Sarah Lavonne: Hi, I'm Sarah Lavonne, and I'm so glad you're here. Here at Bundle Birth, we believe that your life has the potential to make a deep, meaningful impact on the world around you. You, as a nurse, have the ability to add value to every person and patient you touch. We want to inspire you with the resources, education, and stories to support you to live your absolute best life, both in and outside of work. Don't expect perfection over here. We're just here to have some conversations about anything birth, work, and life, trying to add some happy to your hour as we all grow together. By nurses, for nurses. This is Happy Hour with Bundle Birth Nurses.
Many of you have found us on Instagram. That's sort of what led you here. Thank you for following us on Instagram. If you don't, feel free to. If you don't want to, then don't. No big deal. Over there, I recently did a This or That poll, which sometimes we do, and it's fun to ask questions from the community and sort of see where people are at, what their preferences are related to the job. Somebody wrote in that the question was this or that, and they said, "Are you burnt out or not?"
The answers, I can see what the poll results are. By the way, we're never looking at who says what. A lot of times, you'll DM us and be like, "I meant to say this." I'm like, "Okay. There's 7,000 responders. We're good. You're good. [chuckles] It's good. I'm not judging you." The question was are you feeling burnt out or not? Honestly, the answers, I had already been thinking about this, but this poll has had me in a rabbit hole and just really kind of obsessing about this issue of burnout.
Of the-- let me do the quick math. It was 6,189 people that responded. 3,027 people said, "Yes. I'm feeling burnt out," which was 49% of those that answered. This, literally, I sat for a day with and was just like, "I am unwell." I've known this is an issue. We're hearing it across the board. I see it in DMs. We talk about it with our nurse group, with our mentors. I also have been doing a lot of in-person speaking and trainings all over the country.
One of the presentations that I put together is called "The Unseen Force for Transformative Birth Experiences," which sounds really fancy. Basically, the punchline is, if you ever come to my talk on this, go with it. The answer is, you are the unseen force for transforming birth experiences. In there, I talk about moral injury and burnout. Obviously, I've been thinking about this, but when the poll came up, I was like, "Oh." It was very sobering. I'm like, "This is a problem."
What I want to do today is talk about burnout. I realize that the use of the word "burnout" is, to me, a little bit overused, and it's sort of like we're numb to it. I want to break that down and give a little bit on that. Then I wanted to have a conversation with our wise mentors, who are the fabulous, most talented, most compassionate humans that lead our mentorship program and the calls, and just have an honest conversation about burnout.
I had brought this to our Mentor Meeting, which we meet almost once a month, and just talk about what's going on and talk about you as a community and what can we do to better serve you and better provide that education and support. I had brought this question to the group, and just was like, "I am torn up about the burnout rates and how people are feeling. What do we do about this?"
Our responsibility as bundle birth nurses is to stand in the gap, and we've been standing in that gap with education and support being our priority. If they are struggling, what do we do about it? Part of that challenge is that we're mostly virtual, come to our Move Learning retreat because the whole point is helping refill your cup. What do we even do?
I wanted to, one, learn from them, but also have multiple conversations. I've invited them throughout this episode to pop in. I've had individual conversations with each one of them talking about different facets of burnout and really gleaning from their wisdom as we just have a conversation. That really is my goal for today. This is a unique episode that it's going to be a little pop-in/pop-out. Somewhat random, but also not. I hope you see the common thread throughout today because I don't have a solution. I really don't. I have already done the deep dive on burnout and the evidence on burnout and what actually helps.
I just rolled it back because the solution is not a formula. Often, we want that formula for how to fix it. I think the solution lies within. What that means is that if you're feeling burnt out, the solution is within you. I invite you to explore this episode together with the mentors and just take it in whether you're feeling burnt out or not, and just explore what might be here for you, what resonates, and maybe what might be your next steps.
There was a recent report that came out by the American Organization for Nursing Leadership and Laudio. They surveyed over 95,000 nurses across the country and asked them a bunch of questions about burnout. What they found was that they found eight burnout predictors among nurses that indicate burnout is happening. These are the predictors or how to tell that you are burnt out from this recent report.
The first one is arriving early for more than 50% of shifts, skipping breaks for more than 8% of shifts, leaving late for more than 50% of shifts, not taking PTO in the last 6 months, calling out such as an unscheduled absence for more than 10% of scheduled shifts, precepting for more than 20% total hours worked, serving as charge for more than 35% of shifts, and floating for more than 20% of the total hours worked. I think that's super interesting when we think about what's leading to burnout makes me curious.
Now, when we think about burnout as a whole, I want to make a very clear distinction. I think for me in my journey of learning about burnout and trying to figure out what is our solution, how do we help, how do we stand in without being the solution. I don't think I'm the solution. I don't think mentorship's the solution. I think that it's multifaceted, and I think it's going to be different for everybody.
Also, I know that in the moments that I have been burnt out, which has been multiple times, that I'm not currently burnt out anymore, and I haven't left birth. My job, it looks very different than it used to. That might be, and I do actually think that was a component of how I responded to my burnout, but I'm still here, and so are all of our mentors who have also been through burnout. I think I want to remind us that it's not forever, and yet I want to define some things for us to be able to know, is it burnout or is it something else?
That something else I want to define for us is something called moral injury. "Moral injury, by definition, is psychological distress resulting from actions or lack of them which violate an individual's moral or ethical code often occurring when clinicians are unable to provide care aligned with their values due to external constraints." It comes from B. Doll et al. 2024.
Some symptoms of moral injury are guilt, shame, regret, ruminating, loss of trust, depression, anxiety, anger, less ability to care, worse communication, less ability to advocate, or less professional engagement. I think there's a difference between moral injury in a moment and being morally injured as a whole because we all, I'm sure, can think of circumstances where that was moral injury and that is wearing on our systems. If you are a manager listening, we need to be paying attention to this stuff because what happens is it leads to burnout.
If you think about the cause of maybe some of you that are feeling on the burnt-out side, again, it's a spectrum. Burnout, by definition, is these three things. They contribute to, what would be called from the DSM, a burnout syndrome because of workplace stress. This is specific to workplace burnout. I think we can be burnt out in our lives, but we're specifically talking about being burnt out as a labor and delivery nurse.
