Difficult Career Decision, Praying for Direction--Please Advise

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I currently work private duty, very low stress, easy job. Easy to get spoiled and lazy (I've gained 50# since starting this "specialty.")Well, I was in fear the job would end soon so I got scared and started applying for hospital jobs and found one willing to accept me with no experience, but this job is on a telemetry floor and I've been forewarned it is a very fast paced and stressful position.

As I am getting old, I appreciate being able to take life slower, have time to pause and reflect on things. In my youth I was tearing across the fields bareback on horses and rodeo riding and it was go go go! Now, I look forward to cross-stitching and going to bed early. I also know there comes a time to get off your lazy bum and be a grown up and I've got a family to support.

Well, it looks like the private duty job will last awhile longer, though no one is sure how long, but now, I have accepted this position at the hospital, which I will have to try to get switched to nights because even though it will kill me I have to do what is best for my two month old and the unborn baby I'm carrying. But I'm not sure if I should lose my PDN job to take this hospital job and it's making my hair turn grey and I'm exhausted and drained from worrying over it. You know, once it's gone it's gone and there is no turning back.

My husband is as wishy washy as I am so I can't expect insight from him. He did say that I could consider this hospital job as going to school and getting paid for it (in other words, this job would be a real teaching experience that I got paid to do.) In the long run I imagine it would have been better to work at this hospital and on top of that my PDN job--where I utilize no skills outside of using a remote control and eating-- can't be guaranteed from month to month.

When I expressed agony over being away from the baby my husband reasoned that it is only three nights a week (there is a no children at work policy at the agency I work for but the entire family is insistent I am able to bring the baby because it is good for their mother and makes her a lot happier and calmer...but this is definitely not the norm at this agency). Other than the agony of being away from baby I think the prospect of going in a new direction is exciting.

Can anyone offer any advice?

I see from the other thread I started this may be a little redundant. My apologies.

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Mama,

At 32 you are just getting started in life. I think changing directions in life is one of the hardest decisions anyone faces. I have no advice other than to follow your muse.

Which job gives you the zest and passion? I think that the best job is the one for which you feel passion and a sense of mission.

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Specializes in Med/Surg; Psych; Tele.

Mama, you responded to a thread I just posted last night (Thank you by the way!) and I saw where you said that you want to eventually become an NP. If that is the case, I think you will definitely fare better to gain experience in tele. Cardiac knowledge is very respected and highly transferrable and will make you more marketable in the future as an RN. It will also be a great foundation for your NP education and I think it will help you to be a better clinician down the road too.

That being said, know this...it is a VERY stressful environment. At least from my brief experience of 3 months where I worked! I won't lie...it was absolutely nerve-grating. However, I only had a little over 4 months of acute care experience as an RN (brand new nurse at that) and then there had been a year and 3 month gap of time between that first job as an RN and the tele job. So I was kinda like a new nurse starting all over again. It was too much. That's why I stepped back and went back to M/S to get more of the basics. Still though, looking back, that tele floor was still highly stressful/fast paced even for a seasoned nurse. I am not telling you this to scare you, but you need to know that it will likely be like night and day from your current position. However, maybe nights will be a little more laid back.

If you are up for this drastic change, I say go for it. You said yourself that you do not know when your current position may end. But please be careful!!! The way that hospital just snapped you up like that, having no experience, and do they know you are pregnant? I bring this up because some (ok most) hospitals are just looking to place warm bodies. They have no concern about actually valuing and retaining employees (nurses). Just make sure they give you a lengthy orientation with all of the appropriate classes, etc. Good luck to you and stop worrying!!

By the way...you're making me feel all ancient over here! I'm 35 and you're talking like you're over the hill at age 32!! Honey, we're in the prime of life right now!

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Specializes in med/surg, telemetry, IV therapy, mgmt.

i went to work on a telemetry unit after working for 5 years on various medical units of hospitals. in a nutshell, it's just a faster paced medical unit and they have the added bonus of having telemetry. during my first week on the unit the head nurse, who was a real fair person and a sweetheart, sat down with me for a half hour at the telemetry monitors and gave me a basic rundown of what to look for in arrhythmias. she made it sound so easy. and, it kept me going until i was able to take the official ekg class. it's not hard, believe me. and, it's grounded in so much logic you can't believe it. if you didn't get it in nursing school, you'll learn it now and it's really not that bad. it's all about the electrical system of the heart and how the heart muscle responds when the normal electrical impulses decide to take a detour. plus, they'll have standing orders of some kind to treat certain very common arrhythmias (bradycardia, bigeminy, v-tach). get a copy of them, learn them and carry a copy of them on a clipboard for yourself. you'll know these within a week. here's a couple of links where you can get nice information on the basic arrhythmias. there are other weblinks in the ccu nurses forum stickys:

the nice thing about having patients on telemetry is that you know their heart is beating and they are alive. on a general medical unit i always worried about walking into a room and finding a patient dead. that can't happen if they are on telemetry.

