Am I crazy to leave my desk job?

nurseiam · Jan 22, 2003

Doing a residency is a chance for you to give it a try. Not only can the employer back out but you can too. I have four years experience, I just got my RNC, and I do charge nursing but there are still days I think.....Am I really here...this is where I wanted to be?........Yep is always the answer! Best wishes!

Dr. Kate, BSN, RN · Jan 22, 2003

While I think you're nuts, I think I understand the motivation.

Since you do not have any recent clinical experience you will need to take a general refresher course. I recommend you do this before approaching a hospital. It will be to your advantage and the hospital's if you have already done the refresher. There may be some hospitals that will put you through the class, or even give one themselves. Then you need to find a hospital that will train you to NICU. Ideally, you want to find yourself in a new grad type program with lengthy orientation period in NICU that includes specialty educational programs paid for by the facility.

I think it is possible for you to do this and all the pieces come together, But you will have to do some exploratory work. Talk to nurse recruiters, directors of education, NICU managers and find out what they are looking for, what the job and work requires, and what suggestions they may have for getting you where you want to be. (My friend the career counselor calls these information interviews. You are not looking for a job from any one of these people but information. If you write thank you notes as f/u to the discussions, when you are looking for a job, you will be remembered favorably.)

Since this could be a major decision, I strongly suggest that you consult a career counselor before going too much further. They have a lot of tools and skills to help in even very subtle career decisions.

Good Luck

prmenrs, RN · Jan 23, 2003

Much as I enjoy and respect Dr. Kate's advice usually, I would NOT do a general refresher course. That will reinforce adult norms which are USELESS in neonatology--in fact you almost have to UNlearn them. Neonates seem to be a whole different species sometimes.

You have already done the first 2 things I would've suggested--painting Merenstien w/a highlighter, and studying drugs. You also need to know a fair amount about Breastfeeding, and you might want to start reading about premie/nb development--also quite "different". Spanish is also useful. Subscribe to Neonatal Network, it's been around longer than the NANN journal. (Long story) Also, they post a lot of jobs there.

I would look for a level III NICU that has a new grad program, and try to get hired there. Ask to job shadow, to get the 'feel' of the unit, see if they're friendly to new grads; you could ask to speak to someone who's been thru their program. You want a nurturing environment, not a place that eat's its young (or old).

I think you can do it, and I hope you find it fulfilling. I would be willing to bet you'll do fantastic!!

2banurse · Jan 23, 2003

Of course you are nervous about changing direction, but that is just normal. Don't put the age thing into play. As you have seen on this BB, there are people starting nursing at all different ages (me, I'm 38). Good luck in your second interview.

Kris

dawngloves, BSN, RN · Jan 23, 2003

Jump, jump. jump!!

Do it or you'll always regret it.

Good luck!

RainbowSkye · Jan 23, 2003

Hey, I'm 49 (50 this year!) and I left a cushy Monday - Friday desk job for weekends in the ER. Now while I'm a little more achy than I was when I was 20, I far prefer working directly with patients. As a matter of fact, I just started back to FNP school.

Good luck!

llg, PhD, RN · Jan 23, 2003

I am now in the "desk job," but have spent most of my career in NICU's, often coordinating orientation programs. I would expect someone with your background to have a very difficult time making the transition. However, it is possible. The advice people have given you about finding a strong orientation program etc. is good advice.

Also, I doubt that a general refresher course would do much good as it would probably emphasize adult med-surg which is a totally different world from NICU. Unless you can find a refresher course that at least gets you into an ICU or working with babies insome way, I would not bother.

Finally, you might want to read some of Patricia Benner's work on how people progress "From Novice to Expert." If you can't get a copy of her books, there were some great articles during the 1980's in AJN.

You are an expert in the work you have been doing, but now, you are going to be a novice again. It's probably going to feel as if the rug has been pulled out from under you. In my experience, it is the emotional reactions to that "uncomfortable" feeling that comes with that loss of expertise that causes people with backgrounds similar to yours to quit NICU orientation programs before they have had a chance to develop a level of competence that enables them to feel comfortable.

