Been an RN for 20 years, can't take anymore

[Nurse Beth, MSN]

Dear Hoped You Could Last,

I'm sorry to hear you're going through such a challenging time in your career. Thank you for 20 years of patient care.

It's challenging to make significant changes at this stage in life, but options and possibilities are available.

It may be helpful for you to take a moment to pause and refrain from making any hasty decisions. If feasible, consider taking a work leave.

Here are some suggestions to consider:

Seek support and guidance. Reach out to friends and family. It's beneficial to discuss your emotions with trusted individuals. A supportive community can offer emotional comfort.

See a professional counselor to discuss your anxiety and feelings of hopelessness and help you gain clarity about your next steps. Start with your employer's employee assistance program (EAP).

See your primary provider for a mental health evaluation and possible treatment. 

Just a reminder, you are not alone in feeling negative emotions. It's important to remember that these feelings are often temporary and will eventually pass. You have coped with difficult situations in your personal life and career and have the strength and resilience to get through this.

Upskill or transition to a related field. Many nurses do not last 20 years at the bedside. While acute care is challenging for you now, many other nursing roles might be a better fit. Register on indeed.com to gain a sense of all the opportunities out there.

With your skills and experience in acute care, you may be able to transition to roles in case management, utilization review, quality improvement, or informatics. Consider outpatient clinics or even dialysis. These positions often value acute care experience and can provide a more supportive and less physically demanding work environment.

Concentrating on acquiring new skills can reignite your enthusiasm for learning and nursing.

Explore part-time or per diem opportunities. If you still want to work as a nurse but need a change of pace, consider exploring part-time or per diem positions. This could allow you to continue working while reducing the stress and burden of a full-time schedule.

Research retirement options. Investigate the possibility of early retirement or semi-retirement. Speak with a financial advisor to understand your options and maximize your retirement savings.

Consider a career outside of nursing. While it may be a significant change, exploring other career paths might open up new opportunities. Think about your interests and skills and consider fields like healthcare administration, healthcare consulting, or medical sales. You may even do something completely unrelated, such as working in a gardening store.

Take care of yourself. Your health and well-being are essential. Take time for self-care, seek medical attention for your anxiety if needed, and maintain a healthy work-life balance.

Remember, it's never too late to change and prioritize your well-being. Take things one step at a time, and don't be afraid to seek help and support.

Transitioning from acute care after many years may be challenging, but finding a path that brings you fulfillment and contentment in your professional life is essential.

I wish you the best in making the right decision for your future.

Nurse Beth

 

[martymoose, BSN, RN]

Thank you very much Nurse Beth. It is very helpful to get someone else's perspective when all I see is the "brick wall".

I should utilize the EAP, and a financial planner. The anxiety of the job is almost making me not function. And the discord between the company and the union currently is only making it worse.

Thank you for the insight.

[brandy1017, ASN, RN]

Some of jobs in a hospital that might be less stressful to transfer to would include pre-admitting nurse, case manager, outpatient, cardiac rehab, GI colonoscopy, IR nurse and maybe PACU.  These are a few suggestions to try to maintain hospital health and retirement benefits.  Since many hospitals are big corporations you can check out their various other clinics and hospitals for openings.

While you are working I recommend starting a Roth IRA if you don't have one.  It can be used as an emergency fund if need be since contributions aren't penalized and after 5 years and you are 59 1/2 even the interest is tax free and no penalty if you need to withdraw from it.  As I mentioned before you can make withdrawals to keep taxable income low to get best cost for health insurance premiums on the ACA healthcare.gov site.  If I had to pay full price my insurance premiums would be around $700 month as they go by age, but due to income low with help of Roth they are only $35 a month for a silver plan with a $1050 deductible. 

Also while still working choose a high deductible and max out your HSA which I did as well for several years before I quit.  That money is yours and sometimes the employer will add some as well.  You can use that money for current or future medical/dental/vision expenses or you can save the receipts and then pull money from the HSA in the future and just make sure you have the receipts in cause of an IRS audit.  There is not a time limit on when you take money out of HSA for your med bills as long as you keep the receipts.  This also is tax free and helps keep your income low while either using it for past or present med expenses.  Technically you could use it to pay for COBRA health insurance premiums which lasts up to 18 months after you leave but I think Obamacare is much cheaper even though you can't use the HSA to pay premiums.