the other thing about a telemetry unit is organizing. that's a big thing. take time to determine when you have meds (po and iv) due as well as treatments and fingerstick blood sugars. you will also need to do some type of complete assessment on each patient you are assigned to and most nurses do it toward the beginning of their shift. hospital nursing is very task and priority oriented. it's primarily concerned with getting the doctor's orders carried out. you fit hand-holding and empathy in when you can. the rest of the time you stamp out fires. depending on the type of patient the unit generally takes you could have nursing home type patients who are total care and confused or plain old cardiology patients who have to mostly rest up. telemetry units tend to get a lot of admissions. a lot of doctors would like to get their patients on telemetry monitoring. also, in hospitals it is important that you check to make sure you have signed off all the doctor's orders for your patients and that they have been set in motion to be carried out before you leave your shift and that you have charted off on all your patients. this is a copy of the last report sheet i used as a staff nurse. [attach]5032[/attach] feel free to download and use it. however, when i was recently hospitalized i saw that the rns each carried their own 3-ring notebook and had a computer generated kardex sheet for each of their patients inside. some also had other sheets of information in these notebooks for their own use. these notebooks solve the confidentiality problem. a "brain" sheet on a clipboard can be peeked at by anyone if it is left lying around.

one other thing is that you review the code blue policy. i worked on an icu stepdown. the ccu stepdown unit had more code blues than we did and they were mostly in the bathroom (people vagal'd out when they were trying to have a bm on the toilet). the only people who should be "pushing" are women during labor. thus, many cardiologists prescribe stool softeners for their cardiac patients.

i used to know the mnemonic for the placement of the leads for the telemetry wires (we only had 3 wires) and it went white on right; smoke before fire. recently, i was hospitalized and on a telemetry unit (left with a brand spanking new medtronics pacemaker!) and they had 5 lead wires that were white, brown, black, red and green! i wrote down the color placement of the leads in my puzzle book so i would remember how to put them back on after my daily bath (i didn't want to disturb the nurses). don't ask me what they all meant, i just made sure i got them all back in the right place. i periodically went up to the nurses station to look at the monitor and every time, to my chagrin, my heart was in a paced rhythm of 60--my sa node has pretty much gone on strike.

you have experience on your side. i did ltc and then private duty nursing for a couple of years before i finally went to hospital nursing. the days get less harrowing. i just spend a few minutes reviewing information in the nursing books i had a home when i had a question. it only takes 10 or 15 minutes to do this. i recently posted the chest pain check list i made for my first hospital job. it is on post #8 of this thread. https://allnurses.com/forums/f99/help-me-what-do-you-look-if-patient-says-243259.html you might want to copy it for yourself to use at this new job in case a situation of chest pain comes up.

i also wanted to say that i have been kind of following your current situation. your posts are always interesting to read. i have had cancer twice in the past and beat it both time with surgery and radiation therapy. i ran around for years since saying i'd never do chemotherapy knowing in the back of my mind that i was likely to get hit with it again and i was really lucky to have beat it before. sure enough. this time it's been a lot worse and even though i had surgery, there has to be chemo because the likelihood of seeding is very probable. funny how my attitude toward chemo changed immediately. now, i'm just po'd because it's taking so frigging long to get it started (pacemaker, septic infection in the surgical wound that still isn't healed after 2 months). i'm not as open in stating my feelings about it as you. i'm directly blaming that on a mother who wielded a belt to keep us kids in line and knew how to use it too (probably denial on my part :lol2:).

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Specializes in LTC, Sub-acute, correctional.

Whew, you sound like you are in full-blown crisis mode worrying about this. It's no doubt a scary prospect to start something new, but in a way it's just as scary to stay on the path you're on now. You're gaining weight, losing confidence, and becoming depressed. There's really nothing good about your situation now, as you've said yourself. All you can do is accept that you're going to start this new job, you've already taken it. Then you just go there on the first day, and make yourself get through that first day. Then that day is over, and maybe it's a little easier to go there the next day, since you've already made it through one........ if you give it some time and it's not for you, what harm has been done? You will at least have gained some confidence and gotten out of your current rut. That makes it easier to take on the next job, if that's what the case may be.