Another big issue that trips up nurses "finally" going into NICU after so long of doing other things is that they sometimes have an unrealistically romanticized view of taking care of those little babies. The harsh, day-to-day realities sometimes disappoints them. Also, such people are sometimes really fearful of making a mistake and become too afraid of hurting the kids to feel comfortable in NICU. After enduring a few months of discomfort, they go back to where they DO feel comfortable -- back to their old jobs.

Remember, it is very common for people in NICU orientation programs to dream about the unit -- sometimes nightmares -- and to feel nervous as they are going to work. The questions sometimes are: Can you tough it out long enough to get through that stage? Are you tough enough to withstand that stress? Do you really want to put yourself through it at this point in your life? If they answer to those questions is "yes," then go for it.

Of course ... a lot depends on how high the acuity and pressure is in the particular unit you are working in. Some "Level III" NICU's are a lot less acute and less stressful than others. "Level III" covers a big range. In fact, my state (Virginia) now has 4 official levels because there was so much difference between the top and bottom of the Level III range.

Good luck! Keep us posted!

llg

Dr. Kate, BSN, RN · Jan 23, 2003

I agree that referesher courses tend to be focused on adults and that is not what you want to do. However, you have no acute care experience except for school, 10 years ago. It will be a challenge to find someone to hire you into NICU.

I go back to the rest of what I said, get out there and talk to recruiters, NICU managers, and the folks in education--they're the ones who do and recommend the hiring.

I can only speak for my hospital and neither the recruiter nor the dir. of ed. would pass you on without a more substantive commitment than I read the book and worked on calculations. The dept. manager might be more accommodating.

It isn't that I don't think it can be done, it's that it isn't going to be easy.

llg is right about the emotional aspects both of NICU itself and being a novice again. I had "romantic" ideas about NICU and went so far as to start an NICU didactic course. I knew I was in the wrong place when the instructor started talking about finding a baby in a puddle of blood equivalent to most of the baby's blood. Far too scary for this adult ICU nurse. I also know about being a novice after being an expert--that can be very, very hard on the self concept. What helps is knowing that you are able to become an expert because you have been one before.

One last thing, if working with the sickest of the neonates is your heart's desire get out there and find a way to do it. Life is too short for regrets and wondering about what might have been.

Good Luck

Wren · Jan 23, 2003

:) Thanks SO much everyone for the terrific advice and "telling it like it is". I found something to agree with in everyone's post!I didn't mention in my earlier post that I am in the process of going through a refesher course plus a 12 week ECG class. I think it can't hurt even if I don't use much of it in the NICU.

I met with the Nurse Manager today and she was great. I clearly stated that I consider myself at the level of a new graduate and we talked a great deal about their orientation program. I picked this particular hospital (38 bed NICU) because they have a reputation of hiring a few new grads a year and having a terrific orientation program. I had a lot of questions and she took the time to answer them all. I met some of the other nurses and I already know one who has worked in this unit for 3 years.

Interestingly, the Nurse Manager said the same thing that a couple of you mentioned and that is that I have to go back to being a novice and be able to tolerate knowing nothing. I think I can do that. We are all novices in the beginning and we have to start somewhere. In some ways it's easier now because I am mature and my ego's not as shaky as when I was 20!

Anyway.... I think I will get offered a job there. If not, it helped me to realize that I really truly have to try this and I'll apply at the next hospital on my list. If I don't, I will always wonder if I was just a coward. Thanks so much for your help and I am sure you'll hear from me again (hopefully not in too much distress!

Wren · Feb 1, 2003

Just a postscript..... I wanted to let you know that I was offered the NICU job!!! I start on 2/24 and there is a 3 month orientation so I am reassured that I will get the support I need.

Thanks everyone for your advice and support. I am sure you will hear from me again when I have questions!

dawngloves, BSN, RN · Feb 3, 2003

You go girl!!!!