Those three things are emotional exhaustion, depersonalization, which just means cynicism, sort of being negative, and detachment from your patients, so if they no longer-- it's harder to see them as human beings and just more like a job, or caring, like you can't care anymore, "I feel apathetic," and a diminished sense of personal accomplishment in the job. When we look at the stats specific to OB nurses, over 33% of OB nurses meet criteria for at least two burnout dimensions. If we break it down, 29% of OB nurses feel emotional exhaustion regularly, 19% feel depersonalization regularly, and 44% feel a diminished sense of personal accomplishment right now.
I do think that is reflective of what's going on in our culture of birth. Again, this just breaks my heart. What are we told? We're told to build resilience. "You should be more resilient." "What doesn't kill you makes you stronger." Yet, I love in the book Shatterproof, she talks about a resilience ceiling. This resilience ceiling, really, it's the limit beyond which traditional coping fails, where you have reached your max. You are done. You cannot do any more.
What ends up happening a lot of times is we do this thing called grit gaslighting, where we have a tendency to shame people for not persevering at all costs. The way I want to start today is that you matter. Your life matters. Your energy matters. Your time is currency. Your job matters. Your passion matters. Your joy matters.
If you are feeling any of these things, you relate to any of that. We don't want to shame you for not persevering at all costs, and instead, have space and have created space for a conversation related to all of this, so that you can show up as you are and just be and not be shamed for how you are.
As we have this conversation with these mentors, I hope you feel encouraged that you're not alone, that whatever feelings you're feeling, I guarantee you that we, at some place or time, have felt that way, and that there is hope on the horizon. I want to remind you that you're not going to be here forever. Carly(ph), I know, has an experience of burnout, and she is not currently burnt out. I would love to chat with Carly about how she moved through it and her experience of burnout.
Carly: Being a nurse is hard. Being a nurse in OB is hard. For me, I felt really burnt out in my career five years in, and I thought, "Maybe this isn't for me. Maybe I need to transition into something different." It felt hard to bear to bear witness to so much trauma and wanting things to be different than they were, and just feeling like a small piece of the solution and not enough to solve this really large problem.
For whatever reason, when I was moving through that, I felt like I needed more before I called it quits. I felt like I needed more tools, more education to turn things around for me. When I found Bundle Birth, I felt like this is the thing. I remember setting the alarm on my phone to sign up for mentorship. I remember feeling like this was the only thing that was going to save me.
I just had this gut feeling like, "This is what it's going to be," because I think it spoke to that part of me that felt like we want to solve this problem, but this is hard. I felt really seen for all the reasons that I was feeling burnt out. When I found mentorship, and I got in, the education, the confidence, the tools, everything turned things around for me.
I think it gave me more agency over my presence in the hospital. My role as a nurse, I felt more empowered, I felt more confident, and it didn't solve all these bigger problems. I think I just felt closer to the nurse I wanted to be. We're always closing that gap. It's always a journey, who you are and who you want to be. We're always working towards that. It's always changing, which is a beautiful thing. We're always learning. It felt like it closed the gap quickly.
Sarah: I think something to note for those that don't know Carly, Carly, you are one of the most kind-hearted, compassionate, empathetic, soft, in the best way, people that I know. I can imagine that there's other people that get into birth and nursing that are that soft heart. I think there's a spectrum of people [chuckles] that get into labor and delivery. I think I'm very empathetic, but I'm also like-- kind of power through it and suck it up. "You got it. Grrr." You are not at all that.
I think it's just something to note that if you are a listener, and I think we can be all across the spectrum, and feeling burnt out. There is something to say for those that are a lot more tender naturally. I think that's beautiful. It's something I admire in you. I think that there are certain components of labor and delivery that make it extra hard for people like that.
Carly: Yes. It felt like it was breaking me. I felt like the only option when I felt very burnt out was to become jaded and hardened and to turn into a different nurse. I didn't want to do that. The hospital I was in, we were really up against it. It was a hard place to work. It was a hard place to be a patient. The nurses that were able to keep working there became jaded. I don't blame them one bit. It was the only way through.
I was privileged enough to be able to leave and look for something different and move across the state. I think that if you're feeling like this is changing me at my core, this is changing the way I'm able to show up for my patients, that's where my tools come into play is identifying that early on because it still happens. There's still moments where I show up, and I'm not the fullest version of myself. I'm not giving my all. I'm not that soft version because that takes vulnerability, and that takes energy. The more in that soft side of myself I am, the more the job threatens to hurt me.
Sarah: Then how do you combat burnout, the system, and survive? Now you're well beyond five years and still here.
Carly: I'm still here.
Sarah: Thank God.
Carly: 10 years. [chuckles]
Sarah: Wow.
Carly: I'm still here. Yes. I do have a system to sustaining my spark. When my cup is full, when I'm feeling good, when I'm feeling well-rested, I'm in a groove, I take on more. I take on the things that really fill me up and ignite my spark. I pour into my committees, my patients, my coworkers. I go the extra mile. I take on teaching moments. I contribute to a project. I say yes to more. Maybe I compliment my coworkers and build them up because I know how good that feels when your cup isn't full.
This is the best version of myself. It's maybe half the time. It's not all of the time. Showing up bigger when I do feel capable ties me to my purpose. It makes me feel proud of myself. It reminds me of why I'm a nurse. I don't want to be a nurse if I can't access this side of myself.
Sarah: Can I ask how you know if your cup is full or not?
Carly: I'm excited to go to work. I want to sit with my patients for a very long time. I want to know everything about them. I feel really present. Those things are hard. It's not always the case. I don't care what assignment I have. I'm ready to roll. I feel lucky to be there. I always feel lucky to be there. I never lose sight of that. Especially, no matter what it is, I'm ready to take it on. It's just an energy. It's just how you feel at work.
Sarah: Then what do you do when your cup feels more empty and depleted?
Carly: Yes. It looks a lot different. I think a lot of the work is identifying this early so that I don't wait until I'm completely depleted and at a breaking point to fill that cup back up. When my cup is empty, I'm more in self-preservation mode. I do good enough. I tell myself that's okay. I really try my best to believe it. I conserve my resources. I just pour back into myself.
I think one thing that I've learned over the years is at this point, work is likely not going to fill my cup back up. I need to do that. Even a great shift, I'm still feeling a little burnt out. This looks like a really robust self-care routine, advocating for myself, having strong boundaries in and out of work, having a transition leaving work. For me, listening to music on my drive home. Going for a walk right when I get home. My off time will look a little lazier. I'm just trying to regulate my nervous system and feel grounded.
