Burned out and undecided

I have found worlds of difference between hospitals and even between units. Unless you have a passion for hospice--if you do, it isn't coming across here--I would give the local hospital a try. You won't have to sign another contract (don't take relocation if it's offered), and you will get a better idea of whether hospital nursing just isn't for you. Hospice will still be there if you decide you'd rather do that. Good luck!

You don't state why you are considering hospice. Is it because you feel a strong desire to help people with end of life issues and their families, or is it because you think it will be an easy alternative to hospital nursing? I have worked both hospital nursing and as a hospice nurse in the field. I can tell you that if you think that hospice nursing is easy, you will be disappointed. It is very emotionally taxing, and you get into a lot of issues, family issues and otherwise, that you never have to deal with as a hospital nurse. My most recent hospice position was as an intake nurse in the hospice office, and our hospice case manager nurses often times felt burned out, emotionally exhausted, and spent, not to mention that they often worked well over their 8 1/2 hour day, because hospice field nursing isn't like hospital nursing where you just punch out and the next shift takes over. If a patient or their family needs you, they need you and you can't just leave because it's 4:30 or whatever. Also, you will deal with things like going into iffey neighborhoods, patients' pets, some of whom get very territorial when you try to assess their owners, less than sanitary homes (I've seen cockroaches and had fleas jump on me), second hand smoke (was in a living room once with EIGHT adults chain smoking while I was attending to their father who was dying of, naturally, lung cancer), and other issues that you don't see in an inpatient hospital setting.

I'm not trying to discourage you from trying hospice, just letting you know that unless you go into it because you have a strong desire to do that type of nursing, it is very easy to get burned out doing that type of nursing as well. It doesn't present exactly the same problems and challenges as inpatient hospital nursing does, but it has challenges all its own. As far as losing your clinical skills if you go into hospice nursing, yes, you will become rusty in some things if you do it long enough, because a lot of the skills that you use in the hospital are aimed at helping a patient to heal and return to a normal, productive life, and in hospice, it's all about keeping them comfortable until they die. No curative therapies allowed, or they have to revoke hospice.

Thank you all for your advice. It is greatly appreciated.

As far as hospice being a possibility, it stems from a few things. 1) After nursing school, a few of my school friends applied to hospice and were offered jobs. Every now and again I see my school buddies and they just rave positive about their job. I hear over and over again how much they love their job. I have to admit, I am envious. The reasons that they love their job vary, but the overall consensus is that they love helping families go through that difficult transition. They feel a sense of honor knowing that that they helped a dying patient die with dignity and pain free. That's basically the jist that I hear whenever we talk about their job as hospice nurses. Now I have also heard the other side of being a hospice nurse. How it can be absolutely emotionally draining, the hours can be long and extensive, the never ending paperwork, the constant back and forth with families and the inter-family politics. Just recently we hired a nurse who on the floor who just left hospice because she was just burned out on hospice.

2) I have always been interested in hospice nursing. Even when I was a nursing student I strongly considered doing hospice house as my first RN job. However, I was discouraged by some professors because they told me I should have acute care experience first. We all know that story. In the hospital I have worked with hospice patients and their families and saw firsthand how wonderful hospice can be for patients and their families. The hospice nurses I know are wonderful and are truly an asset to the nursing profession.

I agree that there can be worlds of difference between hospitals. I do enjoy acute care. I love learning new things and new skills. Even with 2 years experience, I find that more and more there is a never ending abundance of new skills and concepts to be learned. I love teaching people and helping patients and families understand biological processes of diseases and the treatments that go along with those processes.

I am considering float nursing because I am so over unit politics. This is part of my problem. Our floor is difficult. The acuity on that floor should really be a PCU level. Plus everyone on that floor is unhappy. Everyone. Including our director. That makes for a toxic work environment. Everyone is so busy, especially on day shift, that we find it difficult to help out our team members. We are being told by our director that we aren't working hard enough, our scores went down, work harder with less. It is beyond frustrating. I am hoping with float nursing that I can just go into work and do my job and not get caught up in the floor drama. If not float nursing, then I was considering switching gears all together and going onto a cardiac floor. Just so I could learn more and get a different perspective.

This has not been easy. I have made the decision to leave the floor which I know is the right decision. Other nurses who have left our floor I still keep in contact with and they tell me over and over again, it's not nursing, it's that floor. They all seem happier now that they have moved on and taken different positions within the hospital.

