I am sick of being a job hopping RN

Nurses Career Support

Published

  1. What should I do?

    • 1
      Stay where you are: LTC
    • 2
      Find another job; maybe the one you are interviewing for

3 members have participated

I need advice. I am a RN with 2 years of experience. My speciality is cardiac although I have med surg experience as well. Ever since I graduated from school with my BSN in 2010, I have had this love/hate relationship with nursing. I will start with my first job.

I worked my first job as a floor nurse for a year before deciding to challenge myself in the ICU. I left my first job for a neuro ICU job that only lasted 1 month before I resigned. It was not a good fit. I then was taken back by the hospital corporation I worked my first job at (BJC Healthcare), but was hired on at another hospital of theirs which was the worst hospital ever. Too many unstable patients leaving the ER unstabilized to go to the floor, crazy ratios with it being a cardiac unit (6 patients, acuity not considered), bad management, etc. Too many safety issues. So I spoke my mind about all of these safety concerns, nothing was done to address them, and I left. Very quickly, I was interviewed for my current job.

Not even 2 weeks passed from my last job that I was interviewed and hired at a LTC facility. This place cannot keep RNs. It is so different from the hospital and not in a good way. Nurses who do not do assessments, CNAs who "fake" vital signs, no supplies, no clean gowns, unstable residents not being sent out of followed up on (except by this nurse who does assess and send them out!). Many, many safety concerns. I went from bad to worse. I an a night RN who watches 36 residents with the help of 2 CNAs (that is another thing -- usually, the CNAs have this nasty habit of calling in. With it being late at night, there is no one to come in for them. CNAs are then stretched, having 28 residents or so a piece. Crazy, right?).

I feel secure in my critical thinking. I assess my residents and keep them safe. I call doctors when necessary to follow up with abnormalities and concerns. However, I am not sure if this is a good fit for me. I have an interview with a med surg floor today. I do not know how to feel about it.

My husband is sick to death of nursing. Tired of hearing me talk about the negative aspects of nursing. He wants me to just stick to a job. I want a safe job with competent coworkers and adequate supplies. However, I am tired. I am sick of moving around with these jobs. In two years, I am on my fourth job (3 if you do not count the month I spent in ICU). That is alot for 2 years, I know.

What are your thoughts? Should I stay at the LTC where I am despite all of my concerns and the crazy high RN turnover rate? Or should I start another job for probably less pay (LTC pays more than the hospital) for a job that is farther away from home? I love my residents although I do not like how my current place of employment is ran. I see too many safety concerns.

Is there such a thing as a "safe" nursing job?! With my experiences in addition to my nursing buddies, I am starting to think there is no such thing as a safe nursing job, safe environments to give patient care. I am beyond bummed at this realization. I have really high standards of care and am very detailed oriented. I detest sloppy nursing practices.

What are you thoughts? Please help. Should I suck it up in LTC (even though I am a good critical care cardiac RN) or go back to the hospital?

@Saline Flush: My plan is to have my MSN as a Family NP in the next 3 years. I was accepted into an online MSN program for FNP. Going part time, it will take me three years and a semester to attain that goal.

I agree with your thoughts about LTC. Although I care about the residents, it is not a good fit. I would rather have the craziness of the hospital. They cannot keep a RN past 2 weeks where I am. I am already an overachiever, apparently: I have been there a month. I will probably be there until the end of August. Many are scared off by the facility, and rightfully so. The pharmacy is horrible - despite requesting meds, many do not come because they say it is the facility's job to have the meds although the facility does not have them. The residents fail to get all of their meds which is definitely a problem. Nurses who do not assess: I had to send out a hypotensive resident with a systolic in the 80s with frequent liquid diarrhea (except for me, no one took her vitals as reflected by the chart) and a G.I. bleed within the same week when assuming my shift at 2200. People are not taking vitals, and are not assessing. CNAs "fake" vitals, writing numbers that do not correspond to the residents' baselines. I take my own vitals-I invested in my own automatic blood pressure cuff. There is only one large blood pressure cuff (put that on a smaller framed person, a person gets inaccurate, lower than average blood pressures from the cuff being too big). Not enough supplies: running out of tube feeds, no cups for urinalysis, etc. CNAs that do not show up to work, stretching the ones that I do have where they can have upwards of 28 people each. A CNA is a nurse's eyes and ears when they are not in the room. I do not like having to stretch them because it impacts the quality of care. I hate manual paper charting because it is repetitive and time consuming. Computer charting is much better (speaking from experience). Night shift is the shift that I am on. It is the only one where there is one nurse to 36 residents (which include a couple trachs and g tubes). On days and evenings, they have one nurse to every 13 residents. I suppose the management and staff think that things come to a standstill in the middle of the night. Not so. The list goes on.