Yes. For me, burnout threatens to make me forget why I became a nurse. It disconnects me from my truest self. I need to anchor myself to that purpose. This looks like letters from patients in my locker, setting alarms on my phone with mantras. The one on my phone right now is-- it goes off 30 minutes into my shift. It says, "What would it look like to give it my all?"
Sarah: Aww. That's so cute. I love that. [chuckles]
Carly: Just trying to remember why I'm here.
Sarah: Well, I think when I'm listening to this, it takes a lot of intention, which is a lot of the reason why we're focusing in on burnout, because I think we tend to power through, myself included, and it's so easy to just go, go, go, go, and never slow down. What I'm hearing is you being extremely present in your body and in your sensations and in your brain and knowing, "Am I depleted or am I full?" Responding accordingly, and also really holding space for no matter where you're feeling in that. Whether you feel depleted or full, there's no judgment. It's just, "This is how it is, so I'm going to be more lazy." I love that.
Carly: Yes. I think it's important to remember that burnout is often due to structural issues. It is not your fault. Practicing this radical self-compassion and forgiveness when you get to that point, I think, is key. It is hard to be a nurse. We are constantly being asked to do more with less. We bear witness to heartbreaking trauma, often without any support for ourselves. We don't have safe staffing, manageable workloads. We put our needs last during our shift. We move quickly. Of course, our nervous systems [chuckles] feel fried. If we want to do this work, if we want to show up for our patients, which is such a privilege, then yes, it takes sustaining ourselves to keep going.
Sarah: Typically, I'll hear something, and then I'll be like, "Ooh. What about this? Ooh, how do we fix it here?" I am very much that "fix-it boyfriend" of yours that's like, "Well, have you tried blah, blah, blah? What if this?" A lot of times, where I am trying to practice more, especially in this conversation, is to just be and not try to fix it.
What I love about Carly's conversation is that it takes this deep awareness of your current state, and then an active response based on you knowing yourself so much. I think, though, when we think about and ask the question, "What do you do to get out of that feeling, to get out of a burnout state, to not feel the way you currently do?" What we hear all the time is, "Go do some self-care." "Get in the tub and take a bath," when you're like, "I don't even have a tub. I only have a shower." Or "Go light a candle," and you're like, "How in the world is that going to help me?" I do think that self-care is a little oversaturated. I know that one of our mentors, Bree(ph), has a take on this that I think is really good and interesting.
Bree: I love this question because it gives us the opportunity to really validate our burnt-out listeners and why it does feel so cringy when they hear all the self-care. It's because nurses are not exactly burnt out because they're not deep breathing or taking the bubble bath, like you said. Burnout is a multifactorial systemic problem, really, a learned helplessness from prolonged work trauma and stress that results to a feeling of overwhelming powerlessness.
I even think burnout can be a symptom of suppressed grief from personal life, work life, or even a loss of self from, disregarding our core values. Yes. When self-care ideas or strategies are thrown out at us nurses, it can feel like putting a smiley-faced band-aid on the perineum of a stage 3 hemorrhaging patient. It's just cringy because it can come off deliberately ignorant because, A, it's super simple for a complex issue, and B, it puts the blame specifically on the nurse rather than the full system.
Sarah: Then are you saying that self-care techniques are not effective at combating burnout, so we shouldn't do self-care?
Bree: Dr. Brian Adair, professor at USC, states, "We can't yoga our way out of this when referring to burnout." I'm a yogi myself. I'm a big fan of self-care techniques, yet I still believe burnout is a shared responsibility between the individual nurse, management, administration, and even government. Yet, this is where it gets tricky because where do we have control as nurses? The more value we put in things outside of our control, the less control we have, meaning, we give our power away when we focus on what is out of our control rather than focusing on what we do have control over.
Sarah: What do we have control over?
Bree: I think when we get down to the very foundation, what we do have control over is our agency, which, really, I believe is really the only thing in this life that is truly ours. As a bundle birth nurse, we really fiercely protect patient's agency, "team underwear," Justine's term, with our cute little pin to signify we protect our patient's choice from as little as if they want undies or not.
What if we stepped into our power of truly protecting, owning, and exercising our agency and accountability for our life? Again, I'm not saying burnout is nurse's fault. It's prolonged work trauma and stress, perhaps even suppressed grief and loss of self. What I am saying is empowerment comes from exercising agency. The sense that we can be a hammer instead of a nail in life, meaning we are at cause rather than effect. Agency is really the opposite of helplessness.
Sarah: What have you found in your life that's been helpful to understand about agency? When you felt out of control, what are the types of things that you've grasped onto control to give us an example of what that could look like?
Bree: I think that the most effective way to do this is not necessarily going above and beyond because that takes so much more energy, and a lot of us don't have any more energy, but maybe switching habits for more healthier, empowering ones. For nurses, that could look like an intentional work playlist on the way to work, choosing to walk up the stairs, or as they go up the elevator, using a visualization.
One of our mentees, I love this, as they rode the elevator, they pictured their spiritual team when the elevators opened, greeting them, if that's your thing, giving them a high-- like a pep talk basically, or rallying them up. Have you heard of Hal Elrod 's book, Miracle Morning?
Sarah: No.
Bree: Okay. He has this acronym of SAVERS. Basically, he studied the most successful pe-- or what he terms "the most successful people" and their habits, and he came up with this morning routine. The acronym is SAVERS. The S stands for silence or meditation, A is affirmation, V is visualization, E is exercise, R is read something uplifting, and then S script is journaling or writing three things you're grateful for.
This may sound like a lot, especially to a burnout nurse, but what I'm saying is that you can implement this in your routine to work. You can have a moment of silence or prayer while you're on your way to work. You can say a few affirmations with some visualizations of how you're going to take care of your patients or how you're going to navigate obstacles. You can take the stairs. That's exercising. Then, reading and scripting instead of checking social media at work. You could read something uplifting, write it in your notes, something you learned.
