Some clarification on my part:

I just knew I would offend someone when I mentioned how some nurses feel "stuck" in a certain job or area. I know this isn't true for everyone who works in a certain particular job for 10 or more years, but I've seen it happen lots and lots of times over the years. I worked with some nurses on Mother-Baby who had done it for 15 - 25 years and they were so burned out it was pathetic. They made the rest of us miserable to have to work with some of them. Just the facts. I also worked with 3 NICU RNs who were in the same boat and just as burned out as they could be. On the complete other hand, there were many old timers who were wonderful mentors and excited to help newbies learn things! An angelic LPN who had been working on the Postpartum and then Mother-Baby Unit for 30 years taught me the best way to catheterize a Mom with a swollen, sutured, and painful vulva. I'll always be indebted to her!! Claudette Miller, if you read this, you know who you are!!!

Also, when I suggested "doing something different every few years" I did not mean "job hopping" which is in my humble opinion an entirely different situation. Job hopping is going from place to place, unit to unit to unit, city to city, etc. with no rhyme or reason or well-thought-out plan for it. To me, "doing something different" means growing and stretching in your chosen field or area. For instance, begin in NICU as a new grad and become comfortable for 4 or 5 years. Apply to be a preceptor for the new grads and do that for a few years along with staff duties. A few years later become a charge nurse. After that join the NICU transport team or become a Discharge Planner or Outreach Coordinator. After all this experience a person may decide to grow more into another direction such as management or advanced practice nursing in which case they would want to take some classes necessary to pursue that vein of work. I've worked with nurses who "climbed the ladder" in their own unit this way. As a matter of fact our Assistant Nurse Manager started in the lowest rung as staff RN and 3 of our NNPs were all staff RNs who worked their way up, showed they had what it takes as well as the skills and desire to be a NNP and our hospital sent them to NNP school if they signed a contract to work in our NICU for at least two years. In this way a nurse could begin and end their career without leaving the NICU Department while still growing, stretching, making contributions and never becoming burned out. Rather than staying and growing in the NICU, another possible scenario would be to work on Mother-Baby for 5 years until you no longer feel challenged, then try the NICU for another 5 years. After that go to Peds for a 5 year stint, then L&D for 5 years. A new grad doing this would be about 45 years old at the end of this rotation and could return to college if she/he hadn't already and become a fantastic Maternal-Child nursing instructor. Wouldn't we all love a nursing instructor who we felt had been in the trenches and knew a lot from their own life experiences about what they were teaching us? I don't consider growing and stretching in a certain area (Maternal-Child) as job hopping. On the other hand, a nurse who stays at one job for 1 year or less and then goes on to another job and then another on and on because she can't find what she wants or because she is incompetent or difficult to work with as opposed to changing jobs due to moving from place to place as military wives must do is certainly job hopping and to be highly frowned upon I agree wholeheartedly! I would never encourage anyone to do that!

By the way, I don't think 5-7 years in one job is a short amount of time. One of the blessings of the nursing profession is the ability to go from one area to another with a few weeks of orientation. The doctors have to spend 2 years or more learning their new field and passing competency exams if they decide they'd rather be a psychiatrist rather than an internist. (Which is what my sister-in-law did.) Being mobile in our profession is one thing that keeps us from becoming burned out. Selling our soul to the company store isn't always the best thing for everyone. If a person is completely happy in their job, with their coworkers, their managers, their physicians, and administration and know deep in their heart would never want to work anywhere else, then I say Hallelujah and stay where you are!!! Great jobs and true happiness are so incredibly hard to find that if it comes to you, grab on and hang on tight to a great thing!!!

I'm only making clarifications to my earlier post here. Not trying to hurt anyone's feelings or anything remotely similar to that!!!

Most respectfully,
Anaclaire

In our unit, all the things you mentioned are things that we just do. We dont' have to apply for them, we are all expected to take charge duties and we volunteer for transport and preceptorships. We have no ladder to climb LOL.

And those people that are burned out to the point of misery would be miserable no matter where they went. Nursing takes a toll on you no matter where you work and how many places you go. It is a tough, demanding job.

The girls that I work with that want to have all those experiences in different units sign on as PRN and they float among all the Mat. Child Units. They love it

As for feeling challenged...every area of nursing always has new things and you can feel challenged if you set your mind to it. Make a better d/c plan, set up a group to help with setting new policies, the possibilities are never ending.

I agree NicuGal

I agree with you too NicuGal. I suppose there are differences in NICUs all over the country. The one I am thinking of was quite large with specific jobs for "Discharge Planner", "Transport Coordinator", "Outreach Education Coordinator", "Assistant Manager", Neonatal Nurse Practitioner", "Clinical Nurse Specialist", and "Manager". The people in these positions actually were required to apply for their position and that was their main focus as opposed to "Bedside Staff RN". The Staff RNs assisted them in small ways by working with these other people but their main job was to be bedside nurses. Some of the positions I mentiion require additional education after an ADN or BSN Degree.

Similar to what it sounds like your NICU does, if our managers and seasoned RNs felt a Staff RN would be a good Charge Nurse, Preceptor, Mentor Program Candidate, or Transport Team Candidate, the Staff RN would be approached and offered the opportunity without having to 'apply' for such a position. If agreeable, and after an appropriate orientation, the Staff RN would find herself scheduled for Charge, Transport, or Preceptor on certain days when the new schedules were made. Every Staff RN had the opportunity to decline any offers and many did. For example, a few of our RNs who declined being Transport Team members did so because they had previous back injuries or terrible nausea when riding in the back of the Moble Trauma Unit or for family reasons felt they could not be available as needed. In our hospital each nurse had to be offered any position above "Basic" Staff RN. We could let it be known that we would like to have one or more of the added responsibilities included in our Staff RN position, but ultimately we had to be officially offered the work. (Not every person who wants to do a certain job actually has what it takes to do so... we had to have at least 2 years experience and preferably charge nurse experience to be a Transport Team Member for example.)

Our "Outreach Education Coordinator" (BSN Preferred) worked mostly with other Outreach Education Coordinators of other large hospitals, physicians and employees of outlying hospitals, and with state government agencies to obtain grants and further the development of a viable and adequate network of hospitals in relation to our Regional Perinatal Center. It is a full time job and no bedside care time is available. Our hospital was a Perinatal Regional Center for critical undelivered Moms as well as babies. Maybe that's why we have that position which is not a Staff RN position.

Same for our "Discharge Planner". (ADN or BSN) Her complete focus is to begin the discharge process for each baby upon admission and to follow each baby each day to keep them on their marks and preparing for discharge constantly so that they wouldn't have to be kept in the hospital longer than is necessary. She is responsible for teaching CPR and First Aid to the parents before discharge, obtaining any equipment the babies will need at home from apnea monitors, to suction equipment, to ventillators. She also worked on scheduling follow-up appointments with specialized physicians and routine follow up care all our preemies receive for at least 2 years after discharge. She makes up each baby's "Baby Book" of teaching sheets and updates them nearly every day. This, as you can see, is a full time job too.

Anyway, I suppose our NICU is simply set up differently than yours. That's all.

Floating for fun and prn profit is a wonderful opportunity for those who want it. Challenging oneself on a daily basis is an excellent thing to do to keep from becoming bored and to be a better nurse each day. Great suggestions for everyone! After all, bedside nurses make up the majority of the nursing profession and we need to be as happy and satisfied as possible when we love the bedside. Which by the way, I choose as my favorite place too.

Warmly,
Anaclaire