Sigh...the dreaded day...advice needed

Nurses Career Support

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Greetings to all.

I just discovered this site only hours ago through a friend of mine. I am absolutely overjoyed to have stumbled upon such an amazing site such as this one. I am writing this post because...I am seeking outside encouragement...or advice...from other healthcare professionals whom can provide me with an outside perspective.

Presently I am an NP, however, I have never worked as one...in fact...I have never utilized any of my nursing licenses...neither my LVN or RN. I was inspired to become a nurse when I was 14 after being hospitalized for an extended period of time by the nurses who provided me daily care. When it became time for me to pursue a nursing education I soon realized upon the completion of my LVN program that although I loved nursing I was not yet comfortable practicing nursing yet. Eventually, after competing my RN program, I still felt the same way...and my fears and insecurities as a nurse prevented me from once again accepting any job offers and thus I refrained from utilizing another license which I worked extremely hard to obtain. I than decided to stay busy and further my studies which culminated in an APN degree...but sadly...my fears only increased because of the heightened level of autonomy, increased scope of practice, and responsibilities required of APN's. After fulfilling my educational goals and dreams...I never was able to muster the courage to secure any nursing job either as a nurse nor as a midlevel provider. With my education complete, income needed to be generated so I accepted a job not in the healthcare field and am making much less then I am capable of bringing in when considering the income scale of both nurses and APN's in my present location.

In between my schooling I took some time off to marry my longtime partner, who has been my rock throughout my studies, and is the reason I have been afforded the opportunity to pursue my education. He has never pressured me to secure a job and utilize my education until recently as an injury has rendered him disabled which resulted in him leaving the work force until he makes a full recovery. I now feel it is my responsibility to secure a position where I can generate a higher monetary income and make up for the loss in finances, especially when I know I am capable of doing so. A week ago he told me as I was providing him care that perhaps I should consider securing a job in the nursing field.

I am scared...I am discouraged...I don't know where to begin...and despite me being confident in the knowledge I possess...I still do not feel equipped to work as either a nurse or a clinician. I am looking for words of encouragement here I guess or any suggestions on what I could do to overcome my insecurities and fears...or possible suggestions on what work I could possibly do which would ease me into the nursing world.

If you can make it through this long thread...and provide some words of wisdom regarding my circumstances...know that I would appreciate it more than words can express.

Sincerely,

PinkPinster

SleeepyRN, Thank you for the reply. I do absolutely understand the necessity for Xanax when needed and am all to familiar with it...trust me lol I am just really nervous I guess about how it is to be actually working as an APN. I remember when I did my rotations with my preceptor at a Family Practice. The physician heavily relied on her to see the majority of the patients and when she did request his help he didnt seem to enthused. My preceptor even stated once "remember you have to be just as good as a the Doc you work with because he wants a provider there to lesson his load not add to it." That remark worries me because I remember collegues of mine who stated to their employers when they were new grads that they desired orientation etc. and were not given it despite being promised it and thus disappointed the physicians they worked with. This is why I was tinking of utilizing my RN license...but I am not sure what I would tell employers when they ask why I have never secured a Nursing position or why I desire to pursue bedside nursing and not work as a Clinician. I also have witnessed and experienced several stressful and discouraging working environments during my rotations through both LVN and RN schol. I was aquanted with the phrase "nurses eat their young" from the begining of my nursing studies and despite having an advanced nursing degree, I am very much still "young" in terms of my nursing career. I also feel that if collegues knew I was an APN and working as a RN they would expect so much more from me despite the fact that I would need refreshing and orienting...so much worries...
I feel for your situation very much. I can relate in many ways. I want to be clear on one thing though. I wasn't advocating Xanax, just giving an example as terms of service prohibit medical advice. (Although I take it myself. I AM dysfunctional without it, and not ashamed to say so)I do realize family practice s rely heavily on NPs. Im just sure there are places that would offer a better experience than what you have heard. I truly wish you the best of luck. Keep us posted.
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Yes, sorry if it seems flippant but I didn't mean it that way.

You say it's just about nursing but if its been holding you back for years, you do need to seek some help. Like the above poster said you're not functioning. Maybe you don't need medication but talk therapy to work out your issues with the profession. Finding the "perfect" job is an unlikely reality, so you are going to have to change rather than hope you find something that makes you feel comfortable. Your first job and your first

Days at new jobs are going to be scary, whether or not you think the job is a good match.