Lastly to those that have a house you may want to get a HELOC before you quit, but consider it just an emergency fund if your back is against the wall and use it as sparingly as possible since rates are now up to 8% and probably will go higher.  It is a variable line of credit off the equity of your house it can go as high as 18%, depending on your lender, if the Feds jack rates that high and I guess it happened back in the 70's with the stagflation so be warned.  The days of cheap credit are over.  You can pay as little as interest only for the first ten years and then have to start paying off the principle after that.  Again I stress this is only for real emergencies and I would try to make more than the minimum payment because you don't want to get overextended and lose your house.

Once you quit you have to decide if you will get another job elsewhere and whether you will take your social security early at 62.  If you aren't working that is probably your best bet.  But if you are working it probably won't make sense due to their income limits before they start withholding part of your social security payments if you make more than $21, 240 a year.   It is complicated.  But if you quit at 62 or later and already made that or more they don't go by that total, then they look at the monthly income after you stopped working.

The only downside of Obamacare is since the premium subsidies are tied to your income if you decide to get a job in the middle of the year and then make a good nursing income you would be hit with a tax bill as those subsidies would no longer apply since you made too much money so you have to keep that in mind as well.

PS to the OP that has only 8 years left on her mortgage just remember you are almost done and it is mostly principle and not interest at this point!  Think of ways to make it work to make enough money to pay the mortgage till you can bridge to SS at 62 if you can't find a better job.  In fact I did an 8 year refi 2.6% in 2020 and took early retirement at the end of the year so it will be paid off when I'm 63.

My unionized hospital was the only one in the corp system in the city, but there was a neuro clinic attached so several of my coworkers went there and are happy.  It is much easier and still have union benefits.  So an attached hospital clinic might help you retain your union benefits talk with your union rep if that is an option as well if there is only one union hospital in the system.

[jag nurse, RN]

You are me almost to a T.  I'm two years older than you and just resigned after months of hard decisions.  Bedside nursing has done my body in to the point of no return.  I just can't lift these people anymore.  There is higher acuity, heavier people, and of course never enough staff.  I haven't decided whether it's retirement or just a break.  I'm only out a month so still trying to process.  I very much miss the hospital environment, and it's hard not being a nurse.  I pray you find what works best for you.  Please know you're not alone.

[SunDazed, BSN, RN]

I am about the same age, but have only been in nursing for 18 years. I left acute care for a vaccine research job for 2 years. The nurse role there was just to do chart reviews and give shots, since all the participants had been recruited before I arrived. Then I went to hospice, as the research job was just a 2 year gig. I was in hospice home care as a visit nurse and at a hospice house. I had to take a break from hospice when my dad, cousin, and uncle all died. I went back to the hospital just in time to work through Covid. Luckily, it wasn't as bad where I am at compared to other places. I returned to a hospice job when I was ready, as I knew staying in acute care would wear my body down.

Hospice is a great fit for me. And there are many different roles in telephone triage, night on call nurse, hospice house, day visit nurse, case manager. The hospice I work for lets nurses move through different roles when there are openings to keep people happy. It is nice to change it up from time to time. They also let nurses go to per diem when they need a break. They weren't as flexible that way pre pandemic, but they are now. 

Good luck! I came to nursing late (in my late 30's) so I need to work until I am 65 or 70. Hospice doesn't pay as well, and the benefits aren't as good as the union hospital contract. But I have a better work-life balance and not having to lift as many people, I think I can extend my physical expiration date!

[Jenny Hanks]

I am in the same boat! 59 years old, been an RN for 23 years and have worked in mostly outpatient jobs that were basically acute care for oncology and infusion nursing.  I got tired of that and tried case management, which I hated.  Worked for an allergy clinic and hated that as well.  Prior to getting my RN I was an LPN and did nights at a small hospital and worked in family practice clinics.  Currently I work in phone triage, which to me has been the best so far.  But overall, I hate nursing but I feel stuck because like some of you I did not handle the pandemic well - for many reasons that had to do with my role and not enough help.  We still do not have enough help.  I suffered a nervous break down about a year ago and took 3 months leave of absence.  Now I am getting through life thanks to medication.  But the point is, I hate this job.  I am not a people person when it comes down to it.  But I can't retire.  I'm living paycheck to paycheck right now with rent and inflation through the roof.  I've thought about going for my nurse practitioner, but that's more school and more money!  I understand how disappearing seems the only option when you are stuck in a career.  I'm still trying to figure out how I'm going to keep this up for at least another 10 years.  It'sa little scary!  

