Not many people that I can talk to about this...

[j_tay1981]

I'm a new nurse at my first RN job. I work in a large urban hospital in the Midwest. We are a level 1 trauma center so we can be quite busy. I work on a neurology floor that also acts like a med surg unit as well. I have been off orientation approximately 6 months. I love my coworkers (I work on the night shift) and I have had decent success there (my patients like me, or so my leads have said, and I was nominated for a Daisy award at the three month mark which was pretty cool).

Unfortunately, I'm miserable.

I specifically sought out a med surg floor because teachers and relatives who are nurses said that med surg is a great place for new grads to start in order to learn time management, assessment skills, etc. I had zero interest in med surg in school (it was my least favorite clinical rotation as a matter of fact). I was happier in ICU and oncology.

My biggest issues with my current gig are the nurse patient ratio and the pace. Also, many of our patients are very trying (since we're neuro we get a lot of dementia patients who can become violent, plus we get a decent amount of everybody's favorites: alcohol detoxers and narcotic seekers).

I had been having a really rocky start to my career: getting out of the door on time had been an impossibility for me until recently since I was always behind on charting. That has improved, but not by much.

In short, I feel like my job is too much, too fast. My coworkers are beyond awesome in how helpful and friendly they are, but I'm definitely the weakest link on that floor. I simply cannot get a grasp on the pacing, the multitasking and keeping track of everything that needs to be done with my patients. It's nerve-wracking to the point where I feel nauseous and feel my chest tightening on the drive in.

I'm sorry if this turned into a gripe session, I didn't mean for it too. I'm simply frustrated and feel trapped. What other options are there for me at this point? I'd love to have a lower nurse/patient ratio (wouldn't everyone?). I've considered OR, PACU, ICU, among other options. I just think it would be a red flag for hiring managers if they saw that I left my current job in under a year.

I feel like I can't 'hack it' here. I didn't want my job to feel like simply surviving for 12 hours, but that's where I'm at. I've had to stop myself from snapping at my more obnoxious patients as well (never looks good on a 'How did we do?' survey when the RN tears into the patient).

Advice welcome and appreciated. This is my second career and I don't want to back out now. I'm not a stranger to hard work, but this is beyond me.

[xoemmylouox, ASN, RN]

I think this is all normal. Neuro is a tough floor. Perhaps try switching to another floor. You will find they all have their challenges, but some people thrive is areas while others struggle by. Do what makes you happy and realize time management is a skill you will continue to improve.

[Sun0408, ASN, RN]

If the ICU is what you want, go for it but let me tell you; you will still deal with the ETOH withdraws, the demented, the violent, the rude pts and family etc.. Neuro is tough and trust me, you will see a lot of it in just about every ICU, some more than others :) While the ratios are better; have 2 or 3 pts is tough in its own right. The pts are sicker, more complex and can turn south in a second..Each unit/ specialty has its own set of challenges and rewards.

[SuesquatchRN, BSN, RN]

Honey, it takes a year to stop shaking. Honest. Just hang in. It WILL come together.

[ComeTogether, LPN]

Can you try to focus on the things that you do love? Your awesome co-workers, the few patients you truly enjoy, the huge difference you make in some of their lives, your paycheck (hehe) etc..... I fee like if you could try to look at the good things and get excited about them maybe it would help.

I'm not a nurse so I have absolutely no idea what I'm talking about, but I thought I'd throw it out there. :-)

Best wishes to you. I really think you have come a long way and I think with a little time you will feel so much better about all of the craziness.

[DalekRN]

If your facility's policy is that you have to wait six months at a position before transferring, then you are good. A year seems so arbitrary. Switch if you want to! It takes a lot of guts to switch. But it may not be easier.

[VICEDRN, BSN, RN]

Does anyone actually like working neuro? Anyone?

As for "needing" med surg, I think that's a croc. Transfer when you can.

[jadelpn, LPN, EMT-B]

I do not think it is a bad thing to want to specialize. I would look at specifically where you would like to be. Make an appointment (on your off time) to speak with the manager of the floor. Discuss your interest in the specialty, and what steps the manager things you need to take to transfer to the floor. They may say a year of Med/Surg experience. They may have a different track in mind. Ask if there's any openings or potential openings on their unit. If there is not, or you find that they want more experience, bide your time and watch for internal job opportunities, and apply, heeding the managers advice.

The worst thing you could do it to change your nursing persona or practice due to over stressing it. You have spent a great deal of time and energy to create a practice that your co-workers admire. Don't throw all that work away. We all have "things" that gets to us--I happen to enjoy addiction nursing, but ICU would not be my thing in the least. So think about the things you like, and keep your eye on openings. Keep on refining your practice. It will come together, even though now it doesn't seem so. Once you find your niche in multi-tasking, it will take you far. And that takes at least a year. Talk to your nurse educator--get your ACLS, PALS, NALS whatever it is that you can to make yourself marketable to your choices in specialization. Research what you can about getting certified in your chosen specialty. And let the manager of the unit know that you are interested in pursuing that option as well.

Another thought is if you are a union facility, look at your contract. There is sometimes language about "shadowing" in a potential job. Your seniority would give you a slight edge on someone who would be an outside hire. Or anyone who was hired after you.

There is no harm in asking for guidance to get where you would like to be. That your plans are in place going forward may make it a great deal easier to do what you are now.

Good luck in your endevours!!

[Chesam7]

It sounds like you are just plain unhappy. If you are unhappy and dislike what you are doing you are less likely to be productive. You have to find your place. I think each area of nursing has its difficulties but its up to you to find out which ones you enjoy dealing with

[j_tay1981]

If the ICU is what you want go for it but let me tell you; you will still deal with the ETOH withdraws, the demented, the violent, the rude pts and family etc.. Neuro is tough and trust me, you will see a lot of it in just about every ICU, some more than others :) While the ratios are better; have 2 or 3 pts is tough in its own right. The pts are sicker, more complex and can turn south in a second..Each unit/ specialty has its own set of challenges and rewards.[/quote']

I've considered this too. I know I can't escape certain aspects of nursing. I'm attracted to the better ratios of ICU, but I'm concerned about how adept I'd be in a higher acuity setting. As of now, I deal with heparin, labetalol and insulin drips. Also nicardipine drips. I don't know if that means anything or not. Some other hospitals here don't allow med surg nurses to do these drips (I'm told).

[j_tay1981]

Honey it takes a year to stop shaking. Honest. Just hang in. It WILL come together.[/quote']

I'll hold you to that :)

[SuesquatchRN, BSN, RN]

I'll hold you to that :)

I'm good with that. The first year on the floor is terrifying. The second is still hard but you're no longer sick to your stomach every day.

:)