, because nurses are not just nursing. We’re either dating or married. Maybe we have pets, or children, or ageing parents, or friends. This is good on the one hand, to be invested in life, but what happens when things fall out of balance?

Falling out of balance

I convinced myself I had to work more, do more, and simultaneously be there for my parents, friends, and community whenever I was needed. Because I had convinced myself that I was a helper, it felt like asking for help meant I wasn’t good enough, or strong enough, or that I was somehow a failure. When confronted by those feelings, it felt like the only thing I could do was to try harder and prove myself wrong. It can feel like trying to hold sand in our hands even as it slips from our grasp, and then blaming ourselves for not holding tighter.

It can be even harder for helpers to stop, even when continuing harms them, because of the guilt and shame associated with stopping. If I don’t show up for my shift, the team will be that much worse off, or my patients won’t get the care they need. We fall into the trap of thinking that the entire healthcare system, and thus our society, depends on us doing this task that is slowly harming us.

My Turning Point

I couldn’t let go, and it led to the severe burnout that eventually ended my nursing career and plunged me into a depression. The turning point for me was when I chose to take action and speak to a counsellor. Counselling changed my life, and not in any specific theoretical way, but in a real, grounded way. I found a counsellor who partnered with me, co-created an environment that felt safe and free of judgment. That experience of counselling led me to a place where I could pause, find my center, and move forward with a greater sense of meaning and purpose than I had ever had previously. That counsellor helped me see that I was in the water, and in those sessions, I was able to realize that I wanted to get into the lifeboat. There is nothing wrong with wanting to help those that are suffering, but I realized that if I stayed in the water, I would have tired out, or the frigid waters of the North Atlantic would have caused me to get hypothermic, and I’ll drown. 

I was at a choice point: If I wanted to survive, I had to climb into a boat, or accept someone’s hand and assistance. Once I was safe in a boat, dry and warm, I realized that I was able to resume helping others from a sustainable position. As a counsellor, I was able to build myself a position to support others that are still in the water to climb into their own boats.