As far as not burning my bridges, I plan on leaving on good terms. Even though my experience has not been easy, I am still grateful for the opportunity. I was hired as a new grad with no experience. My director gave me a shot to earn experience and make a living. That is something I can not thank her enough for doing. So when I do resign, I will state in my resignation that I do desire to be PRN and hopefully she can still keep me on.

Again, thank you all for your advice. It does help reading about others experiences and just knowing I am not the only one going through this. Thank you.

It sounds like you would be a good hospice nurse! I have just seen so many people on these forums who hate their jobs and think that hospice nursing is a piece of cake and the "easy way out" of more stressful jobs, and having been on both sides of the fence, I can attest that there are times when hospice nursing is extremely difficult. But you sound like you would be going into it eyes wide open, so to speak, and more importantly, that you have a true understanding of the real reasons to be a hospice nurse.

As far as float nursing in the hospital vs. working on one unit (I have done both...I've been around a while, lol), and not only do I not think that float nursing is harder, I think it is a whole lot better in a lot of ways. In fact, I am getting ready to start a new position in a local hospital system's internal float pool this week, and I left a full-time position on one floor in another hospital to do it. My reasons for preferring to float are that you can avoid the politics of being on one floor, who is friends with whom, who is mad at whom, whose side are you on, yada, yada, yada (and since nursing is dominated by women and women can be very, very vindictive and catty at times...well, you know...), anyway, that stuff gets old very quickly. Also, it gets boring taking care of the same types of patients day after day after day. At least when you float you get to change scenery often and even (so shoot me, I'm just being honest) get away from a particular patient or patients who absolutely drove you nuts the day before. It's so nice to work different floors and by the time you go back to a certain floor, Mrs. Doe, who was driving everyone up a wall, has gone home. I love floating, and I will never work on one specific floor again. Even if you do get dumped on once in a while, it's so worth it to me.

Good luck in whatever you decide to do.

Working at a smaller hospital would probably be less stressful. They also work short staffed, but at least the drive would be less. Working as a floater would give you alot of experience in different areas and maybe you could find your true love in nursing. Hospice is a rewarding position, but sometimes it can be depressing when you get attached to the patients and they pass. It is not fast paced and you depend on yourself more than others, but there are still call-ins. It is hard to change jobs, my you think it through and God be with you in your decision.

Maybe you could try PRN somewhere, while you debate. I am also starting to feel burnout....nursing for 2 years. I like my job, but it's the lack of staff, lack of resources, general fatigue. No surprise there. I've been pondering my next move for a couple of months now. I'm undecided. Probably within the next few years, aside from PRN, I won't be at the bedside. I'm not impressed with the general direction that nursing is heading. But, there are many options.

Being a float nurse is something I did in the past and actually liked it. Every shift was different - different patients, different coworkers..I was able to do my job and not get caught up in the politics of things. The money was better. It would also be a good idea for you since you are unsure where you want to go - you would be able to try out a few other flavors of nursing and the smaller hospital which you will find to be different from a large one anyway. If, after a period of time, just being in a hospital doesn't suit you you are better positioned to find something else. I too live in a small community and I too am going to be driving 50 miles 1 way to a larger hospital to work. Until the nursing job market improves that is just the nature of the beast these days. Good luck and leaving the floor you on are, regardless of what you chose, sounds like the right course of action for you.

Maybe you could try PRN somewhere, while you debate. I am also starting to feel burnout....nursing for 2 years. I like my job, but it's the lack of staff, lack of resources, general fatigue. No surprise there. I've been pondering my next move for a couple of months now. I'm undecided. Probably within the next few years, aside from PRN, I won't be at the bedside. I'm not impressed with the general direction that nursing is heading. But, there are many options.

This was me a month ago. I was feeling burned out with bedside nursing. It took some months of thinking before I finally made the change. Now I am working at an ambultory surgery center and couldn't be happier.

As for the OP, there is alot of great advice given here. Good luck to you with whatever you decide to do. :hug:

Have you considered inpatient hospice? That's what I do, we have the same shifts as hospitals (i.e., no on call, 3 12's) and practice many clinical skills (except IV, which we rarely do). But it's not available in all areas, often you can only do in-home hospice.

Agree with pp, float nursing is probably more stressful than regular med/surg. Guess which units normally need floats? (Yes, the worst ones of course). That's why the pay it typically better.

But whatever you do, I wish you good luck. And yes, I would not stay one day beyond the contact period and not sign another one!

It sucks having a toxic work environment- lately we have had lack of communication. I find myself getting ******* at and having to pick up the slack in my stations since i float. Our nurses have the worst communication skills at shift change. You should try hospice if your interested.. Your at a point now where you have 2 Yeats solid experience.