Chrisrn24,

Thank you for the clarification. I apologize if my response to yours came off short...I was somewhat taken aback I must admit by how brusque your initial statement was which prompted me to reply as I did. Your more in depth clarification(2nd post), I found very realistic however and was just the type of advice I needed to hear. So thank you for that. I immensely appreciate it. What I meant in regards to my anxiety was that it doesnt effect any other aspect of my life as in my everyday routine etc. Only when I am considering utilizing my nursing education. But...although I do not like to acknowledge it...I needed to hear that it is in fact dysfunctional...and I recieve treatment for it :) so don't worry... I simply utilize the help PRN. :) Thanks bunches.

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I agree and I don't believe that this answer was flippant, as another poster believes. It is simply the truth and sometimes the barebones truth is difficult to hear.

OP, I feel for you, I really do. I once suffered panic attacks for the first time in my life (I was 40) because of my med/surg position. However, I sought treatment, and with counseling and medication was able to return to functioning as an RN.

I disagree that your anxiety is not dysfunctional. From your post, I see that you have an advanced degree that you achieved primarily out of a desire to avoid the actual practice of your chosen profession. Now you have pretty much reached the pinnacle of educational opportunities (at least without clinical experience) and are having to face what you have spent years avoiding. That could certainly be labeled as dysfunctional since you are simply unable to do what you really, really want to do.

I'm sorry that this response is not what you hoped for, but I sincerely believe that reaching out to a counsellor or even your PCP would do wonders for your state of mind. I also firmly believe that it is a failure of the nursing profession to allow a student to achieve an independent practitioner degree/license without actual experience.

Greetigns roser13,

Despite what your perception is based off of my initial post, this advice is exactly what I am seeking. Which is why I was so enthused to have found this site in the first place. As I originally posted, I am seeking an outside perspective and was well aware that I was potentially going to recieve somewhat critical responses...which to be truthful was extremely discouraging...albeit necessary. You see, I already sought help in regards to my anxiety to practice nursing...which has absolutely done me wonders. As I stated previously, I already have secured interviews...which is a huge step from where I was. I still have fears however which of course is normal...I simply decided that perhaps additional...insight was needed by fellow professionals who could perhaps give me direction...words of encouragement...and state facts which I may be to biased to accept or see...so with that said thank you for your opinion and advice. It is appreciated.

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

I think you should start applying for RN jobs. Just because you have an APRN degree doesn't mean you have to use it. In OB, I work with several NPs and one CNM who all work as staff nurses. They have said that they enjoy the less stressful position of being a staff nurse. Anyway, how about working as "just" a staff nurse somewhere for a few years to allow yourself to gain confidence in your skills, and THEN try the jump in to the midlevel care provider role.

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OP, your anxiety IS dysfunctional if you have not been able to even take a first step as an LVN, and RN, nor an NP because of it. Have your other self read your first post. Both parts of you need to acknowledge this problem you are having, and you subconsciously have done this by coming here... but you are not allowing yourself to consciously do this (you're fighting yourself).

Remember that many here are begging for a chance to even get an interview! So you may get some eye-rolling. Nursing is hard, it's scary and you are right to be scared. Being scared causes anxiety. But it may be that all you need is a swift kick in the pants - someone to burn your books and lock you out of your house so that the only place to go is to a job. Literally. Yes, you may hate it and quit. This is common. But you don't know until you pull up your big girl panties an get out there. Once you do, you might find that you step up in a big way, and all this over-worry was worthless wasting. :up:

I just kicked you hard in the butt. Get some help and give yourself a chance.

netglow,

Your kick was well received :). As I just stated in one of my responses, I already have received help from my PCP and take medication PRN. Which has done wonders. In fact, it is one of the main reasons which I have been able to apply and actually secure two interviews already. I simply felt that I needed additional input from others who could give me an outside perspective...regardless of what it was...as long as it was able to be used. I still have fear...which I listed in multiple response already...I was also hoping to receive advice regarding my other concerns about wanting to apply for an RN position and not knowing how to articulate in an effective, honest, and professional manner of why I choose not to work as an APN or have not secured a nursing job in general for that matter...It seems people have been more intent however to focus in on my anxiety instead...which is understandable as it is a pertinent issue and we for the most part are all nurses of some degree here. :) Again thank you though,

I will be sure to wear my big girl panties to every interview :)

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Hey, meant no offense Pink, because the more you read here you'll see that it is often those with the most anxiety that DO step up once they are "onstage" so to speak.