I feel like today talking about burnout all over, it's like look inward, look inward, and yes, we have work to do on ourselves. Totally. I don't want the magic of looking outside ourselves to be lost because there's so much power in that, and there's that magic of that little high of doing something small for someone else, and that can be so little as a nurse as on your discharge paper, writing like, "I'll be thinking about you." "I'm your hype girl. You got this." Something just so easy or looking at your patient in the eye, sitting down, using a patient name instead of "mom" or "dad" or "baby."
Sarah: It's like having little moments of connection that you intentionally search for. I think if I'm thinking about burnout and that cynicism on the job and feeling really apathetic, and there's a depersonalization that comes with it as a symptom, where you're like, "I can't care anymore." I know I've said that. "I don't care if I ever see a vaginal birth again in one of my burnt-out seasons of life."
It's like intentionally saying or walking away from this and going, "I'm just going to see their humanity for a moment." You have to be so intentional when you don't have it in you, and yet, sometimes, the thing you don't want to do ends up being the antidote to the problem.
Bree: Yes. It's that human-to-human connection.
Sarah: I love how Bree brought this back to the fact that so often, we may feel blamed for our burnout and it's our fault when really, we have to hold space for the fact that this is a systemic issue, that there are components outside of our control that make it more challenging to live and continue to work the way that we are and that contribute to the burnout. I know Jess(ph), one of our mentors, she has had personal experience with this, especially recently.
Then, when we think about Carly and her past experience with burnout, I think hindsight's always 20-20. When you're in the thick of it, it's harder to see, like, "Am I doing the right thing? How do I set those boundaries? How do I find the thing? How do I even know what to do when you're in the thick of it?" I love that we can look back at her life and learn from her experience of what helped her then. What do you do when you're in the now, struggling maybe with some burnout in an environment that is extra challenging?
Jess: It is a systemic issue. Bree and I were actually just talking about this the other night, and I call it "Death by a Thousand Feathers." I heard that term somewhere. I don't know where. I'd give credit if I knew, but that's what it feels like. We have this other extra piece of charting you need to do. "Oh, okay, we're now going to be charting every 15 minutes on Cytotec." "We need you to take a blood pressure every hour when patients are on Cytotec." No evidence. Nothing. Just adding more, adding more, adding more.
It can feel like that. It can feel like death by a thousand feathers. There's just a million little things that just weigh when you are in a situation like that, and you feel like there's very little positive ever said to you. There's very little, like, "Hey, I noticed that you did this or that. That was amazing. I just want you to know we saw that. We appreciate that." Instead, it's coming to you saying, "You didn't do this. You didn't fill out this form." Adding another thing, another thing, another thing.
It can be something as amazing and awesome as, "Hey, we need you to take a student today." "Okay." You're not being asked. You're being voluntold. It's like, "Okay. I feel like--" Recently, I've been really struggling with burnout. It feels a little bit hypocritical because here I am, a mentor for Bundle Birth, and we're trying to love on these nurses. We're trying to help them not be burned out. Then I'm over here in the corner struggling.
There's a lot to that, as you know. There's a lot to it. Some of it's personal. To be honest with you, some of it I did do to myself. There are reasons why, and nobody asks why. They don't care. Yes. I worked too much. I burned myself into the ground. Then I also worked in an incredibly high-volume unit. Anyway, some of it I did to myself. Some of it was unit culture. Some of it is systemic.
I was sharing this with a friend at work the other day. I love what I do. I started hearing myself talk to my husband at the end of the day and say, "I hate my job." That is tragic. You know I love birth. I love what I do. I love my patients. I even work as a birth coach. I don't anymore, but I did as a birth coach on the side because I just love it so much. I want to support people in birth. I want birth to be amazing. I want to be empowering and all those things.
I found myself saying those words. I was like, "Wow. That's gross." When you taste someone who really loves this, feels like it's a calling, is ready to just work their booty off for whoever shows up, and you hear them saying things like that, that's a tragedy to me, honestly. The one thing that's kept me going this whole time, I think, well, besides obviously my husband and my family, is the mentorship.
I would come to these calls as a mentor, and I'm like, "Y'all are just filling my cup. You're filling my cup because it was--" It's just such an encouragement to come to a place where people love birth and want to be better when you work in a place that is not conducive to that.
Sarah: That's a really hard place to be, other than-- especially for those that maybe don't have mentorship. To have that on the other side, or to not have anywhere to go, it feels like lack of integrity based on Jason's definition, my coach, my mentor. He always talks about how when your actions and your values don't align, that's being out of integrity, and that feels internally terrible.
Jess: It does. I was thinking about this conversation because I'm convinced that most nurses who work in labor and delivery are there because they felt like I do at some point. The reason they got into labor and delivery is because they thought it was amazing, thought it was awesome, it's miraculous, it's this incredible place to be. Even the tough cases, even the losses, even all that. It's such a sacred place, and what a privilege to be part of it. Then somewhere along the line, they became cynical, a little bit jaded.
Then I was thinking about that. I was like, "What is that? What is that?" I really believe that cynicism is very much tied to hope. I was thinking about that today. It was like, when you don't have hope that anything is going to change, when you don't have hope that your voice is going to be heard, when you don't have hope that you're going to be seen or that anything that you're doing is really going to matter to anyone or anything, then you get really cynical, a little jaded.
Systemically, we hear all the time about we need to lower our C-section rates. We need to increase our HCAP scores. We need to pass our JCAHO interview. Whatever. I guarantee you, if you had people who felt like they mattered, who felt like they were seen, we talk a lot about being seen, safe, and soothed as a person in labor, but I think it applies to nurses, too.
If management, if leadership, if the heads of the company, whatever, could somehow bring the value back to the humans that they have working for them. Then, all of a sudden, we're having a whole different conversation because if I feel like, "Oh, they care. They want to hear my voice. They want to hear what I have to say. My voice matters, have a seat at the table."
Then, all of a sudden, I'm giving better care. I'm not calling out sick. I'm showing up for my teammates, for my fellow coworkers, and stuff. I'm not getting frustrated if someone's asking me to do a little bit extra. I'm like, "Absolutely. Let me help my people. These are my people." How do we create a culture like that? It's all related.
Sarah: Where are you at now?
Jess: Well, I'll tell you, I'm still on this journey. I would be absolutely lying if I was saying that I'm not. I think we all go through cycles, and it correlates not just with work. It's about what's going on in your personal life, where you're at. My husband and I have had a lot of change in the last five years. We've had a lot of life change. We've had two kids get married. All of our kids were empty-nesting. We've had some struggles with lots of different things.
