Reentry nurse -- ICU? Grad School?

[WestCoastSunRN, MSN, CNS]

Hello everyone! I'm new to AN, and will give a brief history. I have 11 years experience as an RN. Ten of that in critical care (CVICU and MICU). I was a good nurse. I was a preceptor for new grads coming into critical care. Most days I loved my job -- which seemed like a win to me. I left nursing eight years ago to home school my kids. Don't regret it, but it wasn't a good career move. Now I am re-licensed (after an extensive reentry program with 190 clinical hours that I did in an ICU) and ready to move on. I always wanted to go back and get my Masters for NP, so I figured I would do just that and have been doing all the necessary steps in applying for grad school. Why do I want to be an NP? Because I'm excited to be back in nursing -- to be back at the bedside -- and I want to do this job til I'm old -- and I imagine being able to continue on as an NP for longer than I could at the bedside. Also, I really think I would dig the NP role. I love learning, academia and patients. I understand the role for what it is -- and think I could be happy doing it in the RIGHT setting. But I'm a conflicted.

I also love critical care nursing -- which I just can't step back into after eight years off. I rocked my clinicals -- but there's SO much in ICU that has changed since I left. I would need to get hired into an internship at this point to get back into ICU. I may be able to do ICU in a smaller hospital with lower acuity but that's not really where I want to be.

Currently I'm applying and interviewing for jobs. I've already pretty much gotten the ICU door closed on me -- though there is the possibility of getting in through internship. I'm looking at step downs now-- and I know enough to know where I'd like to work -- so I'm not too picky about the specific unit right now. Just gotta get back at the bedside in a supportive environment. That's my first goal.

My second goal is what I'd love feedback on. I'm second guessing the NP thing now as it gets POO POO'ed SO much not only on AN but with nurses I actually know as well. I'll only do it if I can go to a good school -- we've got a couple good options where I live and I'll only consider distance programs that are top ranked and have lots of required on campus clinical/labs. But I'm in my early 40's. Does it make sense to reprise my role as an ICU nurse? I've been there, done that. But I do like it. But I won't --- for some time -- enjoy being at the top of game there either. It took me awhile to become a great ICU nurse. Now I'm older, maybe it will take me even longer the second time around! When I left nursing I didn't have other nurses that didn't like me or scowled at me. When I started out as a new nurse and had some nasty nurse-on-nurse experiences I just thought it was par for the course. I put on my big-girl pants and took it like a woMAN. But I'm so much older now -- so much more life experience. I don't know if I have the patience for all that nurse-on-nurse crap anymore. And while I was received fairly well in the reentry clinicals -- I could also sense the potential for some claws to come out. And I'm not worried about that so much -- I can handle it, but do I want to? Ugh.

I know I will probably make more money at the bedside than as a new NP. This smarts a little b/c grad degrees aren't cheap. I'm totally up for the challenge of whichever direction I go. Just want to go forward with my eyes wide open. I'm not the administrator type -- so that's not an option for professional growth for me. I like the nitty gritty of patients. I like using my brain and continuing to challenge myself intellectually and skills-wise. I thought about CRNA -- but I'd like more variety and don't really care for the OR. I want to plan not just for the next few years but beyond that -- what I can happily do until a ripe old working age.

And.... since I'm not a young'in anymore, I feel the clock ticking.

Thoughts?

[WestCoastSunRN, MSN, CNS]

Sorry that was so ridiculously long. Too late in editing it.

