new rehab nurse - should I stay? (long-ish post)

Hi - after reading many of the posts here, and descriptions of the patient loads, I feel kind of funny posting this here. On paper, my unit would seem like a dream job, but I am not happy here, and wish feedback about a possible career change (still nurse, but different specialty). BTW, I have been working on my rehab unit for 7 months as a nurse, and was working as a therapy aide on the same unit for years before that. I am in my forties.

Well, one thing is easy to communicate...I was moved to day/night rotations without it being discussed with me. This is what really prompted the idea of moving. I was not told that we would ever have to cover 0700-1900 & 1900-0700 in the same week, and they switched me without notice. I just noticed that they were putting me down for Mon 7A-1330P, Tues1900P-7A, Wed2330P-7A, Friday7A-1900P etc. on certain weeks. When I asked they said "oh, that was a mistake, you should have started on day/night rotation". Hmmm. I don't like the flip-flopping, and fee that they did a bait-and-switch on me.

The other thing is constantly feeling harried because of our demanding patients. Don't laugh, because we only have 4-5 pt. per nurse when working with a CNA, or 3 pt. per nurse working alone. It's just that our patients are SO demanding, have the 9AM therapies you all know and love, we have tons of paperwork, the CNAs aren't responsive to pt. tioleting needs etc. (nurses do as much NA work as the NAs sometimes in addition to our Qshift assessments, meds, wound care, etc)) and our patients tend to be much more sick than they were years ago. Just when I think I am crazy for not being able get used to the demands, the experienced nurses tell me they are feeling it too.

Maybe I'm just not being realistic, but I am a hard worker and don't mind running around. It's just that between the patients riding their call bells, management breathing down our necks over our documentation (we have someone who does little else besides scrutinize our documentation), the tons of meds, the wound care, the variety of diagnosis, the sometimes poor contributions of the assistants, the bathing & toileting, and the getting pulled to committees/projects/etc., I'm wondering if this is where I want to work. The nurses who seem less stressed frankly just don't seem to actually do their jobs - fudged assessments, etc.

I was thinking about trying to find work in hospice or home care. I realize there is a ton of paperwork in home care, and other stressors. I just would like to be able to work with patients in a more meaningful way without constantly running.

So, look for another rehab job with day/evening and just toughen up, or consider a move to HH or hospice? Thanks.