Does traumatic arthritis = end of direct patient care job?

[UCRN1111]

Hi all,

I have been a nurse for about 5 years and my whole career I have worked in an Urgent Care. A year ago I fell & ended up with a right ankle trimalleolar fx with dislocation. I'm 13 months out from date of injury, 5 surgeries later, 2 PICC lines later, & was just told an ankle fusion is in my future. I have pain almost all of the time & my xrays show traumatic arthritis. My surgeon recommended I look into nursing management or another position with less on my feet to delay the progression of joint damage as much as possible & be able to easily transition post fusion. She doesn't know how long I have before I'll need a fusion but when that happens she said I'll probably need to give up floor nursing. I love direct patient care & can't see myself being happy in any sort of management role. Plus, I feel like I don't have enough career experience (just 5 years in one position) to be an effective manager.

My dream job is to be a NICU nurse, particularly one that attends deliveries. I'm afraid this can't happen now with my limited ROM and pain with standing for a whole shift. Are there any NICU nurses out there that have accommodations for a bad ankle? Is it feasible to still do floor nursing with a fused ankle?

Does anyone have ideas or suggestions for units or specialties that allow nurses to sit down more than we usually do working the floor?

Thanks for your help!

-Baby Arthritic Nurse

[Ruby Vee, BSN]

I'm not a NICU nurse, I'm a SICU nurse. My arthritis wasn't the traumatic kind, but it didn't end my career at the bedside. I had an awesome manager and awesome colleagues who helped me out a lot with the few things that I couldn't quite manage (time off for joint replacements, for one thing. Ambulating patients for another -- although NICU patients don't generally require ambulating.).

Range of motion won't keep you from bedside nursing -- I worked for several years with severe flexing contracture a of both knees. I learned how to pace myself, even in a busy ICU. I took advantage of every opportunity to sit over standing, and planned my care so that I could sit. Only one surgeon ever took exception to my sitting during rounds (once I explained my problem and once they watched me hobble around), and my manager set him straight. I was able to work at the bedside before and after my joint replacements.

The pain is an issue. I was in pain all day every day, and some nights I was in so much pain I had to take a Percocet before I could make it up the stairs to bed . . . But those were rare. Days when my patient coded several times, I KNEW I was going to pay for it later, but generally the adrenalin involved kept the pain from overwhelming me during the workday.

I think your plan to work NICU is a good one, and it may keep you at the bedside long past your physician thinks.

The thing about physicians is they really don't have a concrete idea what a nurse does all day. My oncology surgeon went through residency in our program, and I worked with her during her SICU rotations. But in talking with her before and after my surgery, it became clear that she really didn't have any idea what kind of movements I used, how much stamina I would need or what workarounds there were. The NP in her office had a far more realistic idea. (Although you have to be careful there, too. It used to be that you needed experience before becoming an NP, and an experienced nurse would have an accurate idea, but a straight to MSN NP would not.)

[UCRN1111]

Thank you so much for responding. It has given me more hope than I could have imagined! I really appreciate you sharing with me! Thank you!