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Do I give up Nursing? How do I survive?

Professionalism   (478 Views 10 Comments)
by NRNPH NRNPH (Member)

181 Visitors; 15 Posts

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Some background. I've been a Nurse for a little over a year. Work nights. Like many hospitals under staffed and over worked. 6:1 ratios with high acuity patients, sometimes no CNA's or CNA's have half of a high acuity floor, act like a step down ICU with some of the patients who are not appropriate for the floor, shorted in everything - the list goes on. You can push for resources as much as you want and get nothing. 10 nurses gone in about a 18 month period for the floor and counting. I'm sure many of you know how I feel. 

No matter how crazy the nights were I used to love my job. Used to. As I have grown in my practice and become more confident in speaking out my concerns for my patients, contacting and pushing educators and coordinators to voice my frustrations and try to spark a change - only to walk away feeling like a total fool. For a place that "promotes" and advocates for so many things, "promotes" highly encourage learning, "state" being open minded, "push" Nurses to make a difference and want changes to occur so that we all can advance and grow in an ever changing field - when the time comes to act, they refuse to live up to their mission and values and change. 

They have taken my questions and concerns with disdain. As a Nurse, every patient I deal with, is a human life in my hands. The patients I take care of each shift trust me to protect them, advocate for them, be knowledgable about them, and over all value their individual lives regardless of how many patients or other people that need care are out there. I like being thorough. I believe I am doing a disservice to my patients if I do not get a whole picture from their chart (even if it is just very basic - it would be a dream to have enough time every day to delve into each patient) in order to serve them the best for that shift. I have begun raising concerns regarding my patient's safety being put at risk. Asking questions why things are done a certain way and trying to learn and also provide feedback as a floor Nurse. Those concerns are easily dismissed and in return we are docked on items that are solely intended to raise the hospital's status and finances. I get that is what hospitals have to do but if the employees can barely keep their heads above water - the patients are the ones who really suffer from hospital issues. All cares are effected. This hospital doesn't seem to understand that or care when concerns are brought up. Like many hospitals I am sure. It feels like they focus on the *** rather than what health care should really be about. I know this could open a whole can of worms and branch into other things but this whole post is really about one thing - Do I quit? I have had it. I feel cheated. Shorted. I have moral crises everyday. I fight with myself constantly after work when I go over how a shift went. The anxiety. The stress. The tears. Work thoughts always take over. No matter where I go, what I do - even my self care get aways. I am tired of being told that my passion for this job is a "new nurse (whatever they say)" and I am devastated. Today I felt that this place robbed me of my love for this job. Its weighing so heavily on me. I have never been at such a cross roads before. I sacrificed so much to become a Nurse but this place has me truly considering leaving the career completely and make me ask "what's the point". I could apply to another hospital but my work has made me feel there is no place in the health care world that isn't different than what things are like now. I am mentally exhausted. I can never refresh. 

Do I quit.

Do I stay.

If I stay, how do I survive. 

Would love to hear what people who have gone through this have felt, thought, and done. 

Edited by NRNPH

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llg has 40 years experience as a PhD, RN and works as a Nursing Professional Development + Academic Facult.

5 Followers; 57,829 Visitors; 13,016 Posts

Here's how I see it:

1.  Why would you give up a whole career (in a field that you say you care about) because 1 job is not going well?   Don't give up that easily.

2.  You have burned out -- probably because you are trying to be perfect and look for perfection in a very imperfect world (and maybe in a lousy place to work).   Deal with the burnout before you make any major decisions about throwing away your entire career.   People who have long-term careers in any field and people who change the world don't just run away when they experience a rough patch and/or burnout.   They address their burnout issues and then start moving forward in their career again.

3.  You've reached that point in your career development where you know enough to identify problems, but don't yet have the expertise or political clout to fix much.  Developing that expertise and power takes time.  Relatively new nurses such as yourself (and at 1 year, you are still a newish nurse) can easily because overwhelmed and frustrated as they run into the real challenges of nursing -- not the challenges of a new grad trying to make the transition from student to practicing nurse, but the more advanced challenges of trying to build a better world as a professional adult nurse.