As far as the RN thing, it's tough to find a position out there. If you actually get an interview for an RN position you can say that you wanted more bedside experience. Simply that. Many RNs who are NPs, work as RNs simply due to the fact that they cannot find employment otherwise. Some do both.

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The OP has severe anxiety issues and as we have all stated IS dysfunctional. This requires more than just s "swift kick in the butt." When we are in this frame of mind of sheer panic, beyond normal anxiety, we can't just suck it up and put on our "big girl panties" talk about offensive to someone suffering from a severe problem. OP needs professional help, not "big girl panties."

"We" must be careful not to transfer what may be an individual's own problem onto another person here. It's just not fair to ramp up their problem to be like yours. Now that's a sure way to cause another person anxiety. Not sure that is what you meant, and nobody here was giving you ideas on what to do with your panties... do you see where I'm going here? The OP wanted the suggestions here, it's her post.

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I think you should start applying for RN jobs. Just because you have an APRN degree doesn't mean you have to use it. In OB, I work with several NPs and one CNM who all work as staff nurses. They have said that they enjoy the less stressful position of being a staff nurse. Anyway, how about working as "just" a staff nurse somewhere for a few years to allow yourself to gain confidence in your skills, and THEN try the jump in to the midlevel care provider role.

Salutations klone,

I really would much rather prefer to work as a staff nurse. I feel now that my education is complete, and I am going to for the first time utilize my license as a nurse...it only makes sense to start as a staff nurse before I attempt to utilize my APN education. My concern is how will I articulate clearly my reasons for not ever having secured a nursing position of any level, despite completing an Advanced degree in nursing and instead secured work in management. How can I convey this honestly and professionally whilst still sounding appealing?

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

I would just explain that you wanted to get your advanced degree right away, but that you wanted to get a few years of bedside nursing experience before jumping into the advanced role.

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Specializes in ED, ICU, PSYCH, PP, CEN.

I agree with the above poster. Just tell people that you had the rather rare chance to continue on in your studies before securing work and you decided to go for it all the way. Now that your studies are completed you are ready to start at the bedside and see where your education and skills can take you.

I recommend med/surg, neuro or ortho to begin with. But you will probably have to take whatever is offered because jobs are scarce right now.

You do have to jump in and get a job and start working. Everyone is scared at the beginning.

I highly recommend you buy and read the book by Patricia Benner called "From Novice to Expert". Her studies have shown that it takes 5 years to become an expert nurse. And everytime you switch specialties you begin over again.

I believe this as I did 1.5 years in med/surg. Then I transferred to ER. The first 2.5 years scared the crap out of me, but by the 5 year I was rocking and rolling.

Last year I transferred to ICU and I am a "baby" nurse again. Scared much of the time, but I work with people that understand that and I am learning so much. I had thought about doing ICU for about 5 years (before I actually had no choice but to take the ICU job) but I never did because I thought I wasn't smart enough for the ICU.

I always ask myself "What's the worse that can happen". In your case it would be to get a job, do a bad job and get fired. You will never know until you jump in and do it. And by the way, I did get fired from my first nursing job. Got another job right away and stayed there 5 years.

You gotta do it because as a former patient you have so much to offer your future patients. You will do a better job for having been in their shoes.

Good luck and get on with it girl.

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Specializes in ED, ICU, PSYCH, PP, CEN.

Also wanted to add that I know many nurses that have their NP and do bedside nursing, and/or both.

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I would just explain that you wanted to get your advanced degree right away but that you wanted to get a few years of bedside nursing experience before jumping into the advanced role.[/quote']

That is perfect.

OP, I know you say you just use a PRN but maybe you need to be reevaluated or sit down with a therapist to discuss your problem. I do apologize if my first response seemed flippant to you, but I am only trying to make you see that this crippling fear isn't normal.

My sister has anxiety issues and once she dealt with them, she couldn't believe she had waited so long to figure it all out and seek help. And plus, a nurse who has experience in anxiety is a great advocate for patients to be properly treated. It will actually probably help you feel more connected to your patients, being able to empathize with what they are going through during the scary time of hospitalization.

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