I'm still on this journey, but I had a moment a couple weeks ago, a moment where I was really unkind to someone in leadership, actually, who is somebody that is an authority over me. I very quickly was like, "What am I doing?" It was like, "What am I doing? This is not who I am. I'm not going to be that person. This is ridiculous." I was just like, "I'm letting this place, and I'm letting this situation change me into this person that I do not recognize."
People deserve to be respected, and they deserve to be honored just because they're human. Whether or not I agree with what was done, how it was done, whatever the moment was, it was a tough day. It was a tough situation. That person didn't read the room, and it was just like, "Oh, my God." It was one of those moments, like, "Oh, my gosh." [laughs] What is happening right now?" We all have those moments, but we're human.
Sarah: Totally.
Jess: I couldn't take it back. All I could do was just like, "I'm so sorry. You didn't deserve that. I shouldn't have said that. I apologize." Whatever. All you can do is the best you can with what you got. Thankfully, I never got to the point in burnout where I was taking it out of on my patients. I think if I got to that point, I might need to just take some time off or switch jobs.
Yes. I think recognizing that I'm human, and I want people to recognize that I'm human and give me grace. Therefore, I need to be a person who gives other people grace as well. We talk a lot about not writing people's stories, and I needed a wake-up call. I'm being really open here, Sarah. You know that I'll say whatever.
Sarah: No. You're fine.
Jess: [crosstalk] I'm a nurse. I'm just still--
Sarah: That's what we do.
Jess: I'm a mess. Everybody that knows me I am a mess, and I am the first one to admit that. I am a freaking mess all the time. Also, so are you, and so is everyone else. I am just being open because I know we're all a mess. Some of us are better at hiding it than others. I'm not good at hiding it.
Sarah: No, I think part of the issue with burnout is that we all are trying to hide it because we don't want to be seen a certain way. We don't want to be judged. We don't want to be seen as weak or fill in the blank. Yet, often, one of the ways to begin moving the right direction is to just be honest about it and admit, "I am struggling."
I love that you are that open to say that one of our mentors who, by the way, is-- You're the perfect mentor for the burnt-out group that's coming up in January. If you are relating to any of this, we invite you to our mentorship group for January. Jess is going to be one of our mentors for that. I will be there as well as one of the mentors, so will Carly. How perfect for all of us to just open up that conversation.
Now, if you're not feeling burnt out and you want to join mentorship, you are more than welcome to. It is for everyone. We wanted to hold space specifically for somebody like you, Jess, where you know you have that repeat.
Jess: How do you mess with us?
Sarah: Exactly. Be honest about it, but we're also not going to sit around and just like, "We hate our lives and everybody sucks and rah, rah, rah." Let's be solution-oriented and let's own what we can. Also, you talk about giving grace to others. You need to give grace to others, but you also need to give grace to yourself because how you are is how you are, and that's beautiful. We love it.
Jess: One last thing I'll say, and this is what Justin used to say quite a bit, is, "The first thought is who you were and your next thought is who you're becoming." I love that. I love that idea of like, "No, I'm not perfect. No, I'm still not going to show up perfectly every time," but I'm trying. I'm recognizing like, "Hey, this isn't who I am. It's not who I want to be." I'm sure there's other people just like that.
Mentorship is so helpful when you're in that space. Community is so helpful and not just a gripe session. It's like, "No, I want to be better. How do I do that? How do I get better? How do I admit my own fault, but then also write a new story and make moves towards living from a place of integrity like you said?" How do we make change? How do we be the change in a place that's difficult?
You can do little things. I started a victory log. It's been very helpful. [chuckles] We have a little notebook where our unit can, if you have a really great experience with a patient in labor you can write it in the book. Then, on a day that's hard, you can look back and be like, "Okay, yes, that's right. This is why we're doing this." Just finding those little moments where you can be excited and you can remember why you love what you do.
Even just little things. I go outside every for lunch. I just sit outside. I don't care if it's 40 degrees. I just want to be outside in the sun just for a moment. Even though we only get 30 minutes, I'm going to use those 30 minutes. Having people. I'm so thankful to have a husband, to have a family, that supports me that they can be my sounding board. I can call and I can talk to them in Vent. I can call my best friend in Vent. All those things.
I do think that you need other nurses. What we carry is a level of crazy that not a lot of people understand. I'll say one last thing because it's funny. I came home a couple of days ago from work and I said to my husband, I was like, "My job is so weird." It's the end of the shift. Of course, it's the end of the shift. They were doing this dinner for us that evening called We Are Thankful For You or whatever. It's just like a, "Hey, We See You," whatever. It was like this little buffet dinner.
It had already started. All the leadership is out front hosting this thing, whatever. It's fine. Anyway, we're in triage and we have a legit emergency. Pull the stuff, get her in the bed, run to the back. We're doing C-section right now. We go through this whole thing, and for 30 minutes, it's just madness for me. It's not even my patient. I'm just helping. We've run to the back. We get this all situated, whatever. That's still going on. The primary nurse was still with that patient. Then I come out and I was actually precepting that day. I'm like, "My preceptor is giving a report, all the things." Then we're done.
Then I walk out to the little dinner thing and I'm standing there with a plate. I'm going to grab a little bit of fruit to have on my ride home. I'm just thinking, "What am I doing? This is so weird." We were just literally in a situation where lives are hanging in the balance. Then I'm standing here in a buffet line. It's just odd. [laughs] We need to give ourselves some grace. It's so weird what we do in so many ways. It's heavy. It's heavy. While you do get stronger by lifting heavy things, sometimes we need to put it down.
I think knowing when to put it down and where, because not everywhere is safe, where to put it down. Who can you trust with the weight of what you're carrying? Mentorship is that. It was that for me. I found you guys really early when I had first come into the labor and delivery world. It was such a blessing to me. I love that we get to do that for other people. If you need people, we're here. We got you. You should definitely just come be a mess with us. It's great.
We're not staying a mess. That's the best part about mentorship, I think, is that you come in a mess and you're not staying a mess. We really are trying to make each other better. I think every single month when we have that call, I walk away feeling better. I know at least one thing that I'm going to do to be better this month. It's very concrete and it's very boots on the ground hopeful.
