Ever felt stuck before? Need some feedback :)

[MrJrod]

Hello fellow Nurses and Murses!

I have to share my story in hopes that others can provide some meaningful feedback, either to commiserate or offer some insight to helpful ways to increase my professional happiness. Either way, thank you in advance for your input.

Let me start by saying I have been a nurse since 2011, worked in SICU for 1 year and 5 in ED. I currently work in a midwest hospital that is considered "Voted best hospital in the state." and is somehow a MAGNET hospital. I currently work in the ED and was bought in 6 months by a friend who was once a fellow staff RN, but is now the department director. He got me the job so quickly I received a call from HR asking me to apply so that I could be hired/interviewed. It's nice to have those connections, but I'm afraid I've boarded a sinking ship here. My friend brought me in to the department because he knew that a department manager's position would be opening soon and I implied that I would be interested in applying to the position. I have worked at 6 hospitals now (I traveled for 3 assingments in ED) and have good insight on what works and what doesn't as far as operations, staffing models, etc. Now the interesting part:

I have worked at this massive ~1000 bed hospital with a >100 bed ED for 6 months and have concluded it is an absolute disaster. The staffing models are dangerous, I have cumulatively had 3-5 30 minute breaks since starting, and have become so stressed out and over-extended I made the very first medication error of my career. I am a very straight laced RN and take mistakes like this very personally. I have a unique relationship with the director and managers of this department. I know several of them personally had worked with them at my second ED job in my youth. (I worked as an ED paramedic for 4 years with them prior to returning in 2016) I have spoken with them repeatedly about the extreme and dangerous staffing models, complete lack of staff relief and poor level of education in the department. Over 70% of our night crew has less than or equal to 1 year of ED experience. My direct manager, who self admittedly expresses that she was "Not manager material," just left her position. Her shoes are the ones I will possibly be filling if I choose to apply to the position. That is of course if I interview and am hired into the position.

Needless to say, I have brought up all these issues with my director and managers on a professional and personal level. I feel helpless and have never worked in such dire circumstances where the front line crew is screaming, "We need help, the ship is sinking!!!!" and the commanders in charge are reporting,"All is well and continuing course." I feel trapped in a professional and personal catch 22. If i work in this role or continue working in this hospital, I'm going to burn out. I feel I already am and I am starting to lose my happy and hopeful attitude. This negative work environment is starting to effect my personal life and darken all the lightens my day. I have had strong feelings to leave the nursing profession entirely and go into coding/software engineering where my technical side can be satisfied. I have thought about advanced practice, however I am interested in primary care. My friends in school and those who have graduated tell me about how they must see a ridiculous amount of patients a day, spending little time actually discussing with and educating the patient. I need some help figuring out what direction to take my life in. Anyways, after that long winded description, has anyone experienced something similar? If so, what did you do about it? Were you happy with the results? What would you have done differently?

[Ruby Vee, BSN]

Whew! A lot of questions -- I hope the writing of your story and the asking of the questions both helps you to feel better and has started you thinking about the answers on your own.

Yes, I've experienced something similar in the ICU. I put together the unsafe staffing and the poor management and was about to do some voting with my feet when the bottom dropped out of my marriage and I had to go from 12 hours a week to full time, and I had to do it immediately. So I stayed.

The bad manager was either terminated or asked to resign (I've never been entirely clear about about that one) and a new manager was put into place that same day. Within six weeks, the staffing was improved (both quantity and quality), procedures changed and long-time charge nurses were no longer doing charge. The culture made the quickest turnaround I've ever seen. I ended up being glad I stayed and enjoying another four years at that same hospital.

If you want to leave nursing and go into coding because you want to be a coder, that is one thing. But your post screams "burning out!" to me, and I hope you give nursing a chance by treating your burnout. Clearly, this ED isn't the right place for you. If you're hanging out there for the manager's job, when it opens, you probably have a very good idea of what you'd like to do differently. But if you're no longer interesting in managing this fiasco, it might be a good time to think about what you DO want in nursing. Try changing your shift, perhaps your specialty, your employer . . . All those things can treat burnout, and you can do a search here for threads addressing the same. Don't incur the expense of another degree to solve what may be a temporary problem.

I wish you well in going through this. I've also been through burnout a few times -- and once went so far as selling my house, quitting my job and moving three thousand miles to address it. It worked, but it isn't a solution I'd recommend to most.

[HouTx, BSN, MSN, EdD]

As always, great advice from RubyVee.

IMHO, the environment you described would be the WORST possible setting for a brand new manager. They do need new leadership, but the skills and knowledge needed to tame that hairball are only found in very experienced leaders. S/He'll need a great deal of operations expertise, because staffing (labor budget) negotiations will be critical. I would imagine that there will need to be some significant changes in the staff mix and competency development .... sheesh, a night shift with all newbies - who DOES that??? It's going to be a real test of endurance and fortitude for a hardened & battle-proven vet. Maybe that's going to be you in a few years, but don't set yourself up for failure with this nightmare.