Guidance re "losing skills" and esoteric specialties

Nurses Career Support

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Specializes in forensic psych, corrections.

Does such a phenomenon exist? If I don't "use" all of the skills I learned in nursing school will I really forget how to do them?

Here is my situation: I have a job that I love right now. I'm working with autistic kids in a non-medical setting. We still deal with sick kids, and I still perform venipuncture, IV starts, the occasional ekg and catheterization, that kind of thing. I no longer do head to toe assessments, hang any IV meds, all the acute care stuff I did before. I'm not quite sure how I landed here, but I'm loving what I do.

Here's the problem: I work in an extremely unsafe area of the city. In the last two weeks alone, a coworker has been robbed at gunpoint and somebody pulled a knife on one of our parents who went out to smoke. :uhoh21:

For my own safety, I'm considering leaving. I hate to be considered a job hopper (only been here 4 months), and have lots of good reasons to stay (including a completely financed education). Lately I've also been thinking that I'd like to move into adult tele, CCU stepdown, eventually CCU... and I worry that the longer I stay here, the more out of touch I might become with acute care. For some reason, I'm not the type of person who can be satisfied with what I'm doing right now, I'm always thinking of the future.

So... should I stay where I am, keep the job that I love and take advantage of the free education (and carry pepper spray into work)... OR... take a tele job at my community hospital with a much shorter commute, safer area, and gain the experience I'd like to use in the future (possibly for travel nursing)? The community hospital I'm speaking of is a decent size, with a cath lab and CCU and decent preceptorship for non-tele nurses. They also offer retention bonuses and have an on-campus RN to BSN program (although I'm sure it isn't completely free).

I should add here that the job I have now is total gravy, and at an absurdly high rate of pay. I know I'm nuts to want to give that all up (already!) and go back to a crazy busy hospital environment.

What do you think?

Specializes in Nursing Professional Development.

Only you can decide what will make you happy in life ... but as to the question of "losing skills" ...

For most people, the longer you are away from the activities, the harder it is to go back. The profession changes, the equipment and procedures change, and your proficiency decreases with time. Think of another example -- some skill you had as a child that you no longer practice -- such as a musical instrument or sport. If you suddenly tried to pick it back up again, you would not have the same level of skill you had when you were practicing it on a regular basis.

This has happened to me a couple of times in my career as I left the bedside for graduate school, had jobs with little bedside care, etc. When I tried to "pick it back up again," it felt awkward and I needed significant orientation. However, because I had only "been gone" for a couple of years, I was able to re-learn the skills quickly in each case.

Now though, I have been away from the bedside for too long and am old enough to question whether or not I would ever want to put myself through that process again. I was once a top-notch NICU nurse able to do bedside care for the most complex of patients. I doubt I will ever do/be that again. At some point, the effort of re-learning and otherwise "going back" just doesn't seem worth it. Fortunately, I have a great job now in education/management that builds on my past experiences and I have no need to go back to the bedside.

So ... it can be done ... but it gets harder as time passes and you age. You need to take that into consideration as you plan your career.

llg

You've got a lot of good replies. But I figured I'd add mine. Working well with autistic people surely is a skill. Frankly if you really like it, you could also really build on this professionally.

Many ICU positions have an extended orientation anyway should you wish to go that route.

But I do know where you are coming from. I worked CCU for a long time, then went into psych. Now I am SURE I am much older than you and I cannot imagine working in the CCU-I'd land in one of the beds. If you maintain some IV skills, phlebotomy,etc. I wouldn't worry so much.

Can the local police give you guys any tips to increase your safety?

By the way, bravo to you. I find that working with autistics kids is extremely hard.

Specializes in forensic psych, corrections.
You've got a lot of good replies. But I figured I'd add mine.

This made me laugh, because you're only the second reply. :chuckle

Thanks to both of you, though. I realize that no-one can make this decision for me, I was mostly looking for insight about leaving acute care and returning.

