seeking help from non-"traditional" nurses..

[loveineverylanguage]

Hi! I work in a mid-size city in the southeast. I have worked at this hospital as a bedside nurse since graduating with my BSN in 2012. This is my first post here and I've been overwhelmed with my job/career anxiety lately, so I apologize for the length of this post! TL;DR at end!

I first worked in the stepdown unit for 2 years, full time. It was challenging but okay. I later needed a flexi/PRN shift and transferred to the med-surg float pool at the same hospital in 2014.

I really enjoyed this for a while, but as staffing at our hospital got worse and worse (and then were recently acquired by a big name organization with a bad reputation), my ability to tolerate this job has waned. I floated to 7-8 different floors regularly on my float pool rotation and I worked night shifts. Night shift has started wreaking havoc on my health and personal life, and after a 6-month stint where I was very sick and hardly worked at all Jan-April (thankful for my flexi option here!) I tried to get back in the game with a regular schedule. One particularly awful night on an overloaded floor, with 7 patients, charge nurse with full load, not enough techs, etc., I decided to reach out to my manager and switch to the ICU-float pool instead. I had considered this for many many months but was always a little nervous about the acuity and emotional toll of ICU work. But around April, I jumped in to 5 weeks of training. (my hospital has MICU, CICU, and SICU). It was challenging but really, really great. Such an improvement! I could actually focus on my patients! I didn't have to consciously choose to neglect and give poor care, which the med-surg floor required. To only have two patients was mindblowing. Though I know often times even ONE of these ICU-patients are a handful, still, I'd rather be overloaded with high-acuity problems of one or two patients, than overwhelmed with running between 7 rooms of varying acuity, patients who are angry, phone calls, falls, meds, etc. It really seemd like I was cut out for this kind of work, which was a relief because, to be honest, I was beginning to question my career choice this past year. I felt that others who work even full time seem to manage it, yet even working fewer shifts each months, I had extreme anxiety and just couldn't seem to cope with the stress of some of the med-surg floors.

Well, I guess I misunderstood how the ICU float pool works at my hospital. I really thought I would mostly be going to ICUs, but after I got off orientation, I have spent more time either in the stepdowns (Which I already went to on my previous pool) or even back to the med-surg floors! I had been told in my initial meeting that I "might occasionally" go back there but I truly thought it would be rare. However, I'm getting the picture that wherever they need me the most is of course, where they'll send me, and since they know I have med-surg experience and can take the full load...well, that's where I'm going to go.

That brings me to the last week I worked which was simply soul-crushing. I truly tried to work my best, being sent to a med-surg floor and then to the stepdown I had already worked at. It was just a clustercuss of bad patients, badly staffed nights, I had a confused patient fall within 10 minutes of the start of the shift, DTs, sickle cell patients, and overall just rude and snappy patients. I could go on but after getting reprimanded for a couple decisions (which truly felt like being kicked while I was down, wondering why I have chosen this life and what other job I can do because I feel like I just can't take it anymore) I feel certain I need to look somewhere else for a job.

I do apologize for my long rant. Here's the TL;DR:

Stress of past 5 years med/surg and now ICU float RN work is getting to me. I truly don't feel like I can go back to work another day.

I have another source of part-time income which is why I went flexi in the first place so I need a flexi or PT dayshift job. Something ... lower stress, please? I've looked into GI lab but want to consider any ''nontraditional'' option. Surgeons' office? Doctor's office? Health dept.? Outpatient clinic of some sort?

To all nurses who work in a smaller, dayshift operation, M-F type place--how did you get the job? Doctor's offices never seem to hire RN's -- just medical techs or CRNPs--yet I hear of RN's working there sometimes. Offices don't usually have websites with a 'career' tab for me to apply online, but just cold-calling offices asking if they're in need of an RN seems..unprofessional?

Clinics and other outpatient centers pose the same problem--not always a lot of online presence. Do you have any recommendations or any types of jobs I'm not aware of?

Thanks for your help and reading my long rant. I could really use the help and encouragement as I have spent the last many weeks feeling like a terrible nurse, and a loser who just can't handle stress like everyone else can.

[Meriwhen, ASN, BSN, MSN, RN]

I do apologize for my long rant. Here's the TL;DR:

Stress of past 5 years med/surg and now ICU float RN work is getting to me. I truly don't feel like I can go back to work another day.

Float pool doesn't necessarily mean that you'll just work your desired unit. Often, you can and will be floated to any unit which they feel you are capable of working on. So getting floated to stepdown and m/s isn't surprising given your experience. Now, if they tried to float you to L&D, IMO scream long and loud about it.

Doctor's offices never seem to hire RN's -- just medical techs or CRNPs--yet I hear of RN's working there sometimes.

That's because it's cheaper to hire a LVN or a med tech/assistant than an RN. There's not a lot in a doctor's office that requires a RN to perform it. So they like to save the money and hire as few (if any) RNs as possible.

To all nurses who work in a smaller, dayshift operation, M-F type place--how did you get the job?

I worked in my hospital organization's outpatient programs until I got bored and returned to inpatient. Why not check to see what outpatient programs/clinics/medical offices that your hospital offers and start there? One advantage is that you'd be an internal candidate.

Also check your city/county/state's government website to see if they have any offerings.

If you live near or on a military base, go to usajobs.gov and see if the base has any openings. You don't necessarily have to be active duty military to apply.

Do you have any recommendations or any types of jobs I'm not aware of?

Public health, community nursing, shot clinics, school nursing, ambulatory surgery, telehealth...

[loveineverylanguage]

"Float pool doesn't necessarily mean that you'll just work your desired unit. Often, you can and will be floated to any unit which they feel you are capable of working on."

Yes, what I mean is, my hospital has 2 designated float 'pools'. The med surg pool, which I officially left, and the ICU float pool, which I officially trained for and transferred to. What I was frustrated with was that I was still not getting sent to ICUs and more often being still sent to the medsurg floors.

In regards to outpatient programs--I am looking at my hospitals' postings but not really seeing anything there. It is a small hospital, though. I do want to look into telehealth.

Really, I was just wondering for the RN's out there that work at independent clinics and dr's office--how did you get the job? Word of mouth, online application, referral, etc.?

Before others point it out, yes, I have only worked at one hospital and perhaps others are better. I have even asked travel nurses who've been at our hospital and they say ours is the worst they worked at! My options in my city are varied, but not great:

Hospital A is a children's hospital, a totally different ballgame. I don't want to work with kids :-/.

Hospital B is owned by the same EvilCorp that bought us out, and has a TERRIBLE reputation.

Hospital C is also For Profit and has a bad reputation, from people I've spoken to directly who have worked there.

Hospital D is a VA hospital and I was just told today by two friends who work there that they got rid of all Flexi/PT positions.

Hospital E is a teaching hospital with good reputation.

Hospital F also has an ok reputation.

I've looked at listings for both E & F hospitals, and the flexi options are almost nonexistant, and they are also a 50-minute commute while my current hospital is 8 minutes away. However, I'd be willing to drive for a better work environment, for sure!