[JKL33]

Just throwing this out there:

One thing that can be extremely helpful in hospital nursing is to reflect on what things are adding to the stress and anxiety (both categorically and specifically) and re-examine which of those elements are truly and actually worth the stress, or worth expending any emotional energy at all.

This is of course not a quick-fix solution by any means. However, though I am not your age/stage of life, I have done it and it is very eye-opening. Anyone feeling stressed should do it.

Lots of facets of the hospital workplace were stressing me out and when I stopped and thought about each one of them, many were NOT AT ALL worth ANY of my emotional energy, since the main thing I truly care about is providing good, safe care to my patients. Soooo much of the crap has nothing to do with that, (and so) nothing to do with me. So much drama. So many unnecessary extra steps and extra rules and picky little demands from here and there and everywhere. I learned to shrug, hard. I simply decided that if it isn't about me and if it isn't necessary for actually providing actual good care, then it's going straight to the bottom of my list of things to worry about. Period. Same thing for all the crap that I can't change: I'll do the best I can, that's all I can do, and whoever doesn't think that is good enough can go pound sand.

If you are really feeling like things are so bad that you're considering giving up things that are important to you, you really should at least consider going through the above process before you make that decision...in my opinion.

take care ~

[brandy1017, ASN, RN]

darnold38 said:

OP: Girl, 58? They'll hire you. ? I didn't even graduate with my Associates in Nursing til I was 60! Second career. Eight years later I'm technically disabled due to back problems that progressed requiring surgery which I had last year. Now, since I waited so doggone long for the surgery, I have residual numbness/tingling in my feet/legs requiring a cane for me to feel safe. I can walk short distances without it though. None of this is conducive to nursing.

Since I too am too poor to quit working (SS benefits and the small pension I get from my ex are just not enough) I started looking for remote work but was not having luck in traditional nursing case management job listings even after 3 years bedside nursing and 4 years in home health. I started looking in other areas, transcription for medical and/or legal, which was my first career, customer service, etc. I finally found a position, 100% remote, doing medical record summaries for a law office. They actually liked my 7 years of nursing vs the 13+ years of legal secretarial experience I had. I'm making almost as much doing that as I did nursing. I also have a paralegal associates degree but never used it, as I took my first nursing job instead, but I always wanted to do something using both my legal and nursing experiences. Oh, and I had a zoom interview for the remote position and went to the office for 1/2 day of training. They all saw my 68 year old face/body with no problems, of course most of the people I met were not youngsters either LOL.

My suggestion to you is to look at your strengths, your passions, your experiences and either go in a new direction or meld nursing with your passions to find a position that you like. I'll bet during the application/interview process, they won't even think of your age. 

Best of luck to you. 

Thanks for the encouragement!  Glad to hear you were able to get a good paying job using all your talents.  It is inspiring and reminds us to think outside the box rather than on narrowly focused nursing jobs.  I think a lot of us get tunnel vision, especially after working at one job or in one field of nursing for a long time.  It's a good reminder that we can branch out and try different things.

Sorry to hear about your issues with numbness and tingling of your feet and legs.  It can be a sign of lumbar stenosis which can be common as we get older, and especially in nursing from the wear and tear on our backs.

  I was recently diagnosed when I finally went to the Dr after years of pain when I stood for even 5 minutes and chronic numbness of one foot.  I didn't immediately think it was my back because the pain would go away when I sat down, plus I've had a couple surgeries on that leg and foot since I was a child so I assumed the numbness was from that. 

I had PT and did abdominal exercises and it actually got much better after about a month, but it didn't last, it's starting to flare up again.  I will have to be more diligent with my exercises.  It is the one pain that didn't respond to any pain meds, which was a new thing for me.  I've lived with bad migraines and even a bone tumor, but pain meds, even just advil would take the pain away so this was a first. 