4.  Read up on burnout -- and I'm sure people will post advice for you on how to deal with it.   Take some time off and do some thinking about where you want your career to go.   It might be time to change jobs.   Then move forward in the direction you want to go.  Be sure to pamper yourself a bit, have some fun in your personal life, etc. get lots of rest, exercise, good nutrition, etc.   Maybe go to a professional conference to surround yourself by people with a positive attitude towards their nursing careers.   Being around up-beat people can help give you ideas as to how to cope with you stresses.   Don't allow yourself to simply wallow in your self-pity and martyrdom.  Either choose to make the most of your current job by engaging in committees etc. that are trying to improve things ... or get a new job ... or go back to school ... or whatever it is that will move you in your desired direction.

 

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181 Visitors; 15 Posts

3 minutes ago, llg said:

Here's how I see it:

1.  Why would you give up a whole career (in a field that you say you care about) because 1 job is not going well?   Don't give up that easily.

2.  You have burned out -- probably because you are trying to be perfect and look for perfection in a very imperfect world (and maybe in a lousy place to work).   Deal with the burnout before you make any major decisions about throwing away your entire career.   People who have long-term careers in any field and people who change the world don't just run away when they experience a rough patch and/or burnout.   They address their burnout issues and then start moving forward in their career again.

3.  You've reached that point in your career development where you know enough to identify problems, but don't yet have the expertise or political clout to fix much.  Developing that expertise and power takes time.  Relatively new nurses such as yourself (and at 1 year, you are still a newish nurse) can easily because overwhelmed and frustrated as they run into the real challenges of nursing -- not the challenges of a new grad trying to make the transition from student to practicing nurse, but the more advanced challenges of trying to build a better world as a professional adult nurse.

4.  Read up on burnout -- and I'm sure people will post advice for you on how to deal with it.   Take some time off and do some thinking about where you want your career to go.   It might be time to change jobs.   Then move forward in the direction you want to go.  Be sure to pamper yourself a bit, have some fun in your personal life, etc. get lots of rest, exercise, good nutrition, etc.   Maybe go to a professional conference to surround yourself by people with a positive attitude towards their nursing careers.   Being around up-beat people can help give you ideas as to how to cope with you stresses.   Don't allow yourself to simply wallow in your self-pity and martyrdom.  Either choose to make the most of your current job by engaging in committees etc. that are trying to improve things ... or get a new job ... or go back to school ... or whatever it is that will move you in your desired direction.

 

Thank you for this. You are right, why let one job make me throw away the entire career - burn out. I guess I weirdly hate to admit it and have avoided that as a possibility. The thought that I could really be experiencing burn out after a year is slightly discouraging - as a seeker of perfection, I feel I should have done better to not be in this place. You are absolutely correct. I take time off to try and push work to the back of my mind rather than truly consider the change. It honestly is a scary thought and disappointing that my first job wasn't "the one" but I'm sure everyone goes through it. I need to choose to do things to create change for the better. I will however maybe spend a day to sulk just to feel it, process it and accept it. 

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9 Followers; 22,445 Visitors; 2,950 Posts

I think your feelings are a reflection of the fact that the principles and ethical functioning taught to nurses are at odds with the business of healthcare. I did not feel this way from the get-go, or at least it seemed less obvious or less frequent. There is no adequate justification for the things going on in many environments where nurses work.

 

1 hour ago, NRNPH said:

For a place that "promotes" and advocates for so many things, "promotes" highly encourage learning, "state" being open minded, "push" Nurses to make a difference and want changes to occur so that we all can advance and grow in an ever changing field - when the time comes to act, they refuse to live up to their mission and values and change. 

 

Yes. And this is an exceedingly common scenario. People defend it and find their own ways to accept it, sometimes solely because they have expended a lot of financial, cognitive, and emotional resources to enter the profession. They want it to be everything it seemed like it would be in nursing school. And yet over, and over and over and over...it just isn't.