Sarah: I think it's extremely helpful to understand that burnout is a symptom of a bigger picture and to not entirely own the fact that it's my fault that I'm burnt out. I think for me that feels really freeing and I think it releases me of the pressure where I am the type of person that blames myself for everything. Everything's within my control. Everything is mine to hold and it's my responsibility. I love that.
When we understand burnout is a systemic issue that contributes to our burnout. I also love Bre's take on understanding the agency that we do have in our burnout. That we have control. We control how we respond. I love Jess's mention of the first thought is who you are and the second thought is who you're becoming, which is definitely a Bundle Birth-ism.
I can't necessarily control that first thought. I can't control a lot of what's going on in me and I can control and choose what that next thought is on that agency side. I think about the boundaries that Bre talked about, of setting boundaries. I know one of our mentors very well, Ms. McCall, is somebody that talks a lot about boundaries and maybe hasn't always been the best at setting boundaries [chuckles] and saying yes or no. I wonder if she has anything to say about this.
Ms. McCall: I'm definitely a yes woman and I'm learning to set boundaries. On the daily, I feel setting boundaries is a skill. It isn't something that comes natural to everyone, but I do feel, and I feel like I'm living proof of--
Sarah: You are.
Ms. McCall: [laughs] Boundaries that can be learned. I just think about us as nurses. We are yes people. We want to please people. We want to make people feel better and it feels good. We get feedback, positive neurofeedback when it's like, yes, we make someone's experience excellent or positive and that feels good. We're conditioned as caregivers, as nurses, to be people pleasers.
I feel what we don't get conditioned to do is to set boundaries. I feel that's something that we have to look for opportunities to say, "Okay, this is a skill I'm now going to put into practice." I think about in my own career, in my own experience, wherever I've worked, I've always had to be the one to make those boundaries. People may not cheer you on for setting a boundary, but they will respect you for setting a boundary.
I think that's equally as important, and something that I'm learning, is that it's not always about pleasing everyone, but it is about earning respect. I think there's also some fear that dwells in us a little bit. I don't know how you feel about this fear of saying no, "How do I say no? How do I let people down?" It is a skill. I do believe it is a skill to let people down, but it's also a skill to protect and preserve yourself so that you can continue to give. It's necessary that we practice our ability to say no.
Sarah: This reminds me of a conversation I had with Justine years ago now. I don't remember what the exact situation was, but I was-- Oh, it was coaching. It was investing in a professional coach, who's a mindset coach and executive coach. I'm with him still today. It's been the best investment into my entire career, having that mentorship, that guidance, that support and all of that. It's not cheap. It's a wild investment actually. [chuckles]
I remember Justine telling me, she's like, Sarah, "You're not doing it for you. Everything you learn, you turn out into change and into Bundle Birth and into your trainings and your teachings. It just oozes from you. Everyone benefits when you're better. I think that's also something. I don't know that I would have necessarily connected that to burnout, but I think when we're thinking about not being okay, a lot of times for me, that was the switch where I was like, "The money is worth it because it's worth it for everyone else."
While that might be the initial motivation, which was years ago now, the initial motivation was like, "I can do this for other people. I don't feel like I deserve it. I don't feel like I necessarily should have that kind of investment into me personally, but for other people it is." I don't know that every nurse is like that, but I do think that's a symptom of a helping profession. If that's what it takes for you to say, "I'm doing this for everyone else."
That's one of the things we say about our Move Learning retreat, that you're going to come back better for everyone else. If that's what motivates you to do the work and to no longer be burnt out or find solutions and actually move forward rather than just be stuck, then start there. Also, what would it look like, even for me back then, to say, "I am worth it." Whether anyone learns from me ever again, and whether I take what I learn in coaching and it never goes anywhere, I am worth the investment.
I don't know if I still can be there, to be honest. That for me, a lot of my motivation still is everybody else and that feels safer, that feels less triggering for me. I clearly have more work to do in that area, but if that's what motivates you, then use that.
Ms. McCall: I think that's where it starts, Sarah, for a lot of us. Our caregivers, our yes people, it's easier to say, "Yes, I'm going to do this for the greater good. I'm going to do this for others." Then it builds to the point where it's like, "I can do this for myself." No, I'm not saying it has to necessarily be like a crutch or an excuse, but it's a lot easier to say no when it's like, "I can't do this because I have a conflict. I can't do this because--"
Sarah: Or you make up conflicts. [laughs]
Ms. McCall: Exactly. You make up a conflict or you make some type of excuse because then it's like, "Oh, they'll understand. They'll understand." I recently had a really neat conversation that for me was a victory, that I had to say no to an opportunity that I really wanted. I really wanted. I wanted to learn from this opportunity. I felt I would be good at this opportunity, but when I processed it and looked at how can I fit this opportunity in with my life and where things are at, I could give this person all these excuses.
It could be childcare. It could be what's going on with my husband. It could be like, "Oh, by the way, I'm pregnant and this is happening in my life," or my other professional commitments. There's a list of things that I could use, but when we had this conversation, it came down to, "I can't do this right now for me because I won't be who I want to be so that I can give in these facets." We might call them excuses, but really they're our priorities. When you sit down and think about it, a lot of times they're excuses or what else is important.
"Maybe I can't do this right now, but I would love to do this in the future." We had a wonderful conversation, and this is an opportunity that I hope will pan out in the future. I hope this might work out. Myself owning that for who I wanted to be and for the quality of work that I wanted to be able to deliver in these different facets of my life, I couldn't say yes, and I didn't say yes.
I think that's telling. Just about our relationships in general, it's like, yes, I can be honest, I can be authentic, and I can also look out and take care of myself so that I can continue to give, so that I can continue to thrive because a thriving McCall or a thriving Sarah is a lot better than a surviving McCall or a surviving Sarah.
Sarah: I love this because, for those of you listening that maybe don't feel burnt out or you're new to the profession, you're like, "Oh my gosh, what am I coming into?" It can feel really intimidating or really holy moly. What I'm hearing here is that this is part of prevention. Prevention is a component of our agency that we have, and part of prevention is knowing yourself. Knowing whether you're prone to say yes or no, knowing what your priorities are, knowing--
Even ahead of time, before you get caught up, saying like, "What's worth my energy? What do I want to invest the little short time that I have on this planet to impact others?" Your time is currency, right? What types of activities will I say yes to before they even present themselves? Me and McCall are very similar in many ways. Me and McCall go way back. She was our first mentor hire back in the day because she's one of my mentors.