A coworker finally had surgery for her back after over 20 years and is free of pain and able to hike and enjoy life, but because she delayed it she lives with chronic numbness in her feet too.  So to those out there with back pain and numbness please get it checked out as it is treatable.

[Black Swan]

Apply at a mental health facility. I only suggest this b/c the RN's who are part time/ per diem love it! And they still have there other jobs like ER, post- partum, etc. Not to mention there are some who are working on their NP! You might like it. I do! 
 

[brandy1017, ASN, RN]

You can ask your Dr for a psych eval, FMLA to take a leave and time off, get medication to treat the anxiety and depression.   Try to transfer to a less stressful job within the hospital system. 

Not sure why you feel you can't leave if it is because you have a pension you don't want to lose or aren't vested in, although that is pretty rare now.  But if you have a pension, some allow you to start early at a reduced rate.  Also there is a loophole The Rule of 55 that allows you to take money from your 401k/403b without penalty when you leave your employer the year you turn 55 or later, but it only applies to that employer's 401k/403b and if it allows it, most do.  Have to check that they allow it and allow periodic distributions vs only a one time distribution.  If they do then you can retire early and access your retirement money without the 10% federal penalty and without any state penalty, but they withhold 20% off the top for taxes till you are 59 1/2.   If you are in a lower tax bracket you should get some of the money back when you do your taxes at the end of the year.

However this loophole does not apply to a traditional IRA so you have to be 59 1/2 or older to take the money out without penalty.  But you could see if you could roll over any traditional IRA and or older 401k/403b's from prior employers before you quit once you verify they allow periodic withdrawals after you leave your employer.  Mine actually allowed all the above, but I had only a small traditional IRA so I didn't move it. 

Also if you have a Roth IRA you can take the contributions (what you put in) out before you are 59 1/2 without tax or penalty and also use it to keep your taxable income lower to get better subsidies on the ACA healthcare.gov insurance.  I would recommend getting a silver plan.  You can use COBRA for health insurance but it is prohibitively expensive, except you could cobra your dental and vision ins for 18 months and skip the health insurance which is what I did.

Had a coworker who basically went manic after her psych NP took her off haldol and she ended up quitting her job and taking early retirement.  So you could say she had a nervous breakdown, but this could have been avoided if her meds hadn't been tinkered with.   Well after a year off she has gone back to work as a home care nurse and was able to get the job in spite of her age, 60 years old, and not working over a year.

I think the nursing shortage, especially since covid, has the silver lining that older nurses are still valued and needed so we can still switch jobs and get other jobs even with gaps in our employment.  Another coworker who is in her mid 60's had no trouble transferring from a hospital job to a GI clinic and is working there now PT.  

 

[brandy1017, ASN, RN]

PS Also to the OP check your pension benefits, if any, and if your pension is frozen like mine was working longer wouldn't change the payments.  You could see what you would get at any age and could start from 55 to 65 and track it.  So if you are staying for a pension that has been frozen it is not a reason to stay and by 20 years I would think you would be vested.  Check your pension plan to be sure!

[brandy1017, ASN, RN]

Also consider keeping several years of expenses till 62 in a low risk fund such as money market or if you have my retirement 403b, all I had was an annuity.  It is crap, but I will move the money to a Vanguard IRA, where my Roth is after 59 1/2 for better options.  I recommend moving your 401k/403b funds to an IRA of your choice Vanguard, Fidelity and Charles Schwab are the top three, once you are 59 1/2 for better options and possibly lower fees.

This is considered the Bucket Method where you have a safe amount of money (say 1-3 years or till 62 for SS) in cash equivalent like treasury, money market or annuity to ride out a downturn and the rest in a conservative mix of stocks and bonds.

Last year I lost 18% even though I had a big chunk in bonds what I thought was conservative, but I knew it was a Schmeta year and stocks usually crash, which they did, and rarely bonds.  Well I took the risk and bonds crashed the worst in possibly all of US history!  On top of that when I analyzed my bond fund it turned out it was full of derivatives and not simple bonds so was much riskier than it appeared and never had a good annual return! 

I used their Vanguard stock funds as low fee, but they switched to the worst performing Vanguard mix of mid-small caps, and even the so called large S&P was not that and had more NASDAQ funds so more volatility!  Before the switch I had some money in the Vanguard small cap and it was doing the best only lost 5%, but thankfully I caught the switch to the new blended fund and moved my money quickly out of there.  My friend who let the 403b advisor choose for her had every fund in the mix, which included several of their own brand with high 1% fees!  It was definitely not in her interest.  Think she lost 24% before she moved it to the annuity for safety.

