Burnout: More Than Just Feeling Tired

Introduction

Do you wake up already exhausted, dreading the first alarm that tells you it is time to get ready for work? You are not alone. A 2020 survey conducted by the American Nurses Association found that 62% of nurses reported experiencing burnout. And the number keeps climbing.

As nurses, we face numerous stressors that most other occupations cannot even begin to imagine. Yet most of us still whisper about it in break rooms instead of treating burnout like the full-blown occupational hazard it is. We are often reluctant to discuss it openly. Why?

In this post, I will help you recognize the early signs of burnout—because the sooner you name it, the sooner you can start healing.

Burnout—More Than Just Feeling Tired

Burnout is not just exhaustion. It is a sustained state of physical, emotional, and mental depletion that no weekend off can cure.

Psychologist Herbert Freudenberger first coined the term “burnout” in the 1970s, observing how healthcare workers became emotionally drained, demotivated, and overwhelmed by the high demands of selfless care.

The World Health Organization in 2019 recognized burnout as an occupational phenomenon with three core dimensions:

• Exhaustion
  
• Cynicism / Detachment from Work
  
• Reduced Professional Efficacy
  

Let us unpack what that looks like in real life.

Exhaustion: The Battery That Will Not Recharge

You sleep, yet you still wake up exhausted. You cannot recall the last time you woke up refreshed, even after a long weekend off. Before your shift even starts, your legs ache. Charting feels heavier than the IV pump. You catch yourself daydreaming about just lying down—anywhere—more than you think about your patients’ care plans. Your internal battery never quite recharges.

Cynicism / Detachment: Silent Compassion Fatigue

You find yourself emotionally shutting down and distancing from your patients? You are on autopilot, working long shifts but appearing competent and calm. Eyes on the clock. Rather than feeling the usual empathy, you now ask, Why bother? It is not that you do not care; it is because caring has started to feel like a liability you can no longer afford to have.

Reduced Professional Efficacy: Doubting Your Skills

Questioning whether you are any good at your job anymore? Small mistakes. Confidence in your clinical judgment erodes. You question positive feedback because you believe you are slipping. Simple tasks that once felt easy now take more effort. The result is a loop: low efficiency → more self-doubt → and even lower efficiency.

If left unaddressed, burnout morphs into anxiety, chronic inflammation, or clinical depression. Recognizing it early keeps the spiral from deepening.

Signs Of Burnout In Nursing

Physical Clues

• Fatigue that is bone-deep, not fixed by sleep – You feel physically exhausted regardless of the amount of sleep or rest.
• Frequent GI flare-ups, headaches, or pain – Physical tension manifests as new or persistent gastrointestinal issues, body aches, and pain.
• Altered sleep pattern – Even when you are exhausted, you are still unable to get good quality sleep.
• The immune system weakens – Your immune system is affected due to alterations in your sleep pattern, fatigue, and generalized manifestations.

Emotional Clues

• Irritabile: Your mood swings and your patience run thin. Things that never used to bother you suddenly feel like too much. You might feel snappy, constantly on edge without knowing why. Most people will attribute it to menopause, but you might not even realize it is burnout until you stop and think about why everything feels meaningless.
• Feeling numb or detached: You experience a disconnection from yourself, accompanied by a diminished sense of joy or excitement. Things happen, and you know you should care or react; instead, you catch yourself thinking, “What’s the point?”, ‘Why bother?’
• Work feels like a trap: You wake up exhausted just thinking about work and wishing you could call in sick. Finally, you go to work, but you feel drained even before your shift begins.

Cognitive Clues (Brain Fog)

• Concentration issues – You are unable to focus on tasks.
• Forgetting tasks – Missing vital steps in care or forgetting routine tasks.
• Mental exhaustion – Mental exhaustion even with minimal effort.
• Cognitive distortions – The tendency to focus on negative aspects of situations while ignoring positive ones. When you incorrectly feel that your work or opinion does not matter.

