Storytime! I was overnight charge nurse of an acute inpatient psychiatric unit every single night I worked (3/7 days a week) for over a year with a full set of patients every night the same as any other nurse working each of those nights except I also had to make sure all the unit administrative tasks got done (some of which would be critiqued by the incoming shift, particularly the assignment / patient split I made for the next shift).

I was really really good at it. I've been working high acuity units for years including specialized units for patients facing legal charges so I know how to handle some really violent patients but I've also been an inpatient myself more than once so I know how to approach a lot of issues with a lot more ...understanding? I guess? Than most. I was really good at it. Even when I wasn't charge nurse I'd wind up taking care of other people's patients so their patients wigging out wouldn't start affecting my patients or for bigger incidents half the time I was the only person that even knew what to do.

But then comes the "we can't assign anyone else because you're the best at it." Well if I'm going to be the dedicated charge nurse can I not have my own patients? Well no we don't have the staff for that. Well can I go work another unit for just one day each week? Can I go work the clinical liason team and respond to behavioral codes in the hospitals medical units? Well no we need you here. And so on an and so on.

And then they start telling me I need to tighten up on my night shift. Don't let them hide in the nurses station but they're not allowed to take anything on the unit to make them comfortable out there even if they keep track of it all carefully. Make sure they do every single round and and it doesn't matter if that wakes the patients up every fifteen minutes (and on top of everything else you're doing you personally need to make sure each person is doing their checks every fifteen minutes). Make sure they clean the whole unit every night. Audit their charting and make sure they're not missing anything.

I lost 40 pounds at that job by the time the supervisor came into the nurses station in the middle of morning report to yell at me about not doing it right. I handed her my badge and left.

The entire time people were offering to listen, to be there for me emotionally. We work in mental health and sometimes you just need someone to listen, right? I had plenty of people listening but no one was helping. Even when I was explicitly offering specific ways to just lighten up on me a little, they said no. They even blocked my attempts to apply to other units in the hospital. Every single night I worked it was like having my head shoved under water and the dread I felt every day before work was literally making me physically ill.

Listening only goes so far.