I took this job because, like I said, I support my family. One income is not enough. I also thought that it would be nice to know the residents on a long term basis. That is a nice thing about LTC. A nurse (a good one anyway) gets to know their baselines. This is all that I like about LTC. I believe a person can determine from the prior paragraph why I am not fond of what I have seen so far. I did not even begin to go into all of my concerns about this place. I have been offered a hospital position after being frank about all of my positions these two years. I agree: switching jobs is not a good thing. However, after this LTC experience, I am going to value the hospital environment much more.

@Viva: My expectations are simple but important: I want to work in an environment conducive to patient safety with the supplies needed to do my job.

I must be able to walk away at the end of the day knowing that I gave safe, attentive care to all people under my supervision and care.

Specializes in LTC, assisted living, med-surg, psych.
@Viva: My expectations are simple but important: I want to work in an environment conducive to patient safety with the supplies needed to do my job.

I must be able to walk away at the end of the day knowing that I gave safe, attentive care to all people under my supervision and care.

I'm sorry; I meant no disrespect when I suggested looking within for the answer to the job-hopping dilemma. You asked for advice, and that was what I gave you. But you should be aware that the environment you're looking for is a rare bird in this day and age, so you may have a very long search ahead of you.

It took me 13 years to find my own Shangri-La. Some nurses never find it, and they either leave the field after a few years, or they become bitter and angry people who are difficult to work with. Again, I wish you only the best.

@Viva: No, No! Thank you for your advice! You are right - I put this post up for people's thoughts on my career. You bring up alot of excellent points. I appreciate your time!

My only suggestion would be to tell you to take a step back and really consider the feelings coming from you because things are not going to get better once you become an NP. Once obama's healthcare bill takes place, in combination with management in hospitals in LTC you will be rushed to see pt's, everyone will be cramped and wondering if they are going to loose their license or if pt's will complain because you won't given them a script for 150 percocets to go home on a friday night for "menstrual cramps".

I'm not at all saying to rethink things, I just see that you're going to be an NP, and I personally hate working with midlevels that have textbook expectations of nurses, and of situations with patients when things are anything but textbook. Wanting me to stop everything I'm doing because a pt is hypotensive at 95 systolic.:no: Or giving me attitude because I didn't drop everything to give 650 of tylenol STAT:banghead: As a provider you will be able to take more time with your patients to do the right thing but you will experience pressure from management and other providers to do things faster, and see patients quicker, which in some cases won't be inappropriate, or skip to quickie assessments, etc.

To make a long story short I'm not totally convinced that those situations that made you quit are totally the fault of management, i think the whole system is broken, and those things you are complaining about are here to stay, and probably will follow you. I hope at some point, or in some facility, you will be in a place that it won't be a problem for you. (sometimes working with cool people that help you, make dealing seem not so bad.) And remember not to take your feelings of frustration on fellow RN's who are right there working next to you.

:twocents:

Specializes in Hospice, Homecare, Recruiting, Psych.

From my experience as a RN for 32 years and my experience as a nurse recruiter, I know that the first 5 years of your career will be finding your niche. Don't be afraid of trying different areas. I had a love for psych and hospice coming out of school. After 4 years on an acute psych unit it was time to move on! I was a hospice RN and supervisor for 19 years with the same organization. I love hospice and dealing 1:1 with patients and families. Unfortunately I was downsized and my position was eliminated. Kassandra, be patient and find what you love! It may just take some time that's all! Good luck and keep that level of professionalism always, it's an asset that I always looked for in the nurses I supervised and in the nurses I recruit now!