I remember back in the day where it was just like, we're both just very passionate and very love our jobs and love making a difference and believe in serving others, "I just want to help and change the world." That is massively risky. If you are feeling like you are that person and you are super energized, slow down and ask these questions of like, "What are my priorities and how do I set myself up to walk into a system?" This is healthcare in general. This is actually work in general. We talked about those stats at the beginning of this episode of burnout in general across the US.
McCall, I'm seeing both of our growth over the last 15 years or however long we've known each other. Of you being able to say no in this circumstance, and I literally say no all the time. I love Oprah, I think says that unless it's an overwhelming hell yes, then it's a no. To really slow down when you're that energized, slow down and really consider how you are investing your time and is it something that is going to build you up for a long sustaining career or is it just going to wear you out?
Ms. McCall: I think those are such good questions to ask there because you can't sprint forever. It is a gift to be-- I always see you as a dreamer and a doer. It's like, okay, you have a vision, you want to make it happen. I think that's how so many of us are. I feel nurses are very cause-driven. It's like, "Yes, this is a good thing. I'm passionate about it. I want to make a difference. I feel empowered. I'm in."
However, if you're always in, it brings that fatigue. Sometimes you have to take a time out. You have to take a time out for yourself. I love that suggestion about asking these questions early on as far as, yes, what are my priorities, what are my goals, and how do I pace myself so that it's not an all-out sprint, being more distance runners. Then I also think, being distance runners is asking ourselves early on, too, or just stop where you're at.
Early on, later on, it's never too late. Just stop where you're at and just ask yourself, who's your community? Who's your support? Because as I think about burnout, so much of whether I've been working as a staff nurse, whether I've been teaching at university, whether I've been in leadership, you always need to have a person. You always need to have someone. Whether it's the nurse that you talk to in the parking lot. There was a very specific nurse that it was at parking lot tonight after the shift.
Sarah: Yes. It was breakfast for me. We're definitely going to breakfast in the morning.
Ms. McCall: Breakfast in the morning, brunch, lunch. It's whatever it is. Even just a phone call or a text. Somebody who gets it and gets you. I think that's the thing. Somebody who gets your environment, gets the industry, and then also gets who you are and is a safe person in a safe space that you can just talk to, share with. It's that community that's going to give you the courage to say no and the encouragement to be able to practice it because they do know you and they believe in you and can cheer you on. They want you there.
Sarah: Have you ever been burnt out?
Ms. McCall: Yes. Multiple times. It's a tough question because, have I ever been burnt out? Yes. I feel burnout isn't just a one-time experience. It's not a one-time destination, unfortunately. I feel like, in my own experience, I've gone there as a cycle. Again, being passionate, being motivated, I feel we go through these phases where it's like, "I want more. I want to try more. I want to do more." Then you say, "Yes, yes." It's coping with labor, right? You're coping, and then, "Nope, I'm not coping." You end up in that risk for burnout if at that point you don't make some changes.
If at that point you don't look at your priorities and have the ability to say, "Okay, let me do a little inventory here. What do I need to say yes to? What do I need to say no to keep going?" It's a pivotal moment. It's not too late. Once you get to that point where you're like, "Wait, I've bitten off more than I can chew," you're not done. It's just a pause. I've had experiences where I've tuned into that and made some adjustments. I've had experiences where I haven't paused and tuned into that and just said, "I just need to push harder. I just need to find other ways to make it work. I just need to make it work."
If you're always making it work, it's not really going to work and it's not going to last. That's when I get burnt out. Then I'm picking up the pieces because I've now not only overcommitted myself, but I've had the emotional response to feeling like I'm failing in so many areas because I didn't make adjustments that then I feel burnt. That's when I feel burnt out, like a shell. I feel when you're burnt out, you feel there's just a shell left and you're not in the work anymore. The work is still there. The work's never going to go away. There's always opportunities to make a difference. If you're not in it, if it's just a shell that's in it, I feel that's when you're burnt out.
Sarah: I'm having a slight aha [chuckles] because now I've talked to you all. I think and I wonder, I'm going to externally process this for a second, but I think when we think about burnout, and I think of burnouts, overuse, moral injury, struggling with your job, not being able to show up in the same way, or feeling out of integrity with who you are and the way you show up, call it whatever, I wonder if there is a perception that burnout is abnormal. I think even going into this, I don't know that I would've necessarily said it's not or even recognized, but also I'm hearing literally all of us talk about the fact that we've been burnt out.
I haven't fully shared my story yet, or I have in pieces, but three months ago, I was unwell. I talked about already earlier that there was a time when I said I remember I was standing in triage and I was like, "I don't care if I ever see a birth again." As it came out of my mouth, I was like, I don't know if I'm okay with that. I want to, but I feel that way right now. That was a huge alert to me and something's got to give.
For some of us, it might be leaving the profession, but if you know internally that you're like, "That's not it, but I don't know and I feel hopeless and helpless and I don't know what to do," something has to change. It has to. Instead of fighting the fact that there's something wrong with me because I'm feeling burnt out, what if we just said this is part of the cycle of your career and almost embraced it as a component of normal.
I will say that my internal sensations that way have forced me to level up. When I think about, that's what moved me into peer mentoring, which led me very quickly to being forced to take on your management role. I did and I ended up in management and that was really good for me. Then my frustration, I wasn't really burnt out when I started Bundle Birth, but I was frustrated with the system and that led to a change.
Even in the last three months, I do not feel burnt out and I changed that. I had agency within, it took six weeks. That's not true. It took probably two and a half months. In that two and a half months, I have been so fiercely protective of my mindset and being protective, but also very intentional that I do not want to be here. I cannot be here. I love birth. I love Bundle Birth. I love these nurses. I love the families we get to serve. That's never been questioned. I don't want to lose my spark either because there's still so much more in me that is here to give.
By not fulfilling that role, it's a loss. It's a loss to me. It's a loss to the world, whoever takes it, and I don't want to lose that. That cynicism, that crotchety, more attitude than I'm used to or resentment or fill in the blank where you're just apathetic and like, "I can't care," maybe that is a part of the cycle. Maybe that is the opportunity to go wakey wakey, [chuckles] something has to change. It might be saying yes. In Carly's case, it was. It might be saying no. It probably always is saying no to something that feels more aligned and yes to something else.
