Anxiety and night shift. Hospital to clinic? Thoughts and advice appreciated!

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Hello friends.

I have been in L&D for 4 years, and Emergency for 3 years before that. I always wanted to be in L&D and OB nursing, and I worked so hard to get into this field. I thought I found my niche, my passion. I am still passionate about all things OB, and I still love my job, my unit is close-knit and my coworkers are supportive. I feel so lucky. My dream is to be an educator in pregnancy, childbirth, lactation and newborn care. But...

I have been struggling with increasing anxiety over the past 2 years, with the last year being particularly worse, and it's starting to affect my work. My self confidence is at an all time low. About 8 months ago I transferred out of high-risk labor to another hospital in my system, to a low risk unit so that I could do more postpartum care and less complicated labors. I am seeing a therapist and practicing self-care and good sleeping habits, which helps immensely. But a huge part of my anxiety comes from working night shift, and never being able to establish a good routine. I feel isolated and unproductive being awake all night, but if I switch my sleep schedule all over the place between shifts my anxiety gets out of control.

My husband and therapist are encouraging me to find a day shift job. I'd feel better if I could get into a prenatal clinic, but no such luck. It looks like primary care for me. The idea of leaving L&D breaks my heart and makes me queasy. On the other hand, the idea of a Mon-Fri day schedule and going to bed with my husband every night sounds like a dream come true.

I am deeply conflicted, and so, I turn to anyone here who might have some insight or advice. Anyone here go from hospital to clinic/ambulatory care?

I apologize for the lengthy post. Thank you all ❤️❤️

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Specializes in Adult and pediatric emergency and critical care.

Have you considered something like lactation or newborn home visits?

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Specializes in Primary Care, LTC, Private Duty.

I went from night shift in a hands-on specialty to day shift primary care.

Something to consider when your start time is. Don't discount that it will be a huge adjustment to your body to flip back to being able to sleep at night, especially if you have anxiety issues and/or will be starting at what was, essentially, your bedtime just last week. Been there, done that. Even if you aren't naturally an insomniac, your nights schedule has basically turned you into one...however temporary that may be depends on your body. Plus, when you're working 10 1/2 hours starting at 7AM, you basically don't see the sun during the winter months, which can be hard on the mind.

Something else to look for is whether you'll be doing five 8's or four 10's. Five 8's is actually my preference: you're at work essentially with the rest of the "real world", have time to decompress and chill in the evening, and can be on a decent sleep schedule with time to still get things done on the weekend. Only working four days a week might sound nice, but depending on the needs of the practice, you'll rarely leave at 10 hours on the dot, especially if you are working 10.5 hours minimum to account for your half hour unpaid lunch break. When I did the four 10's, they usually turned into four 12's (through no fault of my own...if "your" provider that you're tied to has poor time management, it doesn't matter how good yours is-you're stuck there until the MD releases you/all the patients are done). Sure, I had an extra day "off" but I was usually trying to catch up on any weekday business that I wouldn't otherwise be able to attend to that it just turned into a different kind of work day. Then, come the weekend, I was super drained and exhausted.

That being said, primary care has been my favorite specialty. If you're considering the switch, I'd be happy to chat more with you about some of the in's and out's and tips and tricks I picked up! ?

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Specializes in Nurse Leader specializing in Labor & Delivery.
1 hour ago, PeakRN said:

Have you considered something like lactation or newborn home visits?

Great idea! OP, do you have your BSN? Do you live in a community that has a Nurse-Family Partnership program?

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23 hours ago, PeakRN said:

Have you considered something like lactation or newborn home visits?

Yes, I've applied to a scholarship for a lactation program, and I'm saving up/budgeting to become an ICBLC. But that will take time to get my certification and find a job. I'll be working toward it in the future ? I've never thought about newborn home visits, I haven't found any positions like that for RNs, but it's a great idea an I'll keep an eye out!

23 hours ago, River&MountainRN said:

That being said, primary care has been my favorite specialty. If you're considering the switch, I'd be happy to chat more with you about some of the in's and out's and tips and tricks I picked up! ?

Thank you, thank you, thank you for all your insight and info. I really, really appreciate it. You made me feel a lot better about this potential transition and I will absolutely message you to chat about this more! You rock!

22 hours ago, klone said:

Great idea! OP, do you have your BSN? Do you live in a community that has a Nurse-Family Partnership program?

I do have my BSN! I've never heard of that program, it looks wonderful and PERFECT for me! I've sent an email to the person listed for the program in my county, asking if job openings are posted on the county website etc. Thank you so much for bringing it to my attention, through all my searching for RN positions related to prenatal/OB care it never came up.

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