Feeling tired and restless after almost 2 years. Next steps?

[SistersofMRSA]

I've worked on a fast-paced ortho/trauma/renal & pancreas transplant/urology/general surgery floor within an urban, Level 1 trauma center since October 2009. I completed a RN residency program and have since become transplant certified (can take fresh transplants 1:1 and 3:1 post-op) as well as have oriented to the charge role. I've precepted two new grads. I was chosen by my managers to pilot a staff-led education initiative on my unit, and have received awards twice for nursing excellence.

I work in a large teaching facility with what seems to be a revolving door of RNs with ≤ 2 years experience. As a result, we're fast-tracked and often orient to roles early in our careers that are usually reserved for more senior staff in other facilities. While I know I still have plenty to learn, I feel I've gained solid skills and clinical judgment since I began my career on my unit. I also believe my accomplishments would not have been possible without the positive relationships I have with my managers/leaders and co-workers. However, I feel like I'm not being intellectually challenged in my day-to-day activities at work and am beginning to feel burnt out due to issues ranging from nursing cuts and take-backs by senior management to difficult patients and families. (I realize this isn't unique to my facility.) I've become a broken record, as work is all I can think or talk about when I'm not at work, and I wish I didn't care about certain things as much as I do.

I talked with my NM about my next steps and she suggested a transfer to a higher-acuity setting, getting certified as a nurse educator, or pursuing a leadership role. While I completed a direct-entry MSN program, I feel like I still need more time at the bedside before I'm comfortable using my MSN. While I respect my managers/leaders, I'm also wary of the growing disconnect between nursing administration and staff RNs. I don't want to be a checklist-pusher in a white coat who obsesses over monthly HCAHPs scores and adds to the already staggering workload of staff RNs.

Given my manager's suggestions and my desire to add upon my current knowledge/skills, I applied to and interviewed with my hospital's PACU. Despite receiving positive feedback during my shadow day and interview, I was declined a transfer because "more qualified candidates were being considered." I'm okay with it, but I also feel somewhat shaken because some of my former colleagues with comparable experience have transferred to the same or similar settings without mention of their qualifications or lack thereof.

I'm at a point where I may change facilities and cities altogether, as my only connection to my current city is work. I moved to my current city after spending half a year looking unsuccessfully for work in California (where I graduated) and New York (where I moved after graduation). (Thank the hiring freezes of 2009!) While I've become close with my co-workers and live with my significant other, none of my family or close friends are nearby.

I'm miserable and feel increasingly unsatisfied at work, though my experience in finding my current job scarred me for life. I feel like I'm stuck here until I have a job offer in writing from elsewhere. However, the places I would like to move prefer in-state licensed applicants. I already have 2 active licenses, and feel like applying and paying to endorse to yet another state is foolish unless I'm going to use the new license! I also do not want to pursue further education at this time, though I may consider it in the future.

Any suggestions or advice? To those of you who have been in a similar situation, how did you climb out of your work rut? I feel like I'm not able to see the big picture clearly right now, so any and all perspectives are appreciated!

[netglow, ASN, RN]

Don't have advice for ya, just love your name.:)

[gettingbsn2msn, MSN, RN]

Lots of decisions to make! You sound like an excellent nurse. however, you are being caught up in all the healthcare administration drama (as the rest of us are). Do you plan to move with significant other? What about relo back to California? What about a travel position back to California? I am thinking you have many paths that you can take. Also you have your MSN which I believe would open many more doors for you in management or leadership.

Many of us are frustrated with management and leadership. I believe that they need to return to their core which is patient care and satisfaction. Sadly, that does not appear to be the case. I hope that you can make a difference in whatever path you decide.

[nurse2it]

Dear Sister,

If you are miserable and feeling stuck, that probably won't change since it seems you've already explored other options available w/your current employer. Weigh the pros/cons of staying/leaving, put it on paper. Seems simplistic but it helps to look at it in black & white. You are obviously an intelligent, educated, experienced nurse with great written communication skills and clever to boot as evidenced by your username. If you are not on linkedin, join asap! Once you post your profile, I bet your inbox will be overflowing! Good luck to you.

[KaksRN]

Good luck to you. Your post is very well written!

[Genista, BSN, RN]

Hi SistersofMRSA! I love your name, too. You seem like a wonderfully bright, intelligent RN with a great sense of humor and purpose. I wish I had a crystal ball for you (and one for me, too, heh heh). I have been in the trenches at a level 2 trauma center for over ten years, and could relate to some of your dilemma...wanting to find a good fit, but feeling stuck and restless and not even sure where that good fit might be. Are you still interested in PACU? Maybe that would be worth waiting for with dogged determination, if it is something you are curious about. I am seeing now that even experienced RNs are having difficulty moving into new specialties with the economy as it is.It used to be easier to move around, but lately it is VERY hard. I believe that yes, maybe there were some other strong candidates that took the spot you were seeking (despite your amazing experiences, which frankly impressed me). Somewhere, someone will be snapping you up quick! The question is what do you want? Decide on that and then keep making moves in that direction. I am in a similar place right now and not 100% sure where I want to go, but I do know I am hoping to go somewhere else...and do some exploring. Maybe you need to do some exploring if you aren't sure what to do next? Sometimes making a move is adventurous, and who knows where it may lead. Just a few thoughts, anyway. Hope you find whatever it is that works! Good luck!