Career Conundrum - It is a long one

Well, here goes. I have been a registered nurse since 1999. I went to work at a large teaching hospital after graduating from nursing school. I worked on a cardiac step-down unit with a patient to nurse ratio of 7:1 to 5:1. This unit managed patients with chest pain including drips and provided pre- and post- cardiac catheterization care. I worked there for 6 months and became discontent, so I took a "pie" job working in an ENT clinic. I was miserable and bored. I missed the excitement of the cardiac step-down unit, so I went back after a month or two. When I asked for a job on the step-down unit, I told the nurse manager that I would probably be leaving within the next 6 months because I wanted to pursue a graduate degree. Despite telling him this, he hired me back.

So, after 6 months, I relocated to another area with the intention of getting some ICU experience and going to school to be a CRNA. The job I took was in the CCU at another teaching hospital. It was a horrible decision. I took the job with so much confidence and interest, but quickly learned that I had a lot to learn. I did not have the same support in my learning that I had at my previous job. I felt I was just put out to swim, float, or sink. I despised working and was fearful of going to work. I would get nervous and panicky before my shift. The staff was miserable. I would ask questions to the nurses I worked with, but I was never given a good answer. I only remember one nurse who I thought was worthy of being called a registered nurse. She was a truly gifted nurse and I will forever remember her. Just because you have RN behind your name, it does not mean that you are a good one. I only worked in the CCU for 4 months and left on my own accord. The nurse manager tried to persuade me to stay and work step-down, but I refused. When I do something, I want it to be done right and without the guidance I was scared that something was going to be done very wrong. I have been scarred by this experience and probably will never return to that teaching hospital.

Fortunately, before I quit my position, I learned that I was accepted into a FNP program, so I put all my energy into studying. I eventually took a per-diem job as a registered nurse working in a small rural hospital in the Women & Infants Unit. After finishing the FNP program, I fulfilled my National Health Service Corps obligation in public health. I have enjoyed working as a FNP, but I miss working in the hospital setting - learning about new therapies, drugs, and procedures. I have been out of the hospital since Jan 2003. I want to learn more and I feel that the teaching hospital is the place to learn. I am considering returning to the hospital to work. I have been offered RN positions in the CTICU and NVICU at a major medical center. I want to do it, but I have some reservations, given my past experience. I was assured that all nurses despite experience have to go through an orientation period, which could be tailored to his/her needs. I have never doubted anything that I put my mind to, but this I do have some doubt. In addition, I will be taking a huge pay-cut. I am looking for self-fulfillment in my career and I know for me that involves learning and studying. As nerdy as that sounds, learning and studying gives me self-fulfillment. Any advice would be appreciated!