just one more comment concerning this, I promise :) I think your suggestions are good, however, the problem I have is that I have no control over my patient population. I work on an inpatient unit and am assigned to a specific corrider. I never know what issues my patients will have until I read their chart. Typically, I work with patients who are acutely depressed/suicidal, and/or have substance abuse issues, marital and family issues, anxiety, etc. I have been able to say no in the past when, after 10 years working psychiatric intake in our ER, I requested to be moved to a less stressful environment. I was proud of myself for taking that step. I think my big issue right now is just feeling like I have nothing left to give right now...stressing "right now". I like what I do when I am feeling better and have more energy and less depression. But I will get thru this...I always do..my strength is resilience motivated by responsibility to my family. There may come a time when I will make a career change, but there are things that stand in the way of that currently that have nothing to do with my issues spoken about here. thank you for letting me talk incessantly. I am really trying to figure this all out...