Because when you're saying no to something, you're always saying yes to something else. Knowing that burnout is a part of the cycle and it's there to guide you and it's an opportunity to have that wake-up call and go, "What control do I have? So much. I'm going to own who I am, align with who I am and what I believe and what my values are and move that direction." What advice would you give to nurses looking to find their spark again?
Ms. McCall: I feel my advice would be twofold. I think you need to take a step back, take a pause and let yourself heal so that then you can look back and see the big picture. The second part of my advice would be, as you're in your step back, approach it as to what brought me here in the first place. Why was this a priority? Connecting back with your purpose, connecting back with your why and reminding yourself because you know it. It's who you are.
Sarah: It's in there.
Ms. McCall: Yes, it's in there. Yes, you'll know and you'll feel it. When you're in the burnout, when you're in the moment, it's really hard to feel the spark again and I think you need to take a break. I think there's some type of removal to step away from the situation so that then you can see with clarity again.
Sarah: I just feel so much gratitude to our mentors, to this community, to all of you who listen. I just love the power of community. When I listen to all of us and we have multiple of these conversations, it's like the common thread is we need our people. To me, you all are our people, the mentors are our people, our mentees are our people. I do want to cordially invite you to our January 2026 mentorship program/mentorship cohort. Myself, Jess, and Carly will be your main mentors.
It really is an opportunity for all of us to come together and have these types of conversations. We also do talk very specifically about very specific OB-related topics. You learn, you get a workbook, you get the call, come or not. You also have an app, you can take it all on the go. It is my favorite thing of what we do because what we stand for here is this education but also this support piece. When we talk about burnout and we look at the fact that Carly has been there, but she's not there now and she taught us how she sets boundaries.
It's really also that's a common theme I'm hearing, is this boundary of knowing thyself and then saying yes when she feels she can and saying no when she feels she can't, and fiercely protecting her energy in that way. I love how Bre reminded us that, yes, it's a systems issue and also we do have agency. I talk a lot about this in a lot of the classes that I teach. We talk about this in mentorship. That really is the point of mentorship, is you can control yourself.
I also remember one time I was driving with my mom where I had that aha moment and I was being bullied at work, which I talk about in mentorship and we'll talk about on the call if we need to. I just said, "I can't keep going and the unit is this and the morale is this and I can't stand this person and I just feel so put down and I don't feel safe in my environment." My mom was on the phone. She was like, "Well, what's something you can control?" I was like, "Nothing." She said, "The one thing you can control is yourself."
That for me ever since, I think a lot of times we like to blame everyone else, myself included, likes to blame everyone else and yet what if we looked internal, which Bre also reminded us of do something internal to care for yourself and make those little baby micro habit changes that actually support your health, support your mental health, support your well-being. Also we could look outside of ourselves for that support, whether that be community or writing the sweet note to the patient and doing that little extra thing. That actually does fill our cups in that way.
When you're feeling so burnt out, I think also, a lot of times, you heard from Jess, who's in it right now. I love that honest conversation. I love that we can all come together and be really candid and open. I love that she was that open with us about where she's at right now. Also, offer grace and understanding and recognize and admit when we're in the wrong.
Even her ability to share that story about something embarrassing. We have all been there. We're all a mess. We all need that safe space. It's not any space. Not every space will be safe. I hope that you find in the Bundle Birth nurses community, especially in our programs, that we want to be that safe place for you outside of your current environment.
Sometimes that is the change that you need. For her, it's mentorship and giving herself grace, being honest, admitting that she's struggling, recognizing that what we carry is a little bit crazy. Knowing that community is one of the biggest antidotes, at least for her, and that we've seen, honestly, throughout all of our lives, myself included. How did I get out of my most recent burnout was leaning on the people around me that I know believe in me. Not everybody believes in me. Not everybody likes me. Not everybody can see my heart or my intentions. We are writing each other's stories. It does always come back to that.
Let's stop writing each other's stories and choose to write our own. Your first thought is who you are right now. Your second thought is who you're becoming. We have agency over that second thought.
Then for all of us, whether you're feeling burnt out or you're not feeling burnt out and you're using this as a wake-up call, I do think that, for me, having these conversations, which is a part of what you get when you're in community with people that you know and you trust and are safe, that I even was able to have, you heard it, I have that aha moment of maybe this isn't abnormal and what if we didn't fight it when we're feeling burnt out or we're feeling down, that our life does come in cycles. It happens in seasons.
Sometimes we're feeling energized and sometimes we're not. When you're not or you're noticing that your own energy, your own responses, how you're showing up in the world doesn't align to who you are and who you want to be, that's your wake-up call. Ask the question, "What are my priorities? What do I stand for? What are my goals? Who do I want to be as a human being? Who do I want to be as a nurse?" If you are feeling misaligned, that's your wake-up call. How can you sustain? How can you become that person?
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Sarah: What can you control? Who do you have to support you along the way? Everything is harder done alone. Thanks for spending your time with us during this episode of Happy Hour with Bundle Birth Nurses. If you like what you heard, it helps us both. If you subscribe, rate, leave a raving review, and share this episode with a friend. If you want more for us, head to bundlebirthnurses.com. Follow us on Instagram and join our mentorship program, which is currently open for enrollment.
If you are listening to this later, you are always invited to mentorship. You can follow the link down below, specifically going to our mentorship program. Join the waitlist so you can be notified when it opens. If you're not a part of our mailing list, our email list, that's the best way to know all of the new offerings that we have, all of the new fun things that we're giving you. We give you free education in your inbox on the first of every month. Then our mentorship program does open a couple of times a year, but only for a couple of weeks. If you've missed the deadline, we do invite you to a future mentorship cohort.
Join the waitlist and we'll let you know when it's open for the next one. We would love to have you even deeper a part of this community. Sometimes, at least what I've seen, is that you have to get out of your environment, you've got to switch up your routine. I know for me, the best investment I have made is in myself because we know that when you invest in yourself, everyone benefits.
Now it's your turn to take what you learned today, apply it to your life, and go do one thing for yourself. It could be a small investment. It doesn't even need to be a monetary investment, but do something to better your health, your life, your well-being because you matter so incredibly much. We'll see you next time.