mine comes and goes.  my 2nd job out of school i learned the lesson of "no matter how hard you work, no matter how good you are, you'll never get ahead" (in that instance it was because i was female and young).  so i now gauge how hard i work based on what it does for me.

it's a little bit difficult in a hospital setting - working my ass off doesn't do squat for me professionally.  however, i go to sleep every night knowing that patients (and their families) whose care depends on my applications have nothing to worry about.