I don't feel like a martyr; I just simply think this is very black and white. It is the philosophical equivalent of being punched in the face routinely and then faulted for not finding a way to learn how to more agreeably get punched in the face. You can still choose to live w/ joy/acceptance/gratitude, but there is no requirement that you find your place within nursing, and nothing saying that if you just do the right mental and emotional gymnastics it will all make more sense and everything will be fine.

If you've been a nurse for about a year, it might be too early to say whether you are still coming to terms with the culture shock of having joined the nursing workforce and will eventually learn to navigate in a way that is acceptable to you within nursing. So I do think you should give it a little more time.

You also need to consider whether you have a personality prone to fault-finding or whether your feelings about nursing represent a more rare case in your life where you found something clearly unacceptable to you and don't wish to participate.

I don't believe in burnout as the term has been popularized within nursing. Burnout is when you eat a healthy, delicious salad for lunch everyday and after 10 years decide you've had enough lettuce for the time being and would like to have something else for lunch, maybe a yogurt parfait. Then you may say you're a little "burned out" on lettuce.  On the other hand, when something is objectively not good, not positive, not beneficial (such as high responsibility w/ no authority, or constant criticism, or being asked to do what no one can really do...) then a dislike or a rejection of that is not "burnout," and it definitely isn't because an individual person has "burned out."

 

 

Edited by JKL33

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7 minutes ago, JKL33 said:

You also need to consider whether you have a personality prone to fault-finding or whether your feelings about nursing represent a more rare case in your life where you found something clearly unacceptable to you and don't wish to participate.

I don't believe in burnout as the term has been popularized within nursing. Burnout is when you eat a healthy, delicious salad for lunch everyday and after 10 years decide you've had enough lettuce for the time being and would like to have something else for lunch, maybe a yogurt parfait. Then you may say you're a little "burned out" on lettuce.  On the other hand, when something is objectively not good, not positive, not beneficial (such as high responsibility w/ no authority, or constant criticism, or being asked to do what no one can really do...) then a dislike or a rejection of that is not "burnout," and it definitely isn't because an individual person has "burned out."

 

 

I like your perspective about burn out. When it comes to fault finding, 95% of my career has been spent fault finding in myself. Questioning what I could have done better and being very self critical. I just have spent the most recent portion of my career speaking up and I wouldn't say "fault finding" but more of a holding people accountable. Is it wrong to point out things that could have been avoided if people worked better together? I am the Nurse who goes to work for the patients first and relationships second. I come home every day wondering what I could have done better but I have recently begun to think that everybody who is in involved in the patient's care, is responsible for patient outcomes. I stopped taking all the blame onto myself and started to speak up (only at appropriate times - my patient's safety was put at risk, pattern of unsafe events, serious things) because I don't want it to happen to other patients and Nurses down the road.  I hate that pushing for us to all grow together.. it makes me feel so.... icky for lack of a better word. I get that I am imagining a perfect health care world where everyone is accountable and things run smoothly but there's nothing wrong in trying to take small steps towards that right?

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Daisy4RN has 20 years experience.

1 Follower; 1 Article; 6,026 Visitors; 917 Posts

No, IMO you should not quit just yet. It is very hard to believe and accept that management/admin doesn't really care about patients/safety. When I first started nursing I was quite naive regarding this issue. Over time I had to learn and accept that (most) admins dont want to hear your opinions/concerns/ideas. Most committees are for show only and do little to nothing. And, if you speak up too much you will be labeled a trouble maker. If you choose to stay you need to accept the fact you will not be able to provide the good care that you want, but this is not your responsibility, it is the facilities, you just do the best you can with what they give you to work with (make sure to prioritize). I would also research and consider other careers within nursing that you may like (there are many).

Try not to take "work" home with you. Go over things before you leave for the day, make sure you took care of the important tasks etc so you don't go home and worry. You (most likely) will not get everything done, pass it on, CYA, and dont worry about it.

Take care of yourself, don't dwell of the things you didnt do, but focus on the positive.

Wishing you well!!

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hppygr8ful has 15 years experience and works as a RN - Adolescent Psych.

