Burned Out & Bummed Out - Can't find my nursing "niche"

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Burned Out & Bummed Out - Can't find my nursing "niche"

Hi Nurse Beth,

I've been a nurse for a little over five years now. I am bummed out because I can not seem to find my "niche" in nursing. I have worked in SNF/subacute rehab, OR, and now I am employed in a step-down unit with frequent floats to the ICU and med-surg. However, I have never been particularly happy in any of these positions. I am worried that I have spent so much time in a career that I just don't like.

The source of my unhappiness stems from feeling unable to truly impact patients. In all the areas that I have worked, I mostly feel as though I simply patch the patient up or control symptoms. I don't feel as though I am actually making an impact in their care.

Should I continue to look into other specialties? Or, am I a total lost cause in nursing?

I do have my BSN, but I don't know how utilize it in trying to find a new position. I also feel as though I have "job hopped" too often and look like a risk to employers.

Your input would be much appreciated.

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37 Answers

Specializes in Tele, ICU, Staff Development.

Dear Burned Out and Bummed Out,

You are making an impact but it's important for you to know it and believe it.

What would make you feel you have made an impact? Think back to a time when you felt you helped someone else. Is it more time with your patients, more connection? Do you enjoy talking with them but don't have the time?

Maybe acute care is not the right setting. Have you considered home health? How about cardiac rehab, where you work with patients and actually see their progress towards their goals? It could be that seeing patients over a longer span of time would be more ratifying for you.

Are you a teacher? With 5 years of nursing experience, you could be a clinical instructor. Have you considered behavioral health nursing? There are so, so many things you could do and it's not necessary for you to feel ungratified. Without knowing you, it's a shot in the dark making suggestions but I do believe there is a niche where you can shine and feel that you are making a difference.

I wouldn't worry about job-hopping. You have tried a few different settings, but you have 5 years of experience (great!) and your BSN. Many employers would be more than happy to receive your resume. Keep us posted, friend.

I was going to suggest peds ? I know it isn't for everyone but I work in NICU, PICU, general peds and think it is so rewarding. Sure there are days with unappreciative families, but they are the exception in my hospital. I find families are usually quite open and receptive to teaching. Personally, I think I would find myself in your shoes working with adults (based on what my friends in adult med surg say). But with kids... you are just happy most days.

I think that the peds nurses I work with are the happiest group of nurses in general that I know and while all of us complain at work (because like the other poster said - we wouldn't be paid if there were no downsides!) its about management, patient load, etc - never really about the patients or the actual *nursing* that we do. It's the bull$hit that comes along with hospital nursing these days.

Anyway, good luck!

Three words for you........family nurse practitioner.

As tempting as it is to say, come work in my area, it is great 80% of the time, it is probably best to ask a few questions to see what works for you. When you say "feeling unable to truly impact patients" what does that mean to you? Before you started nursing, what were your expectations on the impact you would have on patients? Did you expect to see the lame walk, the blind see and the deaf hear? I've seen all of these but not necessarily because I cared for them as a nurse. Are you looking for earlier interventions to prevent patients from an actual medical crisis? Then, maybe you need to look at ambulatory care. Are you missing seeing significant progress of healing? Someone mentioned cardiac rehab, which may be worth looking into. Are you looking for physical impact, emotional impact, family or community impact? Psychiatric nursing, community/public health, research, oncology, diagnostic specialties, and case management are just some areas to look at beyond what you have done.

What are areas you enjoyed? What skills do you have? What experiences? Did something click with you during nursing school? Or maybe it is something you read about? Find this.

We all know nursing is hard. Taking breaks are critical. But I still believe nursing helps me more than I help it most day. Plus, my colleagues impress the heck out of me with their selfless acts, intellect or humor. Nursing saves me in some ways by enabling me everyday to attempt to recover from my previous self-centered life and if nothing else, entertains the heck out of me with patient questions. ("If I took my evening dose at 6 pm before the time change, when do I take it now?" Yes, you cannot make this up.)

My first 3 years as a nurse, I had 3 jobs. I would not worry about the variety of jobs. Maybe your ultimate position will need all these experiences. Who knows? Your BSN will help but most of us in the field will be equally impressed with your resilence to keep looking for the right fit for you.

Hang in there. Best of luck.

Dear bummed ou,

So, here's the point: EVERYBODY DIES, BUT NOT EVERYBODY LIVES. Sometimes we do have to suck up unpleasant parts of life (which help us to grow) but it is spelled right out in the constitution that you have a right to Life, Liberty, and the Pursuit of Happiness. . . So, you have ppl who suck it up, and you have people who go on to be happy; thats when you truly make a difference in others. Nursing is a hard profession bc of the "system", it is broken . . . Keep on searching for that right place bc we are meant to search, grow, make a difference in the lives of others around us. I'm a psych nurse and have met a LOT of border bullies in my life. Don't let life drain you so you can't give!! Minimize your potholes, spend your life energies wisely. . .

Specializes in Hospice, Geriatrics.

