leaving rehab nursing/returning to med-surg/please advise

[Lola77]

I need advice. Here is my story. New RN as of Fall 2009. Starting work on an insanely busy neuro/med surg floor that I really loved. I learned so much every day and was really starting to feel confident in my skills (IV starts, assessments, wound care, etc). After only 6 months, I had to move across the state and find a new job. I found a job on a neuro/tele floor, figuring that I could handle it. BOY WAS I WRONG. As a new nurse, my confidence was shaky, I was nervous about new people, policies, doctors, etc (this place was so different - even called labs different names - I was always confused). It was hectic and I had very little support. I began to dread work, get sick to my stomach. We were always short staffed, the other nurses were mean (except for 2) and the CNAs treated me like complete ****. I actually felt like my nursing license was in jeopardy at times. For example, I had no experience at all with cardiac drips, yet I was assigned patients that had them! It felt more like a step down unit, but with 6-7 patients per nurse. I was in over my head.

Finally, after a month, desperate I went to my manager and said I didn't think I could handle the floor. She was very nice about it and said she would speak to HR about finding me another spot in the hospital (I had signed a 2 year contract and had to go somewhere). The only place they would put me was on acute rehab. I think they thought I was a sucky nurse who needed a slow environment (which isn't true! my old floor was known as THE CRAZIEST MOST HECTIC floor in that hospital and I thrived on the excitement!)

Anyway, I didn't know what to do but needed the job so I took the rehab job. The people I work with are amazing - very nice, fun, helpful. The job is easy, it really is. Mostly med passes and helping patients to bathrooms. Some wound care, PEG tubes, trachs, but overall easy. I haven't learned a lot. Our patients rarely have IVs. I feel like I am losing my skills fast. The few times I have to start IVs I have blown the vein (I used to be pretty good!) and when I DO have a medical patient I feel like I don't remember things. You know - lose it if you don't use it. So now I fear that I will forever be trapped in rehab and will never be able to return to med/surg or anything more clinically complex.

I have 18 more months on this floor. I have to stay on the floor with the contract. Also, nurses from my floor are not allowed to float anywhere but the pysch unit!

So, my question is, how can I keep my skills sharp and make myself more marketable to a med-surg job when this contract is over? I have kept my ACLS card current and tell the other nurses on the floor to let me start all of their IVs and to let me know if they have complex wound care or any other medical issues so that I can help or do the procedure - but there really isn't a lot.

Is there anything else I can do in your opinion? I am thinking of getting my BSN in the meantime - think that will help?

I appreciate your feedback.

[xtxrn, ASN, RN]

IMO, the BSN will probably make you more marketable from the education standpoint, but not for skills- you get good at that with actual experience regardless of educational background= I worked with LVN/LPNs who had amazing clinical skills- and RNs who were dumb as rocks with an alphabet behind their names- it really depended on the nurse .

Don't knock yourself too much for the blown IVs- rehab patients often have other issues (like steroids for COPD, etc) and their veins aren't good to start with- I've worked out of med-surg several times, and came back to it, with nothing more than the standard skill check list, and orientation, and it went fine. :) I also started out on neuro- and it was a great place to learn- though I wish my basic med-surg skills had been better with the craziness that goes along with neuro.

You could see if you can pick up some prn "regular"med-surg hours that won't interfere with your contract (unless they own you). Med-surg is the backbone of any nursing - even the ones nobody thinks will have any overlap... all specialties have "regular" sick mixed in :) Even a couple of shifts a month may help your confidence.