4 Followers; 31,625 Visitors; 2,662 Posts

9 hours ago, NRNPH said:

The thought that I could really be experiencing burn out after a year is slightly discouraging - as a seeker of perfection, I feel I should have done better to not be in this place. 

People who seek perfection are often the first to burn out. That is because they exhaust themselves in the pursuit of something that cannot be obtained. I have experienced severe burn-out in my career. It was so bad that it nearly cost me my life in the form of a suicide attempt. A therapist that the BON forced me to see helped me to gain work life balance. I have hobbies and healthy things I do to destress. At the end of the day I do the best I can for the people I serve. I am not interested in changing the world but rather helping those in my small corner of it. I can honestly leave work and not think about the patients until I return the next shift. Sure every once in a while one comes home in my head but that's rare these days 

Hppy

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TriciaJ has 37 years experience as a RN and works as a Retired.

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You've spent the past year developing your practice and proving yourself worthy of holding your position.  Now you're starting to look around and notice some things for the first time.  You're noticing all the creeds, mottoes, mission statements, etc are just decorations.  Daisy is right; committees are for show.  Nothing will ever come out of a committee that justifies the resources spent on it.  You're not experiencing burnout; you're experiencing reality shock.

Admin huffs and puffs about wanting "fresh, new ideas"; no they don't.  They want you to show up, do an impossible job and shut up about it.  You're understandably feeling bewildered and deflated.

Now you have to figure out:  can you adjust your expectations of your employer and yourself and commit to doing a pretty good job despite everything?  Or has the place completely maxed out your bs tolerance?  It's not going to be an easy thing to figure out, because so far you have nothing to compare them to.

I agree with the others; if you can take some time off and clear your head for a bit, it might be easier to figure out your next move.  And don't ever think of a job as "the one".  Even if your next job is everything you hoped for, a new manager comes to town and everything turns to doodoo.  Every job is "the one" until it isn't.  Wishing you the best.

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not.done.yet has 8 years experience as a MSN, RN and works as a Professional Development Specialist.

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Yup. Reality shock, right on time. We live in a nation that allows large corporations to operate healthcare for profit and allows them to heavily lobby (buy) political decisions that benefit them and them alone. Until that changes, that is the reality of the umbrella we all work under. MANY of us are out here in leadership positions advocating for change, both to benefit patients and to benefit nurses (which also benefits patients). Our hands are just as tied as yours in many ways and any advancements we make are often offset by something having to compensate in another financial area. Change absolutely comes slowly, if at all.

You are working with human beings and can expect all the failings and foibles that come with such. It doesn't make them bad people or not as good as you about perfection; in fact, sometimes the snarkiest people are the ones who started out like you and, like you, ran head first into disillusionment.

Most of us encountered this right about the same time in our career that you are. How you deal with it is up to you. I personally got past it by deciding that I could not, perhaps, impact every patient that comes through the door or change the culture of our politicized healthcare world, but patients absolutely need people like me doing the best they can within that culture. After about five years I left the bedside but not nursing.

Good luck whatever you decide. You won't have to look very far to see that your feelings and concerns are pretty much universal in new grads.

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Thank you all for your advice and input thus far! I took a lot of things from each of you and it gave me some peace after must emotional turmoil and questioning morals/ethics. 

I appreciate the term reality shock. I believe it is what I am going through and not burn out. I love my job. I go in no matter what and give my patients the best care I can with what I am given. It is very shocking and disheartening when you build a practice and advocate for changes to increase patient safety and quality, individual care and it feels like you receive blow back for wanting these things and working to fight for it and stand for it as a Nurse in my unit. 

I will be taking some time off here soon and work on some things and figure out what it is I really want and if they are reasonable and attainable. I will always be the Nurse who pushes back for my patients. I am willing to accept the mostly condescending or text book answers that are not enough answers for my patients - for now. I am well aware this is unfortunately a widely felt and known topic. 

Thank you all for reading, responding, supporting. I hope to hear more and take more and use them to better myself. 

Edited by NRNPH

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