Dear Nurse Beth Advice Column - The following letter submitted anonymously in search for answers. Join the conversation!
Yes, it is probably time to move on.
I highly doubt you are stupid or unskilled. It does sound like you are unappreciated, or at least the appreciation is not expressed.
I'll start with the IV skills issue since you said it's your biggest concern. It has to be difficult for you not to feel good about your IV skills as an ED nurse, and you've stuck it out for two years. That's a long time to feel a certain kind of way, and I'm sorry you've endured that.
While IV insertion practice could be beneficial—like mannequin exercises in Staff and Development, if available—the root issue is not a lack of practice. I don't believe the problem is psychomotor skills. Rather, it's performance anxiety resulting from a mismatch.
The ED is not the right fit for everyone. The ED is suitable for a particular type. Read Are You Cut Out To Be An ED Nurse?
You are not in the right environment for you. You deserve to be in a practice environment where you feel accomplished, where you contribute, and where you are appreciated.
You say you overthink, double, and triple-check things. Have you ever considered ICU? The characteristics that hinder you in the ED could make you an excellent ICU nurse.
Here are some additional thoughts:
Communication and Feedback
It's a travesty that a new nurse (I'm assuming) or a nurse new to the ED has not been given regular, helpful feedback. Your educator and manager should acknowledge your progress and be working with you on your professional development to set goals. You can take the lead here and ask specific questions like, "What's one thing I could focus on for my development?"
I'm confident you've had performance evaluations in the last two years. Could it be that you've overlooked positive feedback? The absence of feedback outside of performance evaluations often indicates that you're doing well, as your manager and educators are likely directing their efforts toward those underperforming.
Ultimately, no matter what direction you choose, the fact that you're asking for advice means you're dedicated to improving, and that says a lot about your professionalism and commitment to patient care. Don't let this temporary struggle define your worth or your skills. You're on the right track by seeking guidance.
Very best wishes,
Nurse Beth
Published
I've been a ED nurse for 2 years now and I am thinking of leaving this specialty. For a few reasons. I think the stress/anxiety is too much for me. I overthink a lot of things. I'm insecure so I double triple overthink things and my decisions. I get humbled all the time so I think I am very stupid, unskilled, I feel unappreciated, we get no feedback from our superior, and maybe the biggest one: I suck at IVs. I'm an ED nurse and I thought I would grow out of it but somehow I have even gotten WORSE at IVs throughout my time. I feel like 50% of what you do in ED is start IVs. 1) start IV 2) give meds 3) feel better. If I can't do 1/2 my job especially in emergent situations I feel like I am putting patients in danger and taking the position of a staff member that could be more efficient. Basically I guess I'm just asking for some input/advice. Thank you in advance.
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