To Return to Nursing or Not?

[Cricket183, BSN, RN]

I am possibly facing a dilemma. Six years ago I was forced to leave nursing and go on medical disability. At the time I was 40, working in a very busy inpatient oncology unit and had just received my OCN (national oncology nursing certification). Life was good and I loved my job. I have RSD/CRPS, a rare neurological disease that causes extreme nerve pain, sympathetic nervous system symptoms, dystonia, and various other symptoms. Initially it affected my neck, right shoulder and arm. With the use of a spinal cord stimulator I was able to continue working for about 18 months after I was diagnosed. Unfortunately, after that time the SCS stopped being an effective means of pain control and the RSD spread to my left arm & shoulder, my chest wall & rib cage and my spine. It also started affecting my heart (causing tachycardia & SVT) and stomach (gastroparesis). I went on SSDI. (Luckily I was approved on 1st attempt.) I was on high dose narcotics for 6 years because all other treatments failed. Last December, I started receiving high dose ketamine infusions, a relatively new treatment option, and the results have been dramatic! I am off all narcotics (Woo-Hoo!) and doing much better. Now to my dilemma...

I really want to go back to nursing but there are so many obstacles I don't know if I should even consider it. First, my lisence has been inactive for 5 years so to get it back I would have to take a refresher course as required by my staye's BON. It would cost about $1350. It would be worth the cost if I were able to return to work, but what if I am not? I really won't know until I try. Right now I am able to handle aqua therapy and mild activity but a 12 hour shift? I don't know.

Then there is the whole factor of getting hired. I'm almost 47. Not an age when hospital's typically are looking at hiring someone. Plus I have a disability. Although I am doing better I still have RSD. (And Sjögren's, fibro, and Palindromic Rheumatism). I also receive ketamine treatments every 4-6 weeks, which require me to be out of town Sun-Fri and I need a few days of recovery afterwards. What employer is going to allow me to have that kind of time off?

Then there is the whole SSDI factor. Most people struggle so hard just to be approved and while that was not the case for me, should I even jeopardize it? They have a Ticket to Work program where you can attempt to return to work without it affecting your status for up to 9 months. I just don't know.

Then I read all the negative posts about the state of nursing now and I wonder if I am crazy to even consider going back at all.

Sorry this is so long. Just random thoughts on a Sunday afternoon. I would appreciate any input.

Thanks!

[LadyFree28, BSN, LPN, RN]

As a nurse living with CPRPS and on SSDI, yes, it is possible to return to work; I will caution you about the challenges of having a nursing salary will have you exceeding the amount that SSDI requires to make in a month; I am dealing with those challenges as I returned to full time work last year; and ended up reducing my hours and still make more than the minimal, making it "gainful employment", even though I make less, and most jobs with minimum wage would exacerbate my symptoms.

Contact your local social security office for guidance for Ticket to Work; they may help you pay for that refresher course and one of your options is to return to nursing as a pedi PDN nurse; one pt in the home with smaller kiddos usually did not exacerbate my symptoms; I'm not sure if it would make your symptoms worse; but find out what options you have, they may have options to help you choose as well.

Best wishes.

[poppycat, ADN, BSN]

I was on SSD for 10 years. During that time, I kept my foot in the door by doing 1-2 private duty shifts per month. The amount I made doing that work never came near what would be considered gainful employment but it did keep my skills up as well as my confidence. At the time I was doing this, I was allowed to make up to $800/month without it affecting my disability status. When I decided the time was right to return to work full time, I went to the Social Security office & got all the information I needed. I was able to find a job pretty fast because I had never completely left nursing.

If Ticket to Work is the same as the process I went through, I was allowed to keep getting my disability payments for 9 months after I started full time work. If, for some reason, I had not been able to handle full time, I would just have had to let Social Security know I was leaving full time & my disability would have continued.

Fortunately, everything worked out for me. I've been off SSD since 2004 & am now in a position where I only work 3 shifts a week (27 hours total).

LadyFree28 had a good suggestion about doing private duty. That's what I've been doing for the past 7 years. I have RA & there's no way I could tolerate being on my feet for 12 hours in the hospital. Private duty means I only have to worry about 1 patient & I have plenty of down time so I'm not completely exhausted & in pain on my days off.

There is life after disability!

[NurseGirl525, ASN, RN]

I have been on disability for about 3 years now and have had the same exact thoughts you have. I just got reapproved for mine back in June. When I first decided I wanted to pursue nursing again I talked with my doctor extensively and he encouraged me and thought I could do it. I have epilepsy, fibro, and resolved gastropariesis. That was one of the worst times of my life vomiting every hour. When I was approved again, they sent me the paperwork about how much I could earn without affecting my disability. I think mine is around $980 a month. I was also concerned about losing my Medicare. But I found out that extends for 93 mos after it is terminated. My thoughts are to try part time first and see how I do. Then if I can handle that, I will try full time. It won't be an easy process but I think that is what is best for me. Also, I will be 40 when I graduate, so I'm kind of in your shoes also. Brush up on interviewing skills and have a good résumé!!

[Cricket183, BSN, RN]

Thank you all so much for the input. I hadn't really even considered private duty nursing as an option because all of my experience is inpatient oncology, but I do like the option. Part-time or per diem would probably be best starting out. Looks like a trip to the Social Security office may be my first stop. I also hadn't considered the possibility of the cost of a refresher course being covered by the Ticket to Work program but will ask about that also.

I miss nursing so much. I still have dreams about it from time to time. I know the odds are stacked against me being able to go back but I feel like if I don't at least try I will always regret it. Having to give up my career was a very difficult pill to swallow as I'm sure you can all relate to. I have so many doubts and fears and I never use to be like that. Sometimes I think I am just in denial and not able to accept my disabilities (usually on my bad days) and others times I feel confident and think I can do this (good days). I have been trying to increase my activity level and am slowly but surely being able to do more without significant increase in pain levels. Compared to where I was a year ago, it is amazing. I was on extremely high dose narcotics but still in excruciating pain 24/7, had limited use of both arms/hands (couldn't even wash my own hair), and spent most of my day in my recliner or in bed. Now I am off all narcotics, doing Aqua therapy and water aerobics 3-5 days a week, have full use of my arms (albeit with pain), and am participating in life again. I still have flares when the RSD kicks my butt but with more time and effort I really think I could handle working again.

[llg, PhD, RN]

I just want to thank the posters in this thread. I clicked on it out of curiousity --because I don't know anything about the topic. You guys just taught me a few things that might come in handy some day.

Thanks -- and best wishes to all of you.

llg