You can check out your social security benefits at SSA.gov it will show you what your benefit is projected to be at 62, 65 and up.

Check out my previous comments for more on personal finance books I recommend.  One caveat do NOT invest in REITs as with the high interest rates and work from home those will be crashing!  Also stocks and bonds will probably not be performing well and may crash at any time as the feds keep raising interest rates due to inflation and the government has stopped propping up the stock market with lots of easy money.  Bonds don't do well in a high interest rate environment.  Plus there are more problems on the horizon re the de-dollarization as Saudia Arabia and other world nations stop using the dollar as the reserve currency.

In the meantime talk to your Dr, take a leave if you can, meds do help!  If you find another job, come back and give your two week notice so you don't get stuck paying for your health insurance premiums while you were off.  Use your EAP, I did and mine suggested I quit and find another job.  Well I quit and took early retirement instead, but had prepared as much as I was possible beforehand.

I wasn't depressed, but I was anxious, very stressed, burnt out and on the verge of a nervous breakdown from the bad working conditions, short staffing, constant alarms, mandation etc.  I had thoughts of walking off the job on bad nights, but knew that wasn't the answer.  I had prepared my resignation letter months before hand and kept it ready till it was time.  I also marked down on a calendar when I had a good day to remind myself they weren't always bad. 

Also was thankful for my coworkers and the team work we had.  Be kind to each other, have pot luck meals etc. While you are still there, try to focus on the little things that make you happy, kind patients, good coworkers, etc.  I worked nights so would listen to music quietly at the station and even brought in one of my favorite flowers when it was in bloom. One night near the end I chose to listen to a country song Done in the car even though I knew it would make me a couple minutes late.  Thinking about giving notice and the song gave me a little joy. LOL

Take your vacations!  Even if just a staycation!  It is a mental health break!  Use that PTO as some places will cheat you out of it when you leave.  My coworker lost 200 hours of PTO after she retired because she called in when she was manic.  They knew she wasn't in her right mind, but there was no mercy!  No matter all the OT she did during covid the policy said if you call in they can withhold your PTO, which they did and they wouldn't relent! 

This same director had laid off several CNA's and HUCS without severance prior to covid because it wasn't in the union contract!  No compassion or common human decency or normal professional business etiquette.  At the same time the CNO who had been the Dean of a college denied workers' tuition reimbursement on a technicality when there hadn't been a manager to approve it.  Even as a prior Dean she had no concern for helping them further their education and use the tuition reimbursement when there was a technicality to cheat them out of that benefit!  I guess it is no surprise that she was promoted to Regional CNO but I've heard she has since retired.  That is the snakes and vipers that ran that place!  Took all I could to finish out my 2 week notice!

So the best thing you can do for yourself is prepare, plan and realize you do have choices!  So you are not in the victim mindset but take agency over your life.  I will renew my nursing license next year and I suggest you do the same in the off hand chance any of us get a PT nursing job to keep all our options open!

To me taking my pension early, and SS early is worth it for my peace of mind even if it means giving up some money in the process!  If I had to I would be willing to sell my plasma to make ends meet.  Whatever it takes to be happy and stress free! 

I live frugally, take a couple vacations with a senior vacation club, enjoy my family, friends, pet Buster and hobbies like gardening.  You won't need as much money as you will most likely be in a lower tax bracket and won't have to pay SS/medicare taxes if you aren't working.  Your money will stretch further, but you have to be mindful to make it 62 where you will have SS to increase your income. 

Deal with your Debt by Liz Weston talks about using it as a strategy.  I still have some debt but use credit balance transfers.  Penfed (credit union, anyone can join with nominal donation if they don't automatically meet acceptance requirements) and Discover are good options. Understand the main thing is to keep expenses low till SS or another job.  My pension pays my mortgage.  Get some credit cards before you retire if you don't already have them.  But use them sparingly and pay them off as you go or do 0% balance transfers.  Check your credit and credit score and keep your credit score high so you will have the best options.

Hope this info helps everyone that is struggling out there.