[BedsideNurse]

My thoughts: glad you're excited to get back to work. It's good to be back in certain ways, for sure; bedside patient care, getting your sea legs again, earning money (!)....My first thought is that maybe you should get back in the hospital and see if you still have the patience and stamina for what you used to love. Computerized charting requirements are lengthy and time consuming. Patient ratios are often ridiculous and secretaries and techs are bare minimum, non existent in many units. I've been a nurse for 20 years, but off work for 3 years on two different occasions (=14 years working), so I've done the re entry thing twice, and being a re entry nurse pretty much sucks in my opinion. It's good in some ways, like I mentioned above, but in other ways it can be downright painful, especially if it's been a while since you've been "kicked in the face" as a nurse. It was difficult as a new nurse, but it is harder to take when you are mid 40's, mostly because you aren't used to it anymore (even if we are a lot better at handling it at this point, it's like WTH). Even if such weird/mean behaviors are few and far between, it's just something else to contend with when you got a lot going on and are trying to do well, get your confidence back up, & function efficiently within a new health system or in a new working environment. It can be hard, honestly. Health care in general is hard though, really, so not a surprise that being off work for any length of time makes it harder. Of course, just speaking for myself; maybe the whole rest of the re entry nursing world thinks most every day is awesome. I'd love to be part of that club. Lol. Anyway, keep evaluating what you like, don't like, future goals, etc...and I wouldn't rule out ICU. I know someone out 15 years and came back and she's fabulous. Depends on the person and support in the unit. You said community ICU's aren't where you'd like to be, but they might be more willing to hire you than the sickest of the sick type units, and after being off for quite a while, it might be a good way to get the feet wet again. Probably easier than trying to manage on a floor, if you've never juggled a bunch of patients and are used to critical care staffing and care standards. Community ICU's can be as rewarding and challenging as any other unit, even if not exactly what you like. Every unit is different but nursing is nursing is nursing, in certain ways. As far as wanting to start a NP program goes, hats off to you. I know so many people that are in school for that or have done it and it's a heck of a lot of work, as in truckloads. NP and PA programs; I'm not lazy but Holy Cow. 46 years old and no way. I'm looking down the road--at 50+, and I definitely want to find something a little easier on the mind, body, and soul (if anyone knows of a kinder, gentler nursing that's good for older nurses, please feel free to chime in). Anyhow, good luck with your path. Keep us posted if you can.

[WestCoastSunRN, MSN, CNS]

Thank you for sharing that perspective JenniferhopeRN. You are right when you say community ICUs can be rewarding. I worked for one and it was pretty great and I felt every bit the ICU nurse -- but did get frustrated when I had to transfer patients out of my ICU to higher acuity. I have, by no means, ruled out community ICU. I have lots of irons in the fire right now, job-wise, so we'll see how it all shakes out. There is one job in particular that I am interviewing for that would be a destination ICU job for me. If I am so fortunate to get the position, I could see it competing heavily with my interests in NP school -- which like you said -- everyone and their kid sister wants to go to NP school now! It wasn't like that back-in-the-day (though it was on MY radar back then -- but none of co workers/class mates were interested). So I'm also watching that scene closely -- the NP scene. Hard work I can take but job market saturation scares me. And then there's the whole being a beginning NP (having to work back up to "expert" from ground up, treating sinus infections and chronic BP as opposed to being at the top of game in an ICU somewhere saving lives. That's not to minimize what NPs do either-- I highly value the idea of providing quality primary care to folks and getting to work on wellness initiatives with other NP/PA/MD/DO colleagues. But it's a completely different track from what I've done in the past.

As far as what its like to be a reentry nurse? Well I'm grateful for the opportunity to come back to my profession but I now counsel other nurses who are considering "taking a break" to think long and hard about doing so. I didn't know I'd be gone for as long as I was. Time flies when you're having fun (and working your rear off in another sphere of life). No regrets but now I have to pay the piper. Computer charting and no techs? Yep-- you are RIGHT!!! I'm getting a handle on the charting -- but it was for sure a learning curve. And I had never heard of not having techs in the ICU-- but apparently that's a thing now. Makes it interesting when you have a GI bleeder pooping every 15 minutes and your other patient is getting q30min blood sugars. Fun times.

Thanks again for sharing your experience of reentry (and about the gal that was out 15 years-- inspiring!!).