Thoughts from an RN, returning to the floor after 9 years...

[Tina, RN]

I am an RN, and have not done bedside nursing in about 9 years. I have been home caring for my kiddos for 7 years and prior to that, did insurance case management for a couple years. Now that the kids are older, I really wanted to return to nursing, per diem. The flexibility of working at the hospital per diem could not be beat! Anyway, a while back someone asked me to post after I'd been on the floors for a while, to give my thoughts on how things have changed in those 9 years. Here goes! I'll give a personal and professional perspective...

From a personal perspective, I can say that going to work this time around is much more pleasant! When I graduated at the age of 22 or 23, I was a bundle of nerves, every minute of every day on the floor. Granted, I am an anxious person by nature anyway. I do remember feeling nauseous before my shifts and wanting to burst into tears after receiving report on my team for the day! I was a good student, but the clinical aspects of nursing scared the he** out of me. Again, being an anxiety-prone girl, I was always wondering if I'd accidentally kill a patient.

Now, I am 35 years old and have 2 children, one of which was born extremely ill. I have a lot more "life" experience and a lot more confidence in myself, more comfortable in my own skin. Not to say that an older nurse is better than a younger one, but in my case, I believe that being older this time around has helped me. I did take an RN refresher course, which I'm sure boosted my confidence as well. Anyway, I look forward to my 1 or 2 shifts a week! It's a welcome break from home. I get to exercise my mind a lot more. I have found that I am much more calm on the floor, and take more things in stride (ie: rude coworkers). The extra $$ is great. I feel pretty proud of myself for going back! Now, I do understand that working per diem is much different than working full time. And I do realize that I've only been working for about 6 weeks now. But, hopefully, I won't get too jaded over time... :)

Professionally, there are some big changes. I do see that hospitals are trying very hard to have a hotel-like atmosphere. Catering to the patients and visitors is a little over-the-top. We're expected to apologize for anything that the patient complains about, even if they are completely wrong! It's very weird to think of patients as "customers". Patients and visitors seem to be much more demanding than they used to be. They also seem to have more "attitude" than before?! I don't remember people talking to staff as rudely then, as they do now. It's actually pretty shocking to see what nurses are expected to put up with. There are signs all over the place encouraging patients to question their doctors and nurses. I also noticed that pretty much everyone in the hospital wears scrubs now, even unit clerks. That's odd to me, I don't remember that from years ago. There are waaaaay more "titles" now, in nursing, than there used to be. We used to just have regular staff nurses, a charge nurse and a head nurse on the floor. Also, when I was on a med-surg floor years ago, we weren't allowed to give anything via IV push on the floors. Now, there is a list of numerous meds that we can push. And last, but not least, the amount of paperwork has exploded! I used to complain about the paperwork years ago, but compared to now, it would be a picnic!

Anyway, there you have it. Just my thoughts. :)

[CrunchRN, ADN, RN]

Thank you so much. It is great to here your take on things. May i ask what part of the country you are in?

[DeLana_RN, BSN, RN]

Congrats, it sounds like you are adjusting extremely well (and very lucky to have found an employer in this rotten economy with lots of unemployed nurses to give you a chance after so many years away from acute care). What floor are you on? Ratio? How much of an orienation did you get? Is there a shortage in your area (where?) Sorry so many questions, but many of us can't find work even with recent acute care experience...

Thanks for the insight, and best of luck to you!

DeLana

P.S. Aren't those hourly rounds (the documentation required) way over the top? Or maybe your hospital doesn't have those yet...

[LookForward]

hey thank you for sharing...at 21 i worked as a staff nurse on a med-surg floor. but a couple of months into the job, i decided to head back to school for the bsn. im really an anxious type of person...hope to gain some more life experiences in the next 2 years before re-entering the workforce. hopefully by then, i'll be able to handle stress better and project more confidence...Thanks for sharing your story and insight.

[Tina, RN]

Thanks for the nice comments, everyone!

I am in NY, right in the middle of the state. I actually tried to get per diem work for a while, but no hospitals would hire me without a refresher, since I had been out more than 5 years. So, once I completed the refresher, I was lucky enough to find a job pretty fast. I think that I was able to find a position pretty quickly, because I was only looking for per diem. If I needed full time, I have a feeling it would have been tougher. When I was hired at this facility, there was a mixture of new hires. There were a couple of new grads, and a couple of nurses that already had experience. But none were hired for full time, to the best of my knowledge. There are lots of job openings posted for the hospitals around here, but most are part time. There are also a lot of LTC facilities around, and they have plenty of jobs posted as well. But again, just because a job is posted doesn't mean it will be filled, you know?

I am a float, and I am still on orientation. My orientation is going pretty long, because I'm only doing 1 or 2 shifts a week. If I was able to do full time during orientation, it would be much shorter, I imagine. I also think floats usually get a little more orientation, since they cover a lot of floors. I was surprised by how a lot of things "came back to me", and my preceptors have pretty much let me do my own thing, while still providing guidance. I will be going to med-surg, rehab, ortho, oncology, and PCU floors. The ratio seems to be one nurse to 5-8 patients, depending upon the shift you're working. However, I haven't been to oncology or PCU as yet, so those I'm not sure about.

At my hospital, the CNAs do hourly rounding sheets. We are expected to round on our patients hourly as well, but there is no form for us to fill out. Yet.

LookForward: I feel for you. Hang in there, and maybe see a doctor about anti-anxiety meds? They can really change your life. :)

I really hope things get better for all the nurses looking for work. I know I'm one of the lucky ones, so I'm very grateful.