I had 3 jobs my first 3 years after school. I found what I was good at and learned to love it as I had success after success and took lots of classes, seminars, in-services to hone my skills. Then, after having 31 years of nursing under my belt, I found my niche. Been in my niche ever since. I can't tell you each of those specialties because my likes, dislikes, strengths and weaknesses won't be the same for you. It's a very personal choice for each person. Just plug in your career/ideas/loves/etc. At the end of the day it's ok to say nursing isn't for you.

It seems Nursing Administrators do feel this way (hence lateral violence as acceptable in secret, age discrimination, racism, hazing, etc.). I won't give a speech next on how we must come together in unity in a positive way for genuine professionalism to take place; it's a broken record so it seems. You can't produce courage where it doesn't exist. Those with it however, please continue to stand. What I will end with to the original poster [Nurse Beth] is this advice: You do make a difference upon your client as a nurse. Alleviating symptoms is huge to quality of life. Imagine no antibiotics for an infection that is not life threatening but extremely uncomfortable, or no NSAID for a migraine? Nurses are not here to heal (unless we can) but to help the community exist physically and mentally in as high of state of existence wherever they are on the health and wellness continuum of no sickness to death. I encourage all to remember this; we truly do (or at least can) make a difference. I would even say HUGE. May God bless you all.

Common rule of thumb is care for yourself before you care for others. Honestly you are not a good nurse if you do not reflect and question your abilities, because then you don't open yourself to improve, so kudos for seeing that you could offer more. That not all patients need a patch up, some need forms of touch, being and meditation. I appreciate your post. If I have advice, it is to take your own. Nursing is wonderful, I can see it in the interaction with patients and the jokes between coworkers.

Specializes in Hospice, Palliative Care.

I went to nursing school in my late 30s after being a field biologist for a decade. I started out as on Oncology nurse and was miserable; thought I'd made a mistake spending all that money and 3 years to become an RN. I decided to try hospice nursing and fell in love. I became a Certified Hospice and Palliative Care RN - learning everything I could about EOL (end of life) care and symptom management. I helped people to die well and their loved ones to care for them though that process.

Because of health issues I had to leave hospice nursing - there was nothing else I wanted to do! I eventually ended up being hired to do case management for a health plan. I didn't care for the job initially but now I am working with members who need palliative care and am once again loving what I do and knowing I make a difference.

I would recommend giving hospice a try - or anything related to palliative care.

Best of luck!

Sometimes the culture of an institution can make a difference... Are you in one that has a progressive culture (e.g., related to patient safety, diversity, accountability, etc.)? Have the places you worked in had good nurse-to-patient ratios, good equipment/supplies, regular education for staff, etc.?

At other times, it may take people longer to find their niche more than others. I am someone who is pretty versatile and flexible, but there are certain areas of nursing I cannot work - because if I had to, I know it would be so taxing on me that it would drain me emotionally to the point of giving up.

Example: Pediatric Oncology. I couldn't do it. I have a lot of love and respect for those who can. I just cannot do it. If I worked on a unit like that, I would just break down at every child I cared for when the time came and cancer overtook that child's life. I just could not do it. To be frank, they are the most vulnerable too. They don't deserve it - and then when you are caring for them and say a 10 or 11 year old says, "Why did God do this to me?" - or even a 5 year old - how do you answer that without tears and losing your composure? Some people have the heart and stomach to do it. I would just break down a lot.

Part of finding your niche is knowing who you are, and in nursing school when we had to do those weekly journals for clinicals, I devoted at least a half of a page on this portion of my journals. I made sure all the necessary comments instructors were looking for came first, but I got more comments on the personal reflections than I did on anything else.

I know it may sound silly since we did this in school - but journal. Make a specific nursing journal for your career. It is the only place no one can ever judge you but you. Use it to explore, dream, and (as they tell us when preparing for the NCLEX) rule out options. Start with the general and move into the specific. I don't particularly personally care for ICU (MICU or SICU). During my critical care rotation, though, one floor I went to was CVICU. I loved it. I actually started the morning revising the patient's care plan to reach acceptable and attainable goals. I was always interactive with the patient - I was always doing something to help the patient achieve his goals, but more importantly I learned about the patient's story - what he did, his family, his struggles, what led to his condition. You can learn a lot from a CVICU one day post op CABG patient when he needs to be mobile Q2H walking the hallway at his pace. I know that I either want to work with Cardio/Renal or Diabetic populations in the far future. I am not limiting myself to those areas, but those are areas of strong interest. Incidentally, I am working on a tele floor now as an aid and after passing my NCLEX on Monday**, I will be a nurse there.

Finding your niche - there is no timeline. I know of people in their late 50s that were in nursing school with me.

** About Monday Aug 15, nothing is guaranteed, but trying to stay positive.

You are not a loss to nursing! I would caution against spending more money for an advanced degree - just because if you are already feeling pulled thin, the stress of going back to school and either borrowing/spending a lot of money is not (in my experience) going to help. I wouldn't worry about looking like a job-hopper; you either stay in your current position or have to change it. If the question comes up in your interview, just say you're moving forward and looking to practice a different area of nursing. Some may say look for a part-time or PRN opportunity to dip your toes in and see if you like it but if you feel burned out, this may not be advisable. Ask yourself what you WOULD like your (average) workday to look like. Do you want to clock in at a facility, or go see patients in their homes? Would you like clinic or school nursing maybe?

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