advice needed from seasoned RNs to a newb

[melmarie23, MSN, RN]

I kinda want to quit my current job, and I hate feeling that way. Ugh. I suppose I should back track and preface this by saying that I m currently a per diem float between an acute rehab unit and a med/surg unit.

If I was per diem on the rehab unit only, I'd be fine. I feel much more comfortable and supported there. But the medical/surgical unit? Um no. I had 6 patients today (up from my usual 5, which I also think is too much-especially as a new RN). I dont think I need to explain that the acuity is much more higher on this floor-I'd be just preaching to the choir. And I also know from reading previous threads that 6 pts on day shift isnt all that uncommon, but for me, just starting my 4th month at this job (I had 4 weeks orientation to each unit), I just feel its too many. Its not that I can't handle the acuity, I most certainly can. But not with such a large patient load. I feel that it is not safe, its not efficient and I don't get to spend as much time "nursing" my patients if that makes any sense. I feel like all I am doing is passing meds, or changing dressings, and chasing doctors around. Not only that, but this unit is chronically understaffed. Duh. They have 9 positions open too-a combination of full time, part time and additional per diems. Today, my director said to me "you need to apply for one of the open positions!" and I, as I am in the middle of paging a doc, said jokingly "oh I dont know, I am up to my eyeballs here as it is!" (Not to mention that I also just got another per diem position-but in L&D at another hospital. My current bosses will know soon as I get my new offer in writing. I should also mention that L&D is my dream specialty and that I am so fortunate and humbled to actually be given the opportunity).

The thing is that I've actually found myself liking this sort of nursing more than I thought I would..................BUT, its just dangerous and overwhelming and I never get out on time (I know, I know, "wah wah" tell you something that you all don't already know/experience at your current job). The rehab unit is just totally different. Even when we are short staffed with RNs and LNAs, there are other "hands on deck" between OT, PT, Speech and case management/social work. Just more people around to help out. Plus the acuity isnt as high since these people are more or less in transition before they go home or to a skilled nursing facility.

oh oh oh! And I failed to mention that I am a new mom-my son is 6 months, and that I am still exclusively breastfeeding. Therefore I pump while at work. However today I only got to sneak away for 15-20mins in the 13 hours I was there today? Yeah, pumped ONCE in 13 hours! This is typical when I work a 12...or an 8, but isnt so much of an issue with the latter because I just pump again or feed my son right when I get home. So this is another thing that has me down and just feeling overall crappy about this current work situation. I just can't seem to find the appropriate time to take a longer and/or an additional break I am so swamped. There is just so much to do and to take care of. I am so lucky my supply hasnt taken a hit yet, but the longer this goes on, the sooner is going to catch up.

I dont know what to do. I am not a quitter. But the stress of this, coupled with the fact that I now have my dream job, is making my current look that much more unfavorable to me.

I am not quite sure what I am asking of you all here. Just any words would be appreciated. Thank you.

[Riseupandnurse]

You are trying to juggle way too much. It's very common in a new RN. So many opportunities and pluses and minuses for each option. With all due respect, I will suggest that maybe you might consider what is best for you as a mother. It's true what they say, you turn around and your children are grown and gone. You cannot get that time back. Not meaning to "lecture" you, just reflecting on what I wish someone had told me when I was starting out. Best of luck to you and congratulations that you are so much in demand; that's quite a compliment.

[SageSarah]

Ditto to Janh's post...too much at once. And raising is child is by far the most important job on the planet. You may be making milk just fine, but how much adrenaline is in it from the stress? (Disclaimer for experts--I don't really know if adrenaline gets into the milk--it is more a metaphor for a stressed out mom!)

It takes a full year after nursing school to change your brain from student mode to acting nurse mode. Typically the biggest part of the slump is at 6 months. Still ahead for you, so hang on!

The only thing anyone can do to make that change in that first year is to just slug through it. New nurses who have nothing else to do, have one position on one unit, say the same things you are saying. Seems like you need to make some choices that only you can make.

[melmarie23, MSN, RN]

I am just feeling extremely overwhelmed. It is too much at once. Another part of me also feels guilty because this job was always just a stepping stone to get into the specialty of my choice. And I have that job now and start next month.

I think what I am considering at this point is just drop down to the bare minimum to maintain my per diem status. That is 32hrs/6 week period. And not to agree to 12s for the med/surge floor-just work their 8s. Its just too much and I am totally burnt out. Currently, I am getting called/emailed every day to pick up shifts and I am already putting in 24-36 hours a week for them. I really feel like I am being taken advantage of right now.

[SageSarah]

There will ALWAYS be needs...which is great when you get into a position where you want to work extra shifts. I know very few nurses who haven't done that in their career sometime or another.

BUT, right now you have to think hard about what is important, and draw some very clear and consistent boundaries for yourself and your little one. Get away, think it through, come up with a plan, and do what you need to. When they call, or plead, or want want want you to work, smile and say you would love to, but just can't swing it right now. No need to be defensive or feel guilty, no need to get nasty with them or with yourself. Just "smile and wave" and do what you can. Then go enjoy your L&D, your baby, and be sure to throw around the thanks and the compliments when you do your 8 hours on med surg.