Hello all! This is my first thread on AN and I am asking for any and all advice.
I have been an RN for 2 years. I was hired as a new grad at a large regional hospital. As part of the new grad hiring process, I was put into a nursing internship program and had to sign a 2 year contract to that hospital. I was then placed onto a very busy neurology floor. My 2 years is almost over and I am completely miserable. While I am grateful for the opportunity to have worked on a hospital floor while many other nurses are still looking for jobs, I am completely burned out. This floor is tough. Period. We are supposed to be 5 to 1 on day shift, however because of lack of staffing we are often 6 to 1. Most of the CNA's on the floor are difficult to find. We have high acuity. Lack of help from management. The list goes on and on.
Anyway, since my contract is almost up, I have decided to leave. I know that for my mental and physical well being, I have to leave this floor. The issue is I am undecided on where to go. My current job is over 35 miles from my house. That is a long commute 3 days a week. However, in the city where I live, there is a smaller hospital that is currently hiring. If I apply to the smaller and closer hospital I would apply to be a float nurse. But my current situation had made me weary of hospital nursing. It can be so exhausting mentally and physically. Not to mention all the nonsense with the Press-Ganey scores and how customer service reigns supreme at the beside these days. My other option that I am looking into is hospice. My fear with becoming a full time hospice nurse is that I will lose my clinical skills and therefore make me less marketable if I ever decide to go back into acute care. I am truly at a crossroads. Any and all advice would be much appreciated.
You don't state why you are considering hospice. Is it because you feel a strong desire to help people with end of life issues and their families, or is it because you think it will be an easy alternative to hospital nursing? I have worked both hospital nursing and as a hospice nurse in the field. I can tell you that if you think that hospice nursing is easy, you will be disappointed. It is very emotionally taxing, and you get into a lot of issues, family issues and otherwise, that you never have to deal with as a hospital nurse. My most recent hospice position was as an intake nurse in the hospice office, and our hospice case manager nurses often times felt burned out, emotionally exhausted, and spent, not to mention that they often worked well over their 8 1/2 hour day, because hospice field nursing isn't like hospital nursing where you just punch out and the next shift takes over. If a patient or their family needs you, they need you and you can't just leave because it's 4:30 or whatever. Also, you will deal with things like going into iffey neighborhoods, patients' pets, some of whom get very territorial when you try to assess their owners, less than sanitary homes (I've seen cockroaches and had fleas jump on me), second hand smoke (was in a living room once with EIGHT adults chain smoking while I was attending to their father who was dying of, naturally, lung cancer), and other issues that you don't see in an inpatient hospital setting.
I'm not trying to discourage you from trying hospice, just letting you know that unless you go into it because you have a strong desire to do that type of nursing, it is very easy to get burned out doing that type of nursing as well. It doesn't present exactly the same problems and challenges as inpatient hospital nursing does, but it has challenges all its own. As far as losing your clinical skills if you go into hospice nursing, yes, you will become rusty in some things if you do it long enough, because a lot of the skills that you use in the hospital are aimed at helping a patient to heal and return to a normal, productive life, and in hospice, it's all about keeping them comfortable until they die. No curative therapies allowed, or they have to revoke hospice.
Last edit by westieluv on Sep 17, '12