I have indeed experienced all 5. But, I think the biggest thing we can do is support each other as nurses. When the team is kind to you, these stresses are much easier to navigate through.

Amen, sisters!

I too have experienced all 5. Stress is much improved when nurses help each other and don't chew each other up. During my 36 years there have always been those days when staffing is inadequate. When you go home with an enhanced level of cognitive dissonance because it is humanly impossible to do a good job because there is just too much. It has now become the daily standard in most hospitals to use as few staff as possible. When a nurse is forced to have large, high acuity assignments on a daily basis, and must run all shift long just to get the minimum done, our beloved profession is reduced to sweat-shop labor. That stress is leading to an early onset of burn out, which will compound the problem in the long run. The answer is not an easy one because simply by accepting those assignments, which most must do to pay the bills, we are in fact condoning them, therefore, they will continue.

I've experienced the first four and many close calls. There's another major stressor that has not been mentioned in this article. It has to do with coming on your shift following nurses who are easily distracted, who do not possess critical thinking skill, or who just plain don't care. I call the latter ones "mercenary nurses". Unfortunately, I've met many of them in my time. This being one of the reasons why I've been working 16 hr shifts for many years. I know studies have shown it is not safe to be at work for so many hours and I guess must people find it hard. For me is the best way to get to know my patient's needs and be proactive in taking care of them in a timely manner. Often when I work 8 hrs, I feel like I'm walking into a mine field. Not very comforting especially during busy times when one does not know the patients. As you all know well, shift report leaves many details out, sometimes leaves what I sarcastically call "a minor detail". I totally agree with Debbie D in the point she makes about short staffing. For many years I went home crying and feeling so inadequate. I've learned to be outspoken and to be a nurse/patient's advocate when others kept silent. Its been a lonely road and I have to confess that it has not made me very popular, but in the long run, its been worth it and somethings have change for the best because of it. Nursing is like anything in life. It has many rewards and heart-breaks and you have to take the good with the bad. Most of all, don't take it home with you!

There are other stressors. I've been nursing for over 40 years now. I sometimes ask God why He has given it to me to witness things I cannot change and cannot help, and things that are traumatic in the most basic sense of the word to both the patient and me. I'm concluding that witnessing is a form of helping, too. When a patient is especially brave or especially frightened, it's important to witness them--to be there for them and to let their courage or their fear affect you. As for what was said about aging in nursing, it's true that the ER is not kind to older nurses. For awhile I felt it was my fault that the others seemed faster, that they all rushed in to the "sexy" stuff like codes. Well, I'm not as fast, but I'm much more thorough. I don't let my patients sit on urine-soaked sheets. I can do codes, but I can do what others won't --I take care of "down-and-out" people, the homeless, the drunks, the criminals, the patients in psychiatric crisis. My chief complaint with nursing today is that we seem to serve the computer more than the patient, and that we have to be so careful to CYA that we sometimes cannot be honest with our patients. As far as doing more with less goes, that's not what administrators necessarily want, it's what they have to do to help their institutions to survive in this economy and in this political environment. And Sandy, don't keep those 16 hour shifts going on much longer. At some point you have to trust your co-workers to care for the patients. You can't be there 24-7. And you can't be sharp in your 16th hour. Not if you want to nurse into your later adult years.

My first patient death was actually a calming experience. It was my very last day of clinicals in nursing school. She was an unresponsive elderly DNR and no family was present at the time. About half an hour before my final shift was over, my preceptor found her quietly gone. She called me into the room and we freed the patient from the oxygen mask, called her doctor, and wrote it in her chart. A very peaceful way to end my nursing school experience.

After 23 years in critical care and never letting anything get to me I was a victim of workplace bullying(a mobbing) at a bush hospital in Alaska. None of these events you listed compare, I have PTSD and find it very difficult to live on social security disability.

I'm a 30 year veteran of nursing also. I work at a small hospital in a large healthcare system. I feel strong support from administration, managers, co-workers and the physicians. The stress I feel is related to the physical aspect of patient care, with patients being so much sicker than the patients I cared for in the 80's. Back then they stayed overnight prior to an UGI so we could keep them NPO! Working in ICU for about 20 years now, the pt care has become more & more demanding. Still, the work for me is it's own reward. We see people at their worst, and we hold the awesome power to set them at ease, both physically & emotionally. I feel that our profession has gained more & more respect over the past 30 years. I remember the days of doctors yelling & throwing charts & getting away with it, but it doesn't happen anymore- at least not in my town. Now I find that they do value our opinion and our observations, as well they should since we are with that patient 60X as much as they are. I have seen many patients die, and I am honored to be the one who is there to comfort pt & family in the last precious hours. This is the most wonderful profession there is, and I want to work as a bedside ICU nurse until the day I can't crawl to work anymore.

Many people come into the profession of nursing with their own emotional baggage which hinders their ability to provide competent care. Many people get into helping professions to fill their own needs, and they quickly become bitter and disillusioned when the role does not meet their expectations. You should not embark on a nursing career because you want to be a hero or savior for all the world to see and adore. The most effective nurses are the ones who realize that from the moment you put on the uniform, "It's not about you!" You are their to help a client as best you can using the skills and knowledge imparted to you because that's what a professional does. That client may not appreciate or follow through on your efforts, but that is their choice, and judgement will not help them either. It's called professional boundaries. I have witnessed many cruel, selfish, intolerant nurses in my career. Each time the problem stemmed from an outsized sense of entitlement and a grandiose need for recognition of the self. I call them glory hounds because they care about their patients, profession, or coworkers only if it will impart to them some special reward or recognition.