Devastated and Disappointed

[Nurse Beth]

Dear Nurse Beth,

I am 26 years old and have wanted to be a nurse since I was at least 10 years old. I always pictured myself caring for and nurturing sick people back to health. I finished my RN in May of 2016 and will soon be finishing my BSN. I started as a CNA then LPN in a nursing home then moved to a critical access hospital as an RN and recently moved to the regional hospital on the cardiac step-down unit.

I am struggling. I feel myself quickly falling out of love with the profession and I can see my dream dying. My best is never enough. The next shift always wants something more, doctors are disrespectful, patients are rude and demanding constantly, all the while more and more work and charting expectations are being pushed on us each day. I am disappointed to think I will soon have a degree in a skill that I no longer feel passionately about. And I am devastated by the thought of leaving the only thing I have ever wanted to do.

Sometimes I think that maybe I am just working in a bad hospital (it is magnet status but still doesn't take very good care of staff) or maybe it is just the population in the area. I still have hope of things getting better and don't want to leave floor nursing yet. Is this what nursing has become everywhere? How do I find the right fit for me? If I'm in a bad hospital, how do I find a good one? If I'm burned out this early in my career should I be doing something else? What else could I do with my BSN?

Dear Devastated and Disappointed,

It sounds like nursing is not what you thought it'd be. And it's almost impossible to know what nursing really entails until you practice as a nurse. Many of us are drawn to the nurturing, caring aspect and it's a shock to realize nursing is a often series of urgent tasks with little time for reflection in between.

Those who stick it out reconcile their values with the reality of the working world. They recognize the good they are doing by applying their assessment skills, and how you can comfort a patient with a quick word or touch or even eye contact. They see the bad, but also the good that is there, every day, every shift.

Those who are unable to reconcile the two value systems suffer from the conflict. This is where you are at. If you choose to leave bedside clinical practice, you don't have to leave nursing altogether.

You have your BSN, and good experience. You can qualify for many other positions where you could use your BSN and still help people, but practice away from the floor.

Read Fleeing the Bedside for other job options.

Best wishes,

Nurse Beth

Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!

[babychickens]

Another tragic epitaph due to the failure of the system to address the causes of nurses burn out and. the high washout rate. Studies have identified a rate from 30-50 percent by the 5th year. New nurse's exit their first job 60 percent in first year. Often identified as the chief cause is the direct manager. To date you cannot get this discussed at professional conferences. Just in the last few weeks I have attempted to contact speakers who have abuses of power in the description of their seminar. At first I was so excited that it might actually happen. I even posted it on blogs. Looks like I will have to pull the reigns on my excitement as my inquiry to get clarification has gone unanswered. When the topic of managerial abuses of power has been raised by me and others we are ignored or misled. Our new nurses deserve a better chance at succeeding. There is no accountability for abusers. Not even at a so called Magnet hospital in this case. I have experienced that, too. Perhaps it awaits them when they become aged and are patients staffed by what is left of the workforce depleted by their abuses.

Hi there,

Can you please elaborate on your post? I'm confused by it and I suspect it's due to "not knowing what I don't know". So much of what you're saying sounds like gobbly-gook but I WANT to understand. I'm a student nurse, about to graduate, with MANY years in another field, a handful of years of healthcare, and I do conferences, etc. I guess my main question is: in your experience is it truly the direct manager? How so? And also, do you think it's realistic to find public discussions on abuse of power? I know literature exists on lateral violence or other such topics but what sort of positions do these people hold that you are soliciting for talks? Are they the abused, abusers, former abusers, observers of abuse? Honestly, just super curious.

[aanwyn, BSN, RN]

To the original poster,

I completely feel your pain. We are expected to deal with being understaffed, overworked, and hardly have the ability to fulfill Maslow's Hierarchy of basic needs meanwhile we're expected to give our all for our patients. Hospitals need to understand that if they take care of their staff, their staff will in turn take better care of patients. We are not machines although we are expected to function as such. I have 9yrs experience now and no longer work full time in any position. It makes my life much easier. You can make the same amount of money or more working a per diem and a part-time position. Keep in mind, per diem rates are typically higher because you aren't getting benefits. I work home care per visit (meaning I am paid by each visit that I complete) and per diem on a surgical unit at a hospital that I started at part-time. As a nurse w/ 9 years non-hospital but still clinical experience, I went to work at the hospital and was utterly shocked. To top it off, we were not allowed to request off more than 1 weekend for the entire year that includes the weekend you used in your vacation time. You have to find your own coverage on an already short-staffed unit (impossible). I worked there 4 months part-time and went per diem ASAP. This was a magnet hospital as well. It makes no difference if it's magnet or not. Yale New Haven Hospital has this same 1 weekend/yr policy. All I know is, anytime someone asks me about nursing, I tell them the whole truth. It is not what it was. The hospital is an assembly line with almost no ability to provide the good care that we were trained to provide. I feel your pain. You can always leave the bedside. Try dialysis or home care or other outpatient care centers like a wound center. You could even try working for an insurance company as a case manager, utilization management review. There are many avenues in nursing, just keep searching. I have also wanted to leave the field but cannot think of any other area where I could receive the same pay.

[sesiliachan]

I feel like nursing school paints a different picture about nursing being a job where you are well respected and have time to do everything perfectly.

I graduated from nursing school May 2017 and had no expectations about my nursing career or my patient population. I think that's what made me develop thick skin. I work in a Level 1 trauma center ER in a very disadvantaged, low socioeconomic class and poorly educated community. Sometimes the waiting room gets so busy that we have 40 patients waiting in there and they send a lot of patients to my area at once. One day it was so crazy busy I received a patient who waited for 8 hours to be seen by the MD (it wasn't really an emergency of course). I've had patients curse me out, yell at me, threaten me, but somehow I never let it get to me. We also have some rude doctors that are not the most caring but I try to give my best and advocate for my patients as much as possible.

I think the main reason I am still here and I'm still sane is because of my coworkers and the patients that are actually really sick and need help. Most of my coworkers are very supportive and willing to help. I can always vent to a close coworker without being judged and that really helps a lot.

Also, I try to understand the "grumpy" patients, they've been waiting a lot, sometimes I try to distract them by engaging them in a conversation about something else and they actually stop complaining.

Sometimes, we would be so short staffed I would have to take care of 10+ patients by myself for an extended period of time. But the end of the day work stays at work and I go home feeling like I did my best. And it's ok if it's not perfect. My patients were all alive when I left them and had their most critical needs addressed, that's what matters the most to me. I guess that's an ER nurse point of view.

Bottom line is, wherever you go make sure you find a supportive environment and someone to vent to. If you don't have that support right now, maybe you should look for it somewhere else. If possible, I would recommend applying to a residency program in the ICU or the ER. That's how the best friendships are made, believe me it really makes a difference.