The art of sanity: 5 ways to keep your job from driving you crazy


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Nursing is hard. Nursing is an emotionally draining, physically taxing, mentally challenging job that goes on for hours at a time and for days in a row. Nurses are often asked—or made—to work overtime, or stay late or come in early, or work without enough staff or support personnel. Nursing, in short, can suck as a career choice unless you take steps to keep your sanity intact.

Easier said than done, you say? Not so. Take a few tips from my colleagues, who have done everything in the world for 10 minutes at a time before they became nurses, and from me, whose employment history is checkered, and you’ll have an easier time of keeping sane.

1. Remember that you can do anything for 12 hours. Heck, you can hold your breath that long. Twelve hours (or eight or 16; whatever it is you’re working today) is a relatively short time in the grand scheme of things. If the day is going badly, try reframing it. Instead of thinking, “Oh my gosh, I have to get through the next six hours,” consider thinking, “I have six hours to make a difference to these patients.” It sounds hokey and Pollyanna-ish, but it’s true: Simply recasting your shift in terms of doing rather than having done to you can make a huge difference.

2. Try to have rituals. As nurses, we talk a lot about time management and routines on the job, but we rarely talk about rituals. One of my work pals, who sings with an opera company on the weekends, told me about his getting-ready-for-work ritual: “On days when I work, I’m getting into character just as much as I do when I’m getting ready for a role. Everything I do in the morning, from pouring coffee to shaving, takes me one step closer to the Nurse role.” I hadn’t realized it until he put it into words, but I do the same thing with makeup: I wear a certain amount, applied a certain way, and that ritual acts as armor against some of the horrible things I might see during my shift.

More important are the rituals we have when we get off work. When I come home, I put on sweatpants and a bathrobe, take off my jewelry and makeup, and feed the animals, in that order. It’s the same, invariably, every night. Taking off scrubs and heavy leather shoes means I’m dropping whatever happened to me that day into the laundry basket; I make a conscious effort not to think about the shift I’ve just finished. Washing away the mask I put on in the morning helps return me to normal civilian life. Feeding the critters reminds me that there are things in the world more important than my own niggling concerns and stressors.

(Looking at what I’ve just written, I worry that it reads as unnecessarily negative. I love my job, and I feel the work I do is both valuable and fulfilling—but it’s hard. I need to have a separate personality for work, just so the stresses of the day don’t eat me up. Your mileage, as always, may vary.)

3. Try to cultivate an attitude of thankfulness. This sounds even more hokey than reframing your day, but believe me, it works. Your worst day as a nurse is still a thousand times better than the best day of one of your patients. “There but for the grace of the Flying Spaghetti Monster/God/The Universe go I” is not an unhealthy thing to remember. No matter how bad it gets, you still have at least partial use of your brain, your limbs and your cardiovascular system. Things aren’t truly bad unless you’re on one of those beds in a room with a drain in the floor.

4. Set boundaries. This is something that they teach in nursing school in terms of negotiating with patients, but it has another side: the times when you say, “This far I will go, and no further.” It’s okay to confess to a charge nurse or a trusted coworker that you simply can’t go into a room one more time. Most places, the care for those sorts of patients is divvied up in an unofficial way, as in “I’ll give you a Snickers if you’ll just answer that call bell.” If the choice is between bribing a coworker and walking into a room with an attitude, go with bribery.

5. Finally, lean on your coworkers. This is a recurring theme in my essays, and for good reason: I have the sort of coworkers that people only dream about. When I was sick, they cared for me in more than just physical ways. When I’ve had bad days, they’ve mobilized as a group to get my butt out of whatever sling it’s been in. And when I’ve had good days or just been luckier than normal, I’ve tried to pay that back.

Still, sometimes you have to lean. If you have an ethical problem (“This doctor is trying to convince a patient to rescind a DNR order…is that wise?”), a physical problem (“My back hurts; can you help me roll this patient?”) or a mental problem (“I’m going to kill that oncologist if somebody doesn’t hold me back”), your coworkers can be invaluable. They can help you keep things in perspective, provide valuable physical and mental support, and, if things get too rough, collect money for your bail.

Nursing is hard. It’s a juggling act between giving enough and giving yourself away. It’s sometimes dirty and gross and awful; sometimes it’s just plain wearing. It can be amazing and miraculous and beautiful, too, but you have to be awake enough and alive enough to recognize those times when they happen. Boundaries and rituals and trust can help with that.

Every day is different; every day is new. Every day brings us the opportunity to do something magnificent for the people who depend on us. Our responsibility is to be ready to grab those opportunities. Keep yourself healthy not just for your patients’ sake, but for your own.

Agatha Lellis
Agatha Lellis is a nurse whose coffee is brought to her every morning by a chipmunk. Bluebirds help her to dress, and small woodland creatures sing her to sleep each night. She writes a monthly advice column, "Ask Aunt Agatha," here on Scrubs; you can send her questions to be answered at

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