When You’ve Just Had Enough: A Practical Guide to Absolute Fuckery

There’s a very specific kind of exhaustion that doesn’t show up in HR forms or CPD modules. It doesn’t hit like a breakdown. It’s not some grand fall-from-grace “event.” It’s not burnout—not yet. And it’s not depression either. It’s just… being done.

Mentally, emotionally, professionally cooked.

You still show up. You still do the job. But inside? Nothing. You’re scraping the inside of the jar for a single fucking give-a-shit and all you find is the crust of old goodwill and last month’s unresolved blood results.

You know the days I mean. You’ve had them.

• You’re tired - but not sleepy. More like cognitively concussed.

• You’re talking like a Microsoft Teams transcription error.

• You’re using AI to write your texts to loved ones because the effort of phrasing feels like advanced calculus.

• You’re still taking on work - other people’s work - and someone complains about a perfectly safe, ordinary clinical plan because it didn’t match the aesthetic they had in their head.

• You hit your limit. You leave a little early. You carry the guilt home in a Tupperware.

This isn’t burnout. It’s something more mundane and more dangerous: the normalisation of emotional depletion. That slow rot of always-holding-it-in professionalism, the hidden costs of what nursing scholars call ‘emotional labour’.

So what do you do when you’re in that state?

When your whole body is internally screaming, “I’ve had enough,” but the system still expects you to be a bastion of compassion, logic, and patience? When saying “no” feels more unprofessional than literally crying on a patient? When you want to say:

“We’ve been through this ten times. I’ve explained it six different ways. You’ve refused every option. The answer was no at the start. It’s still no. Why are you still here?”

But professionalism, right?

Let’s be real: there’s no CPD for fury. There’s no NHS pathway for “Oh, I’ve completely fucking had it today.”

And that’s a problem.

When You’re at That Point — The Practical Toolkit

Let’s not pretend mindfulness solves this in real time. No breath-work is going to unfuck a 14-hour day where someone’s asked you if you “actually know what you’re doing” in the middle of your fifth consecutive patient with “just one more question.”

What might actually help?

1. Say It Out Loud (Without Getting GMC’d)

Sometimes I say - out loud:

“I’m actually feeling quite frustrated right now. I want to stay objective, but I can feel I’m losing that. Shall we pause and pick this up again later?”

It’s vulnerable. It’s professional. It works.

Is it perfect? No. But it beats either losing your shit or seething silently until you tell your steering wheel about it at 7:15pm.

2. Allow Yourself the Feeling

The number of professionals I’ve seen gaslight themselves into guilt for feeling angry is horrifying.

Anger isn’t unprofessional. What you do with it might be. You’re allowed to feel angry when:

• You’re disrespected.

• You’re repeated.

• You’re exhausted.

• You’re held to a standard no one else is.

• You’ve explained the answer five different ways and they still say that you don’t get it.

Let yourself feel it. That’s the pus. Let it drain.

Because the truth is, chronic anger, emotional suppression, and burnout are not separate issues—they’re entangled symptoms of an unspoken culture of stoicism in healthcare.

3. Find Your Catharsis

• Scream in your car.

• Write a letter you don’t send.

• Rant to a friend who gets it.

If they say “well, play devil’s advocate…” tell them to go fuck themselves politely and find someone else.

We all need that person who says:

“Yeah mate, they were being a prick. You did fine.”

If you don’t have one, find one. Or be one for someone else. Peer validation isn’t just nice—it’s protective. Informal support and shared frustration reduce emotional isolation and help defuse moral injury.

4. Write It. Rage It. Burn It.

I do this thing where I rant into a voice note or type an incoherent stream of invective at the Notes app on my phone.

Sometimes I blog it - QED. These ones I feel shaping up makes me more honest and humbled by the time - like a bonsai tree made of dogshit.

Sometimes I delete it - mainly because it’s just nonsense, or stuff I’m rehashing.

Sometimes I delete them, empty the cache, and take a cold shower - those ones, those would get me sacked, divorced, or summoned to The Hague.

But the act of getting it out? Indispensable. Reflective medicine starts with honesty.

This is not journaling. This is lancing a boil with words.

If You’re Angry All the Time

That’s the trick, though. If it’s every day? If you’re fantasising about drop-kicking the appointment screens or setting your bleep fire just for catharsis?

That’s not a bad day. That’s a warning light.

Maybe your “resilience” needs checking. Maybe your job does. Maybe you’ve internalised the idea that being treated like shit is just “the job.”

It isn’t.

Being subject to constant emotional dissonance and aggression, then asked to smile through it, is a known driver of burnout. And if the people around you call you “soft” for noticing? They’re already too far gone.

The Medicine of Rage

Sometimes I think every hospital should have a smash room. Like one of those places where you can take a baseball bat to a washing machine and just go nuts for ten minutes. Give staff a sledgehammer and a room full of crockery and see what the sickness rate does.

We preach mindfulness. We recommend CBT. But sometimes what you need isn’t a box breathing exercise. It’s to express that anger safely, without judgement, and have someone nod and say “yeah, fair.”

Final Thought: You’re Allowed to Snap. Just Don’t Snap Alone.

The job is brutal. The system is broken. The public can be lovely, but they can also be entitled, aggressive, accusatory, and fucking exhausting.

But you’re allowed to lose it once in a while. In fact, if you never do, you’re probably repressing something deep and dangerous.

You just need to make sure there’s somewhere safe to do it.

And if you can’t find that place? Then maybe this is it. Right here. This blog. This screaming into the ether. Maybe this is our makeshift smash room — until someone has the sense to build a real one.

Stay Furious

—DW