career dilemma

[seanymph]

I have been really down about my nursing career lately. Not sure if I am becoming disenchanted with nursing or if its that i haven't had a vacation since 2002.

I do L&D, mother/baby and newborn nursery. I knew when I went to nursing school 12 yrs ago that I wanted to work OB. At first I thought that L&D was my first love. Then I discovered the joys of working in the nursery. I like working with the newborns and "stabilizing bad babies" until the transport tem arrives. I also enjoy working with the new Moms on mother/baby, I love doing the teaching. I liked the fact that I could jump between all 3 areas for a change of pace.

Then 3 years ago I started doing travel nursing and have done mainly L&D as that is in higher demand than the other 2. I find that I dread going to work, have a hard time dealing with the labor patient, even though I still strive to do my best by the patient and give them a good labor experience. I am not enjoying the high risk of doing labor especially after being named in a lawsuit where I was not the primary nurse, but was named as I was the other nurse on that night and had signed the "chart" as going in and assisting the primary nurse when the patient was first admitted. I just don't feel like taking the risk anymore that labor involves.

If I could think of another career that would pay me similar income and I would enjoy I would jump at it. Does this sound like burn-out or disenchantment or someone who needs a vacation.

I have taken a permanent position back home as I miss my family and friends, but is L&D, which I am not looking forward to.

Thank you for any advice or insight.

[Kymmi]

Sounds to me like a little bit of both. Not having a vacation in 4 years is a very long time to not have any "down time" and relaxation away from the stressors of everyday life. I also think that being burnout in the L/D scene is a very real option also. Have you thought about changing specialities. I know after doing L/D or nursery for awhile you will need to be trained if you decide to work in another speciality but that isn't unheard of and is a very viable option. What about considering home health or working for a insurance agency....something that you might find interesting yet different than what you are currently doing now.

[seanymph]

Thank you for the reply. I guess having been so focused on OB for so long I could not think of other options. Didn't even realize we could work for insurance companies. Any idea on how to go about it? Thank you again.

[Daytonite, BSN, RN]

being named in a lawsuit doesn't necessarily mean that you did something wrong. however, i can see where it really was a blow to you. have you considered going back to get your bsn? it did wonders for me. it also put me right up into supervision and management which turned into a whole new world of new nursing experiences. i loved supervision more than management because i could still be in the clinical area but not confined to one particular unit. i could help other nurses out and i got to see the big picture of how the whole hospital was operating which was a lot different view than just from my one unit of the hospital.

for medical reasons i can no longer work in the clinical area. i've been studying health information management (formerly medical records). it will net me a desk job that as a hrit (with an aa) or hria (if i get a ba in it) will pay comparable or more than an rn. my rn background is proving to be invaluable for me. for instance, when jcaho came up in our studies, i went sailing through it in my classes as i knew very well what a survey was all about while the other students really knew nothing about it at all and were struggling with trying to understand the accreditation process. i'm learning what the flip side (office side) of the importance of the charts are and i am finding it so amazingly fascinating. it's answering years of questions i've had about medicare, medicaid and social security and how they are driving our health care system. this semester i'm taking classes in how hospitals are organized and licensed. i'm leaving out one of the big components of this career and that is computers. computers have changed everything in the world, including nursing, medicine and hospitals. i didn't understand the importance of these new nanda driven nursing diagnosis care plans that are being taught to nursing students until i started studying health information management. it all ties in to computerized coding of health care delivery. best thing. it's a sit down job and that's what i need right now, but i'll still have my hand in patient things.

i had a friend who worked for an insurance company auditing charts, a law firm auditing charts for appropriateness of nursing care, and for a consulting company that audited charts for correctness of billing. she found these jobs through head hunter agencies. it took preparing resumes, going to not one, but usually several interviews over several months, and just being patient and waiting for call backs. for several jobs she had a company car. she also had a bsn which you may need to get these jobs. in general, she found the jobs very boring because of the mounds of paperwork required and never ended up staying at them very long. she also worked for a very large bed manufacturer as a nurse consultant and educator. when they installed new beds in a facility, she went along to conduct inservices with the staff on how the beds worked. she found that job boring as well. she transferred to one of their divisions that placed specialty beds with nursing homes and hospices and ended up hating it because of all the paperwork that had to be done and having to cool her heels in doctors offices getting signed orders for the beds in order to get medicare and medicaid payment. when you are used to working with patients in busy hospitals, these desk-type jobs don't have the adrenaline rush you are used to.

[catlady, BSN, RN]

You might like working for a disease management company that hires OB nurses. There are a lot of telephonic nurse education programs for pregnant women. Disease management companies usually either are contracted directly by an employer group, or on behalf of an insurance company. It's normally business hours and business casual.