Thinking of switching to per diem status...advice please

  1. Hello

    I work FT on a busy Peds unit. It's a toxic work environment for many reasons with a high turnover rate.

    I am stressed and burnt out to the max. The heavy patient load, constant precepting and being in charge is wearing me out. Not to mention the other stressors of difficult family members and physicians. Some staff members are catered to, (don't have to precept or be in charge as much) They play the game better than I do, acting overwhelmed/playing dumb etc. so they don't get more responsibilities. Unfortunately, the only reward for good hard work, is more work.

    I look terrible, I feel terrible. I can't sleep and I'm anxious all the time. Sometimes I get chest pain at work. I feel like I'm going to explode.

    I'm thinking of switching to per diem status in order to have some more free time to get my head together. Eventually I will phase out of bedside nursing altogether. I just don't want to take the first job offered, I really want to get well.

    I was thinking of quitting and taking the summer off, but then at least per diem would pay the rent. Also, per diem doesn't have to precept or be in charge. I am married, so I have my husband's insurance.

    Does this sound like a good idea? Anyone here per diem and like it? Thanks.
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    About Agent99

    Joined: Jun '06; Posts: 58; Likes: 3
    Specialty: 11 year(s) of experience


  3. by   TazziRN
    It definitely sounds like you need to do something. What about going to another unit or even another facility?
  4. by   Agent99
    Hi Tazzi

    I tried to transfer to another unit, they offered me the position then had to rescind because the nurse that was on disability decided to return.

    I submitted a transfer for a seasonal unit, but that turned out to be an "error" and now won't be in effect until next year.

    I don't have an interest in other units at my hospital, and I also don't want to start all over in another hospital.

    At least per diem I can schedule myself when I want to work and have less responsibilities until I figure out my next step. I also won't be part of the politics and the BS if I am only there a few days a month. I can't take the full time schedule (12 hour shifts) anymore.
    Last edit by Agent99 on Feb 6, '07
  5. by   TazziRN
    In that case, if you can afford it, go for it. If it turns out that per d does not provide the needed income, you may have to think about changing facilities.

    I know that starting over is not an attractive prospect, but I speak from personal experience: you have to decide if your sanity is worth it. I burned out badly at my last place and was scared to death of starting over, but it turned out to be the best decision I'd ever made in my life, next to marrying my husband. I took a $15/hour pay cut, but it was worth it. I was at my last place for 11 years. I'm coming up on 8 years in my current job and I still love it. If I had stayed at the other place I think I would have left nursing altogether.
  6. by   Agent99
    I'm glad you made the switch and love your job.

    Truly, I do not know what to do. I am in the midst of overwhelming stress, and cannot make any decisions. I seriously do not know if I am coming or going anymore. I feel like all I do is prepare myself for work, work or recover from work. I can't sleep the night before my first shift on. I'm irritable or crying or in a state of dread most of the time.

    I'm afraid that if I jump into another job while I feel like this it will be a big mistake.
  7. by   Agent99
    All I do know is that I cannot go on this way anymore.
  8. by   TazziRN
    Have you considered a mental health leave? You could take FMLA and rest while you make up your mind.
  9. by   Mulan
    Go per diem and all you will have to work is the basic requirement. Then you can work as little or as much as you can stand. Good luck.
  10. by   RN007
    Not too long ago, I asked the question about per diem on another thread. I think I used "prn" and maybe you could search for it. I am an older student about to graduate this May and have thought about eventually working prn because my husband carries good insurance. After doing clinicals, I can see I want to avoid the politics of some units. I also want a flexible schedule for my children. My best clinical instructor works prn only and loves it. She's very well respected in the critical care arena and knows her stuff. She, too, doesn't need the benefits and, therefore, doesn't want to be trapped. I'd say go for it, at least until you've got your health back. Sounds like you can't continue in the environment you're in now or you will explode. Take care of yourself first. And please keep us posted.
  11. by   Agent99
    Thank you, everyone, for your kind posts.


    I'd rather not take any mental health leave, my NM is not the most "enlightened" person out there and it would come back to haunt me in some way, believe me.


    Thank you. I will work the bare minimum at first, the less I am there the better.


    Ok, I will search for your thread, thanks. I know someone at work who switched to per diem after going through stress there and she said it's the best thing she ever did.

    I brought home a transfer request, and filled it out last night. I will probably hand it in soon. I have two weeks vacation coming and I don't want to get screwed out of it, so I will think about what day to file it.

    I know once I hand it in, I will feel a giant weight off my shoulders.
  12. by   caliotter3
    Reading your posts sounds so, so familiar. May I suggest home health? With your background, any agency would scarf you up quickly. You can make it work for you. HH agencies always advertise about "flexibility", so you could hold a new employer to this. You don't have to give the whole story, just rest up a little, then work when you want, if you want. You will be surprised what going down to one patient at a time can do for you! (I am describing, continuous care- shift pts, not intermittent, hrly pts). The trick, is to make certain that the staffing coord do not talk you into doing anything more than you want to. Ask around at the agencies in your area, you could have your light at the end of the tunnel sooner than you expect! Good luck!
  13. by   Agent99
    Hi Caliotter

    I think I am finished with patient care altogether, I'm just so sick of it.

    I might even resign totally instead of per diem, and maybe sign up with an agency for very frequent shifts for pocket money.

    I have work tomorrow and I'm already stressed about it. I can't live like this any longer.
  14. by   RNperdiem
    How about even working a 4 or 8 hour shift? Once a week? Per diem allows you to do that. Ever since I went to per diem status, working only 8 to 12 hours a week, I have more of the joy of nursing minus many of the problems. No more being in charge, no office politics, pick your own schedule and work as little or as much as you want.