How great will it be to do this, instead of choosing not to do it??? You might surprise yourself. Good luck!

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i agree with njbikernurse.

and i can't help think you are soooo down on yourself.

feeling old at 32???

me thinks you are truly depressed.

perhaps you should get that addressed first?

i like your husband's perspective about treating it as a school experience.

not only will you learn invaluable skills, but it will give you a much needed boost in your self-esteem.

you are undoubtedly intelligent.

BELIEVE IN YOURSELF.

as the saying goes, "just do it".

we know you can.

leslie

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Specializes in Hospital Education Coordinator.

why add stress to your life? Keep the job you have till after the baby is born and things settle down a little. There is no hurry.

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Specializes in Neuro/Med-Surg/Oncology.
i agree with njbikernurse.

and i can't help think you are soooo down on yourself.

feeling old at 32???

me thinks you are truly depressed.

perhaps you should get that addressed first?

i like your husband's perspective about treating it as a school experience.

not only will you learn invaluable skills, but it will give you a much needed boost in your self-esteem.

you are undoubtedly intelligent.

BELIEVE IN YOURSELF.

as the saying goes, "just do it".

we know you can.

leslie

:yeahthat:

If you find after awhile that home health is where your heart is, you will return with invaluable experience. I think you will have more stability in the hospital though. It will also be easier to move to a different department within the hospital once your foot is in the door. It sure beats becoming stagnant somewhere you don't like.

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If it were my decision, I would stick with the PDN as long as I could. You said that you work for an agency, so will they find you another assignment after this one ends? You could stay at this job and take your time searching for another position in which you are more interested.

As far as doing what is best for your child and the one that you are carrying, what is best for you is best for them in this case. If you are unhappy, overwhelmed, and stressed out, it will affect your body and pregnancy. It will also affect your relationships with others.

I'm sure that tele experience would be a great background for becoming an NP, but it is not necessary. There are a lot of great NPs without tele experience. I definitely would not choose this job on the basis that it may be a good learning experience. Good luck in your decision.

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Specializes in Community Health, Med-Surg, Home Health.

The only thing concerning me is that you are about to have a baby, and this may keep you away from working anywhere, for at least 6-8 weeks. If it is your desire to become an NP, then, I would grab the job at the hospital. I have been reading books about the EKGs and am dying to get my hands dirty with working per diem on telemetry at times.

Most importantly, have a safe delivery and a healthy baby!

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Please don't call yourself lazy. Your home situation alone counts as more than a full-time job. There just aren't that many nursing jobs(that pay) that will leave you with much energy left over after working to tackle your family work. Those few jobs are in demand and require particular experience. Being pregnant and postpartumish does not help your energy level either.

You are facing a hard choice, and can't give you much advise. I am hoping for the best for you though.

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Specializes in Med-Surg, Tele, DOU.

:twocents:

I started working on a tele unit and became pregnant shortly after starting work. This was very difficult, my brain went on strike at the most in-opportune moments, and though I had a telemetry background I had been out of the environment for 6 months due to surgery and complications. To add to this interesting combo, the unit I went to work on was "looking for bodies" as a previous poster put it and I learned that I had never worked in a "real" hospital before. This units standards were much higher than anywhere I'd ever been, which was good. Unfortunately, I wasn't cutting the mustard in my opinion.

Due to stress etc, I ended up with frequent braxton hicks contractions--enough to cause bleeding and dilate: then off to home on bedrest.

I honestly would reccommend that you consider working in a home health setting, or a community clinic setting until you are ready--after baby is born--to make further changes. Only because, it seems that you have a "feeling" that the PDN position may be ending soon. I am careful to investigate feelings rather than ignore them. Your suspisions may be right.

Though home health has its stressors, you can finish the paperwork at home and be close to your family. When you are ready and your family is ready, you can begin to explore other areas of nursing.

Your husband is a bit off on the getting paid for an education part IMHO just because, in school you have more back-up than when you are orienting on a new unit. In school you can still attend classes and ask questions. When money is involved with orientation, I have found that people expect you catch onto things much faster.

If you choose to keep your PDN position, please turn off the television or ignore it. It would behoove you to obtain continuing education credits in an area of nursing that interests you. There are companies who will send you books and a test to obtain CEUs. This way when you pursue that advance practice degree or accept that telemetry position, you will have a nice working knowledge base.

Best wishes.

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