Professional Clues

• Increased absenteeism or lateness – Finding excuses to avoid work.
• Reduced work performance – Tasks take longer, or you are unable to complete tasks you would normally do with ease, and making clinical decisions also feels exhausting.
• Depersonalization – You treat patients like tasks instead of people.
• Loss of professional pride – Are you tired of the nursing profession already? Do you regret ever becoming a nurse or even considering a career change altogether? You may have lost your professional pride.

Why Nurses Burnout

Let us be clear, burnout is not a personal failure. It is a predictable response to unsustainable conditions and stressors. Here are some of the common stressors I notice frequently.

Systemic Stressors

• Unsafe staffing ratios: Assigning too many tasks to one nurse to cover the work of two or more nurses, sprinting from bed to bed and rationing attention, rather than providing genuine care, creates a relentless gap between demand and what is safe. In addition to the long hours and insufficient rest, every task becomes a crisis, leading to physical exhaustion and moral fatigue.
  
• High patient acuity with no adjustment in workload: Nurses already deal with multiple tasks and or responsibilities. Increased patient acuity means nurses are dealing with an even higher workload and more complex cases, as well as unceasing interventions, assessments, and reassessments.
  
• Excessive EHR charting is draining focus: On some days, we spend more time navigating the electronic health record than actually caring for our patients. The nonstop EHR clicks piling on top of already heavy workloads leave you mentally fried with blurred eyes, aching wrists, and emotionally distant from the reason you became a nurse in the first place.
  
• Poor leadership and management bias: Bias or ineffective management undermines team performance and organizational success, leading to demoralization, a lack of trust, and encourages workplace mobbing. Other leadership and managerial aspects include blame culture, unfair treatment, and documentation audits that highlight errors more than wins. Nurses who work at supportive workplaces thrive, while toxic ones increase risk of burnout.
• Lack of control: Having minimal input or autonomy in how tasks are performed or how decisions are made can be frustrating and may lead to a sense of powerlessness. The feeling of being controlled and micromanaged can increase stress and potentially lead to nurses feeling less invested in their job.

Toxic Work Dynamics

• Eat-your-young phenomenon: Describes a toxic workplace dynamic where old nurses undermine, bully, withhold information, or overburden new nurses instead of mentoring them, turning what should be peer support into internal cannibalism. Nurses who work in supportive workplaces tend to thrive, while those in toxic ones are at a higher risk of burnout.
  
• Snake-eat-snake phenomenon: Lateral violence, or what I refer to as the snake-eat-snake phenomenon, describes a situation in which nurses undermine one another through gossip, sabotage, and exclusion. It could be because a nurse possesses a higher degree, or is more skilled, or a travel nurse earning slightly more than the permanent staff, or it could be for no reason at all. Lateral violence can lead to decreased self-esteem, increased stress, and high staff turnover, ultimately affecting patient safety and quality of care.
  
• Hidden Curriculum or Agenda: There is a common misconception that nurses receive high pay for little work, leading to envy, disrespect, and a tendency to form cliques. Have non-nursing coworker/s targeted you for no reason? I have been there.

Personal Hot Buttons

• Perfectionism: The perfectionist mindset, such as adhering to zero mistakes or late submissions, or if my assessment note is not flawless, I will appear incompetent.  
  
• Low self-esteem: A quiet, relentless voice that says, I am not good enough. Erodes confidence, exhaustion arrives more quickly, cynicism cuts deeper, and recovery takes longer. Over-apologizing, comparing oneself to others, having difficulty accepting praise, and failing to contribute during team assignments are common signs of low self-esteem.
  
• People-pleasing: Nurses who tend to neglect their own needs, such as ignoring meals and breaks to help others and not getting enough sleep and rest, tend to burn out faster.
  
• Difficulty setting boundaries: Some of us struggle to say no to overtime or double shift opportunities, thereby blurring the line between work and life, leading to overwork and inability to manage workload effectively.

When these collide, even the strongest eventually cracks, which brings us to the next step.

📌 Bookmark this spot and return next week for our deep dive into Hidden Costs of Nurse Burnout: Health, Job, and Income.

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