Dear Cardiac...um, we need to talk...about us...

[PeepnBiscuitsRN]

First, let me profusely apologize if this is one of those questions that are asked to death- I'll probably go back and do a search for topics of the same nature (ok, I should have done that FIRST, but now I'm typing...)

So I've worked in Tele for almost a year. It will be a year in April, and I can't believe how fast it has gone by and how I've come so far since I started- what I couldn't imagine doing then, I am doing without batting an eye now. I've learned a ton, and there is a ton more to learn. The floor I work on, I've been told, is the floor for people who intend to go into critical care- it's a springboard. It's busy, the patients are pretty sick and usually coming to us from the ICU (be it SICU, MICU or CCU). It's a challenging floor.

So, when I started this job I was jazzed. Cardiac was one of the fields I had a particular interest in. I was very vocal during my interview about how cardiac was so fascinating to me and nearly fell over when the manager told me that nurses on this floor are sent to a special, two day workshop on how to read EKG strips and tele strips. I thought "AWWW COOOOOL!" So I was elated to accept the position when it was offered to me.

Now, I'm interested in cardiac. It IS fascinating, it is a great floor to work on and gain experience. The problem is....*sigh* I've met someone else.

I had had this small interest in perinatal nursing for some time. Ah, you could say we were "good friends" but I didn't really know if I could see a relationship coming from it. I was being realistic, I had just had a baby- I attributed it to the feel good baby vibes I was going on. I had also wanted to be a lactation nurse, but had no idea how to get the clinical hours required by IBCLC, since I'm not thinking we're going to be getting too many lactating women on our floor!

You see where this is going- as the year has gone on, I've become more and more interested in OB. Still focusing on my work on cardiac, and enjoying what I'm learning, I have begun to see that the nurses who have been there longer than a year or more are TOTALLY for cardiac and critical care. They have all sorts of certifications, they go to workshops and read books for leisure on the topic. I've realized I have no interest in this, I've tried- there was a workshop I actually wanted to go to on hypertension and medical treatment of (never got to it, sadly). The workshops that catch my eye are related to breastfeeding, infant massage, kangaroo care, care of the teen mother. I've tried to just brush it off and focus on cardiac- and again, I do enjoy what I'm doing right now! I'm learning like crazy, but...to use the analogy again, the thrill is gone (welcome to REALLY being a nurse?).

My fear is that if I went into OB, the same thing would happen. I'd be all about it, and then get sick of the high-maintenance new parents, or weeping for the baby that is going home with the mom who will ignore her and will be back in 10 months with a new baby from a different dad. I play this out in my head- I mean there will be people...we have the drug seekers who seem to show up 12 hours later back on our floor after being discharged (they go outside, have a smoke and walk in the ER doors complaining of 10/10 pain..."everywhere now give me my 2mg of Dilaudid and 12.5 of Benadryl! NOT ORAL! IV! PUSH IT FASTER!!")

Ok, so after this big long speech (MAN I ramble, don't I? I need to stop that). How do I tell my manager that I don't think this is "where my heart is" (A. no pun intended, 2. apologies for the cliche). If I position opens in postpartum, L&D or NICU I'm going to want to apply (postpartum is a particular interest)...I also have my first yearly review coming up, and there is a section where they talk about your goals for the upcoming year. I don't know how I can give an adequate answer without bringing that up.

So, to close with the same (twisted) analogy, how do I tell my manager " um...we need to talk..." Or should I just be a cheating B*** and have an affair?

[nohika]

Admittedly, I am not currently a nurse, but for your sake I would not let your manager know you're thinking of switching jobs. I've heard of people getting fired before they could quit because the managers were mad that they were leaving.

[NeoPediRN]

Absolutely do not talk to your manager about this...wait for a job to open and apply, then talk to your manager about it...politics plays too big a part to risk it these days.

[nrsang97, BSN, RN]

I agree wait for a position to open, then apply and tell your manager.

[PeepnBiscuitsRN]

I know not to talk to my manager beforehand, it's more a matter of when the time comes- after I apply, and after I would hypothetically get offered a position. Then what do I do?

[Vespertinas]

Girlfriend, you need a diary.

And I second the previous responses.

[DixieRedHead, ASN, RN]

After so many years in critical care, I still want to say, "How the heck am I supposed to know what is wrong if I can't see what their heart is doing?" Way way way the wrong person to ask.

[HouTx, BSN, MSN, EdD]

Over your 'nursing life', your interests will naturally change periodically. That's the really great thing about nursing - you can go off in a completely different direction without changing professions. Your infatuation with NICU may give way for a passion for occupational health in 5 years - LOL. That's what keeps life interesting.

In most organizations, your supervisor plays a big part in inter-department transfers. It's basically impossible to keep them in the dark once you openly express your intentions. The receiving manager will have access to all of your performance evals & work records -- probably will also have a discussion with your current manager. Take the time to read your organization's HR policies to determine what the 'rules' are. In many organizations, there are specific rules that require managers to be cooperative, along with timelines - so current managers can't postpone the transfer beyond a reasonable length of time.

That being said, good manager must always respect and support their staff's professional growth even if it means letting go of them. I can remember many instances of having a nurse return to my department after working somewhere else for a period of time. Maybe you could agree to remain on the M/S prn list for a while after you transfer to the new unit in order to maintain a good relationship?