before putting the old nurse out to pasture.....

[martymoose, BSN, RN]

Hi- looking for career advice- basically have come to the conclusion that I cantt continue with working on the busy med/tele/stepdown floor anymore. I am now too slow, am always behind.Didnt use to be that way 7 years ago. But the clientel has also changed in that time. Is there something for the slow pokes? I do know my shift flipping is contributing to this.Ive gotten suggestions for med offices , but I have yet to see an ad for an RN- they all want med assist or LPN. I cant imagine if i have slowness with med s/tx etc on sd, that i would be any good at LTC.I also am finding that I am getting anxiety from some of these sickies- alot of times we feel they should have not left the icu yet.A plus is that I am very conciencious- almost a little bit too much. High attention to detail.slightly perfectionist. Do not like acute care- i am not an adrenalin junkie- quite the opposite.

So any thoughts? would the OR be a good idea? or would that be too stressful due to the high turnover?Should I shadow dialysis?seems like the only jobs avail in this area for RN's are hospital jobs. Definitly have no intention for mgmt.I cant conscienciously teach- one , i dont have masters , and 2- why on earth would i encourage anyone to enter this profession?

ugghh whats left? thanks for ideas.

[westieluv]

Wow, I think that I could have written large parts of your post, and I'm only 46! I took about seven years off, from 2003-2010, to be home with our kids, and when I tried to get back into nursing last year, I thought that I wanted to get back into inpatient Med/Surg nursing, which is what I had always done in the past. I couldn't get a hospital to hire me at first, because I didn't have recent inpatient experience, so I took a job at an inpatient hospice facility and discovered that I LOVE hospice nursing. I ended up quitting that job, due to the fact that I couldn't get quite enough hours in the inpatient unit, and ended up doing home hospice evening and weekend coverage, which I also loved, except for the fact that I was the only nurse scheduled on my shift and our hospice covered seven counties, meaning that I could literally put hundreds of miles on my car in one twelve hour shift, plus, I was only getting every other weekend. I then went to LTC. NEVER AGAIN! You are right, if you feel too slow for Med/Surg Tele, you don't want to do LTC. I was literally on my feet for 8 1/2 hours straight every shift and I developed foot problems that required medical attention for the first time in my life. The med pass in LTC is beyond awful. I worked afternoons and all you did was pass meds. After the dinner med pass was done, you had to start almost immediately on the HS med pass just to get it all done by 11 pm! I would NEVER, NEVER recommend LTC nursing to anyone.

Anyway, after I got my feet wet with those two jobs, I did get hired by a local community hospital as a contingent Med/Surg float, and I was sooo excited to be back in inpatient acute care nursing. But you know what? Other than the hourly rate is fantastic and I have a great boss and nice co-workers, I am like you, I am finding that it is just too crazy for me now. Even since I last did this in the early 2000s the patients are so much sicker, and yes, we also have patients who would have qualified for ICU when I was working inpatient before and are now on regular Med/Surg units...scary! Also, I am blown away by all the younger (under 50) patients that we get who are addicted to alcohol and drugs and come into the hospital for things like pancreatitis and end up on our DT protocol and are a ton of work and a pain in the behind. It is so frustrating dealing with these patients, and I never remember seeing this much of this stuff when I did this kind of nursing in the past. Every time I work it seems I get at least 2-3 young patients who are only sick because of their lifestyle choices, and I just don't have the patience for this kind of stuff anymore.

Sorry this post has gotten so long. What my point is, is that maybe you would like hospice nursing. The pace is obviously much slower, and it isn't nearly as stressful, because all we are doing is providing end of life care and giving comfort to the patients and their families. I have always preferred the "people" side of nursing, as opposed to the technical side of it, and working hospice this past year made me realize how much I don't really want to work inpatient Med/Surg, much as I thought that was what I wanted to get back into. I am in the process of transitioning to the hospice department of the hospital system that I work for. The difference between this and the hospice job that I had previously is that it would be during the day and only in one mid-size city, as opposed to seven large counties. When you go into people's homes, especially as a hospice nurse, you would be amazed at how rewarding it is. If going into private homes isn't your thing, there are inpatient hospice centers too, and it is so peaceful and soothing after the craziness of hospital nursing. These patients and families are so very, very appreciative of what you do, and it really feels like you are making a real difference in their lives, as opposed to just running your legs off for 8 hours and then wondering what you really did all night, since you are too busy to really focus on anything other than getting your list of duties done. I can't wait to be a hospice nurse again. I found my life calling by trial and error, and I won't work inpatient acute care ever again if I can help it. Maybe hospice would be right for you too.