The Six Month Scream

[ThePrincessBride, MSN, RN, NP]

AHHHHHHHHHHH!!!!

It has been six months since I started my job as a new grad on a busy med/surg floor. I have been on my own for four months, and I have to say that I feel myself growing stronger clinically. My IV skills have improved immensely (which has always been my weakness), and my time management skills are amazing (I usually have six patients, sometimes seven). Charting is a breeze, and I find myself becoming more assertive with difficult patients, doctors, etc. However, I still am struggling with being task-oriented and am trying to learn how to see the "big picture" (any advice would be greatly appreciated!).

Although I am thriving at my present unit, I just can't see myself staying here. My heart is with the little babies, and my work environment is just so dangerous. The number of falls on my unit is outrageous, the staff is still expected to sit with patients (which contributes to falls) while taking on a full load, and now the emergency department is no longer required or expected to give us report.

I ache to be with the babies and to work in the NICU. I have made some necessary steps towards that goal, however, my residency program doesn't end for another seven/eight months. According to my hospital's policy, employees are eligible for transfers at six months. However, I am not sure if that applies to me as a new grad.

Should I stick it out until the end of the residency program or should I see if I am eligible for a transfer now? What pros and cons do you see in sticking it out vs transferring and vice versa?

And for the more seasoned nurses, do you have any stories in which the grass was NOT greener on the other side or the merits of delayed gratification?

Thanks!

[SentinelTruth]

Though I'm still in nursing school and am about to take Med-Surg... I would stick it out for the time, so that you can continue to learn... wait 2-3 years, then do the transfer, when you're more seasoned.

[ThePrincessBride, MSN, RN, NP]

Two years? No thank you!

I think I would quit nursing if I had to stay where I am for that long, lol.

[bluenurse15]

Depends on your hospital's policy. Check with HR to see if you can transfer now. Some hospitals will allow you to transfer every 6 months.

Also you don't have to stay in your current position for 2 years for experience. You have learned a lot already and if you can transfer then transfer to a unit that will make you happy and more suitable towards your goals.

Good-luck!

[CryssyD]

If you feel you're thriving and growing where you are, you could maybe stick it out a little longer. But you seem pretty sure about where you want to go.

I am concerned about some of the safety problems you mentioned, though. How can you take a full load of patients but sit with one? That doesn't even make sense. No report from ER? Whaaat? Maybe the sooner you get out the better!

Ask your manager when you are eligible for transfer. You don't have to go into every reason--just say you really want to do NICU.

Which is not the easiest specialty, mind you. I loved PICU, but it was qualitatively different from NICU--I don't think I could have done the itty-bits. It's also quite qualitatively different from everything else--other than general things like time management, for example, if your heart is really set on NICU, staying longer in adult med-surg really won't benefit you at all. NICU is its own little field, full of conditions and procedures you see nowhere else.

[elkpark]

IMO, it can't hurt to ask if you're eligible for transfer while you're in the residency.

[roser13, ASN, RN]

Though I'm still in nursing school and am about to take Med-Surg... I would stick it out for the time, so that you can continue to learn... wait 2-3 years, then do the transfer, when you're more seasoned.

Uhhhhh, no. No need to "season" any longer with a patient population that you are not fond of. Congrats, OP, on how far you've come in a short time. In my opinion, the only limiting factor is your facility's policy on transfers, and the potential to irritate your manager if it turns out that you can't transfer yet but he/she knows that it's inevitable.

p.s. How can the ED NOT give a report?! Talk about unsafe practices!

[ThePrincessBride, MSN, RN, NP]

Uhhhhh, no. No need to "season" any longer with a patient population that you are not fond of. Congrats, OP, on how far you've come in a short time. In my opinion, the only limiting factor is your facility's policy on transfers, and the potential to irritate your manager if it turns out that you can't transfer yet but he/she knows that it's inevitable.

p.s. How can the ED NOT give a report?! Talk about unsafe practices!

Yeah..they tried to send me a suicidal patient the other week. I called ED. I was pissed.

Had I not looked through the chart, my floor would have ended up with another sitter case without appropriate staffing. We have already had an almost sentinel event.

[Farawyn]

ThePrincessBride, you have talked passionately about your goals since I've been here. It sounds like you are doing really well on MedSurg. You may have to put in your year, but I would definitely go for any opportunities with NICU you can find. Good luck.

[Libby1987]

I agree that it sounds like you're tracking well. I would persist in getting in the area you are passionate about, or at least believe you are passionate about, but I would want to enter that area the best prepared to avoid as many bumps as possible, which might mean understanding "the big picture" first, there will be plenty of other things to learn in that unit.

[LadyFree28, BSN, LPN, RN]

It took me three years to find a specialty that I can really thrive in.

I started in a PICU near the end of my first year as a new grad and personally, was not ready or in a environment that was able to meet the needs that I needed, so my goal was to seek out opportunities to help me be a better nurse, ie, I needed to better improve my assume that skills, decision making and hone skills with working with challenging populations to transition from LPN to RN, so I found myself as a supervisor in LTC. After six months I found another position at a Pedi Post Acute facility and was a shift leader and handled complex kids and emergencies effectively, and stayed there for almost a year before landing a position at a Level I trauma Pedi ED, where 9 months I am learning, but have a supportive environment that believes I am thriving-I still make rookie mistakes, but learn and adapt in making better decisions.

I say this because I knew what type of specialty I wanted to be in, but I had to work on nursing skills to transcend nursing specialties and become strong in those aspects before I could thrive in a specialty, and this was despite taking care of complex kids for seven years prior-I needed to become competent consistently and gain confidence so that I could be the best nurse that I could be.

If you have to stay a year, so be it, however, look towards working your way to NICU by floating to more complex pts or find a Peds job to gain exposure-the more complex, you can transcend your nursing practice and build upon it, and have to do it gradually-you may have to work your way, but you will see your end game in sight.

Best wishes.

[Jules A, MSN]

Would they consider letting you do extra shifts on a prn basis in the NICU? It might not be possible since you don't have training in that specialty but that has always been a great way imo to get a feel for a different unit. Good luck, it sounds like you are doing excellent!