The question you raise is one that has been raised by many of us as we grow in our profession. I for one have faced that same dilemma on more than one occasion, more so from "headhunters" seeking me than me seeking something different. Safety is indeed important, but unfortunately this is the world we live in.......suburbs...inner city...schools....no one is completely safe anywhere.

You appear young, (do not get offended.....everyone is younger than me..) and full of enthusiasm. I can understand your quest to to maintain skills, but nurinsing is so diversified that ALL the skills were learned are never used. We migrate to that area that meets our needs, satisfies us and gives us a sense of well being. This is a profession where one constantly is learning regardless of the area of specialty.

If I were in your shoes, I would not "react" to the violence you have spoken of by leaving something you appear to love. I certainly would talk to the administrator for your facility about some security measures. Then, while these things are sorted I would step back and look at the various options that are available.

Perhaps taking a part-time position in a facility...ie. every other weekend.....one day a week, will be enough to keep the skills you fear losing while at the same time meeting your thirst for learning.

I wish you luck in whatever decision you make.

Specializes in forensic psych, corrections.

Thanks for your input. I'm still fairly young, at 28. I'm really trying not to be reactive to the culture of fear in the city, we have a good security program, its just that the officers are sometimes lax in their duties. I've emailed our nursing administrator and the director of security to voice my concerns, and they both seem responsive. So we'll see how that goes.

I work weekend option and take a considerable amount of call, so I'm not sure if I'd even be able to work a semi-regular part time schedule at another facility. Its something I'm considering, though.

Thanks for your response. I appreciate it.

I can understand your quest to to maintain skills, but nursing is so diversified that ALL the skills were learned are never used. We migrate to that area that meets our needs, satisfies us and gives us a sense of well being. This is a profession where one constantly is learning regardless of the area of specialty.

indbletrble, an amazingly excellent analysis. In my recent job interviews where I was applying for positions totally different than my area of expertise, I was struck by how the skills for the new job(s) were so similar to the ones for the rest of my resume. Assessment, teaching, leadership, prioritizing, handling conflict, crisis. Qualities like work ethic, thirst for learning, teamwork are more prized by employers than if you can do a specific skill. Talk to anyone in nursing management. They would much rather have a good person with a proven track record and train them on the specifics of a nursing position than have a highly-skilled nurse whose attitude/work ethic will be like a cancer in their department. On first glance, it looked like I shouldn't have even gotten an interview, but each time I was offered the job immediately. CharmCityRN, don't let the fear of losing your skills be a major influence on your decision. You are honing your skills more than you realize, just in a different setting.

Specializes in Nursing Professional Development.
Qualities like work ethic, thirst for learning, teamwork are more prized by employers than if you can do a specific skill. Talk to anyone in nursing management. They would much rather have a good person with a proven track record and train them on the specifics of a nursing position than have a highly-skilled nurse whose attitude/work ethic will be like a cancer in their department. .

That is SO true! I wish more people understood that. I've worked with many young nurses who focus on the technical skills almost exclusively. They fail to learn the interpersonal skills, teamwork, attitude, etc. types of things and then wonder why they are not chosen for a new position.

As you said, the people doing the hiring are looking for GOOD PEOPLE who can learn the specific tasks required for the job.

llg

That is SO true! I wish more people understood that. I've worked with many young nurses who focus on the technical skills almost exclusively. They fail to learn the interpersonal skills, teamwork, attitude, etc. types of things and then wonder why they are not chosen for a new position.

As you said, the people doing the hiring are looking for GOOD PEOPLE who can learn the specific tasks required for the job.

llg

This is true in other fields. I came from a different field (computers) and I remember when we interview, it is the same thing - rather have a good person we can train the details than a person who knows all the technicals already but a pain to work with.

-Dan

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.

The only skill i really don't use now is administering pills (majority of the pts. are NPO). I pretty much do everything that i learned in school, and way more.

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