@Tiffany: I have never taken feelings of frustration about work out on those who work with me. I fail to see where that assumption came from. The only bit of dialogue where that may have come from is from my low opinion of nurses who do not assess their patients (or residents), do not give meds as scheduled, and, as a result, put them at risk. I hold my colleagues to reasonably high standards because nurses can kill or harm a patient (or resident) from not assessing when the individual has a change from baseline (which is why one must establish a baseline assessment, very crucial). For example, if a hypertensive person becomes hypotensive, you would not give them their normally scheduled blood pressure meds because you would cause them to "bottom out" which could lead to a code and very possible death. The health status of the people whom we care for is always changing. One must assess those under their care to protect them from harm. In my opionion, assessing and rounding are the two most important things a RN must do. Oh: And slow down when giving meds. Know why you are giving the meds that you are giving and if they are still appropriate to the patient's condition.

Also: I realize that LTC is different from the hospital setting. Very different. However, just because someone is not in a hospital does not mean that you cannot hurt or kill them from not executing one's nursing responsibilities in an efficient and accurate manner. Tiffany, this conversation is not directed at you at all. These are simply my thoughts on nursing.

I am opionated, choose my battles, and stand up for my patients because someone has to in order to keep them safe. I am going into NP school because I like their work. I have worked alongside NPs in the hospital setting, and admire their ability to diagnose and treat with the intelligence that a nurse brings to the table. With Obama Care, there will be more of a demand for all health professionals.

One more thing: Nurses are just as intelligent, if not more knowledgeable at times, than the physicians they work under. Yes, I said it. There is nothing wrong with bringing concerns to the PCP's attention regarding any aspect of the patient's care. Again, patient safety is paramount.

@Lienne: What you wrote is a comfort to me. I have some nursing buddies who have had multiple Nursing Jobs as well, looking for that ideal fit (well, as ideal as nursing can be!). Thank you for your understanding and encouragement! :o

Also: I tell my colleagues to hold me accountable to the established standards of nursing care. If and when they point something out that I may be doing wrong or what have you, they are protecting the patient and looking out for me as their colleague. I am far from perfect, and realize that no one is, or ever will be perfect. Cocky, overconfident people are a higher risks of hurting the people they care for because of their arrogance and pride. It is one thing to be confident yet humble. It is quite the other to never ask questions and make mistakes at the cost of someone who places their trust in them to care for them and keep them safe. Accountability for ourselves and eachother is huge.

Dear VivaLasViejas,

I read your reply yesterday (August 2nd) and it has been "hanging-out" in my head. It really resonated for me personally, because I have personally found that I can always come up with good reasons why a job isn't right. What I have noticed however is that I keep doing this and that while my "reasons" may be true, the real issue has to do with me. The terms that you used, "restlessness" and "dissatisfaction" really ring true. I wish that I would have come to this kind of awakening earlier in life, yet at the same time, I still struggle with restlessness and dissatisfaction. There have been many things that have helped me to deal with this, e.g., history (just looking back over my life and seeing many job changes, relationship changes, moves, etc.), therapy, my faith (christian), as well as the support of good friends and using mindfulness meditation and aspects of Buddhist psychology (even though I identify as christian); such as the recognition that part of dealing with life is accepting the fact that dissatisfaction (dukkha) is an inherent part of life (this is one aspect of "The First Noble Truth" attributed to the historical Buddha). This does not mean of course that people should take abuse, or that nurses shouldn't organize, just that wise action comes from seeing the big picture in a sober and discerning way and not from emotionally reacting to "causes and conditions" (another common piece of Buddhist terminology). Also sometimes (as others have noted in this thread, but not using these words) we have to "lose the battle to win the war." If we are too busy reacting and moving around we may miss out on either a better opportunity when it shows up at the right time or on the fact that the situation that we are in has changed.

Just my "2 cents" to thank you for your comment as well as feedback for Kasandra and anyone else reading the thread who can relate.

Peace.

+ Add a Comment